Endocrine Abstracts

39-year old female reported usage of methylprednisolone (20–80 mg daily) for three months since the last decade of January 2020. She received methylprednisolone for controlling of panniculitis of Weber-Kristen (diagnosis was proved twice histologically in Ukraine and Austria. Before starting steroid therapy, there was no glucose impairment in her history. The patient has different complaints, including fatigue, increased body temperature, hypersensitivity of the skin, vomiting, wound on her back (after biopsy for four months), polyserositis, menometrorrhagia. The patient was hospitalized to the private medical center ‘Universal Clinic ‘Oberig’ in May 2020 and stayed there for a week. During hospitalization condition of the patient was critical due to general inflammatory, hemorrhagic, pancytopenia, severe liver disorders, with some trend to worsening despite the therapy. The ANA-screen test was negative. Sepsis was not proved (in blood, there was no bacterial growth). She did not have any signs of infectious endocarditis on echocardiography. Results of myelography reported the absence of acute leucosis, but there were signs of aplasia and dysmonopoesis. Trepan biopsy was not performed in Kyiv as the patient disagreed. Liver tests were extremely high (data on the presence of viral hepatitis was not proved). Severe pancytopenia (leucopenia was 0.44 G/l, thrombocytopenia was 58 G/l, hemoglobin was 74–95 g/l), and coagulopathy (starting from hypocoagulation to the absence of coagulation) was observed and corrected all the time. Results of PET CT in February 2020 did not report the data of any solid tumor, except some signs of panniculitis. The usage of methylprednisolone had a temporary effect. Glycated hemoglobin was slightly increased, and during glucose monitoring, there was almost compensated diabetes (sometimes we used insulin for correcting hyperglycemia). The patient was discharged from the hospital according to her wish as she planned to be hospitalized in Austria. In Austria, she was hospitalized to the intensive care unit in some hospital and then to hematological as there were signs of hemophagocytic syndrome. Unfortunately, the patient died due to progression of the disease (hemorrhagic stroke happened). This case is rare, and it describes comorbidity of panniculitis of Weber-Kristen, hemophagocytic syndrome, and steroid diabetes.