ECE2017 Eposter Presentations: Reproductive Endocrinology Clinical case reports - Pituitary/Adrenal (5 abstracts)
A rare case of short-term postpartum primary adrenal insufficiency
Myriam Briner 1 , Christina Gattlen 2 , Gunther Kaindl 2 , Martin Lukas Kaufmann 2 , Nic Zerkiebel 1 & Natalia Rudovich 1,
1Department of Internal Medicine, Spital Bülach, Bülach, Switzerland; 2Department of Obstetrics and Gynaecology, Spital Bülach, Bülach, Switzerland; 3German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Aims: Polyglandulare Autoimmune Sydnrome (PAS) is a rare disease and the development during pregnancy is seen even less often. PAS Type II presents with autoimmune adrenalitis and thyroiditis. Symptoms of adrenalitis such as hypotension and hyperpigmentation are overlapping with physiological manifestations during pregnancy making the diagnosis difficult.
Clinical presentation: We are reporting the case of a 28-year old prima para prima gravida presenting two weeks postpartum (spontaneous preterm birth at 36 completed weeks of pregnancy) with hypotension, orthostatic presyncopal events and adynamia. Laboratory tests showed a low cortisol level, while adrenocorticotropic hormone was augmented. Steroid-21-hydroxylase-antibodies and active renin were increased. The medical history was significant for chronic lymphocytic thyroiditis with subclinical hyperthyroidism under L-thyroxin substitution. Synopsis of all findings led us to the diagnosis of PAS type II.
Conclusion: The aim of this case report was to show that during pregnancy or postpartum we should take symptoms of adrenalitis in women with known autoimmune thyroiditis seriously and test for PAS.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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