Reduced blood cortisol, elevated adrenocorticotropic hormone (ACTH) and atrophic morphology of the adrenal glands in computed tomography imaging contributed to the final diagnosis of aAD and SS consequently, since the patient had a past medical history of AIT.<h4>Conclusion</h4>Isolated severe hyponatremia should not be underestimated as the first sign of aAD. This evidence concerns the gene POMC and synovial sarcoma.