Polyglandular autoimune syndrome Type 2 – case report

Detalhes bibliográficos
Autor(a) principal: Malheiro, Filipa
Data de Publicação: 2009
Outros Autores: Mendes, Rita, Santos, Eugénia, Mesquita, Teresa, Rocha, Isilda, Madruga, Isabel, Mello e Silva, Alberto
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1394
Resumo: We describe the clinical case of a 32-year-old woman with the previous diagnosis of thyroiditis, medicated with levothiroxin and with family history of hipothiroidism (sister).During the first trimester of pregnancy she begins the clinical picture of worsening weakness, incapability of weight gain (3Kg during whole pregnancy), alopecia and hyperpigmentation of the skin and mucosal surfaces. These symptoms persisted after delivery and weight loss become worse (about 20%). Hypotension was also noticed by this time. Laboratory tests showed hyponatremia and hypocloremia, very high plasma ACTH levels and very low levels of plasma cortisol and plasma aldosterona. Other hormonal plasma levels were within normal range. The computerized tomographies of the adrenals and of the pituitary gland were also normal. The autoantibodies study revealed positive anti-thyroid antibodies. Diabetes mellitus wasn’t present. After hydrocortisone was started the clinical and laboratory changes described improved.We discuss the polyglandular autoimmune syndrome type 2 in the context of the reported clinical case, reminding the rarity of presentation of symptoms during pregnancy.
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spelling Polyglandular autoimune syndrome Type 2 – case reportSindroma poliglandular autoimune Tipo2 – caso clínicoSíndroma poliglandular autoimune tipo 2tiroidite autoimunedoença de AddisonPolyglandular autoimmune syndrome type 2autoimmune thyroiditisAddison diseaseWe describe the clinical case of a 32-year-old woman with the previous diagnosis of thyroiditis, medicated with levothiroxin and with family history of hipothiroidism (sister).During the first trimester of pregnancy she begins the clinical picture of worsening weakness, incapability of weight gain (3Kg during whole pregnancy), alopecia and hyperpigmentation of the skin and mucosal surfaces. These symptoms persisted after delivery and weight loss become worse (about 20%). Hypotension was also noticed by this time. Laboratory tests showed hyponatremia and hypocloremia, very high plasma ACTH levels and very low levels of plasma cortisol and plasma aldosterona. Other hormonal plasma levels were within normal range. The computerized tomographies of the adrenals and of the pituitary gland were also normal. The autoantibodies study revealed positive anti-thyroid antibodies. Diabetes mellitus wasn’t present. After hydrocortisone was started the clinical and laboratory changes described improved.We discuss the polyglandular autoimmune syndrome type 2 in the context of the reported clinical case, reminding the rarity of presentation of symptoms during pregnancy.Descreve-se o caso de uma doente de 32 anos com o diagnóstico prévio de tiroidite, medicada com levotiroxina e história familiar de hipotiroidismo (irmã).Durante o primeiro trimestre de gravidez iniciou quadro de agravamento progressivo de astenia marcada, incapacidade de ganho ponderal (3kg no total de tempo de gravidez), alopécia e hiperpigmentação generalizada da pele e mucosas. Manteve a mesma sintomatologia após o parto, tendo-se acentuado a perda ponderal (cerca de 20%). Constatou-se nesta altura também hipotensão. Laboratorialmente salientava-se hiponatremia e hipocloremia, ACTH muito elevada, cortisol e aldosterona plasmáticos muito diminuídos. Os restantes doseamentos hormonais foram normais, assim como a tomografia computorizada da sela turca e das suprarrenais. O estudo de auto-anticorpos foi positivo para os anticorpos antitiroideus. Não se constatou diabetes mellitus. Após o início de terapêutica com hidrocortisona houve melhoria do quadro clínico e laboratorial descrito.Discute-se a síndroma poliglandular autoimune tipo 2 a propósito do caso do doente apresentado, lembrando a raridade do aparecimento dos sintomas durante a gravidez.Sociedade Portuguesa de Medicina Interna2009-06-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://revista.spmi.pt/index.php/rpmi/article/view/1394Internal Medicine; Vol. 16 No. 2 (2009): Abril/ Junho; 83-85Medicina Interna; Vol. 16 N.º 2 (2009): Abril/ Junho; 83-852183-99800872-671Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spmi.pt/index.php/rpmi/article/view/1394https://revista.spmi.pt/index.php/rpmi/article/view/1394/952Malheiro, FilipaMendes, RitaSantos, EugéniaMesquita, TeresaRocha, IsildaMadruga, IsabelMello e Silva, Albertoinfo:eu-repo/semantics/openAccess2022-12-31T06:11:39Zoai:oai.revista.spmi.pt:article/1394Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:29:10.367315Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Polyglandular autoimune syndrome Type 2 – case report
Sindroma poliglandular autoimune Tipo2 – caso clínico
title Polyglandular autoimune syndrome Type 2 – case report
spellingShingle Polyglandular autoimune syndrome Type 2 – case report
Malheiro, Filipa
Síndroma poliglandular autoimune tipo 2
tiroidite autoimune
doença de Addison
Polyglandular autoimmune syndrome type 2
autoimmune thyroiditis
Addison disease
title_short Polyglandular autoimune syndrome Type 2 – case report
title_full Polyglandular autoimune syndrome Type 2 – case report
title_fullStr Polyglandular autoimune syndrome Type 2 – case report
title_full_unstemmed Polyglandular autoimune syndrome Type 2 – case report
title_sort Polyglandular autoimune syndrome Type 2 – case report
author Malheiro, Filipa
author_facet Malheiro, Filipa
Mendes, Rita
Santos, Eugénia
Mesquita, Teresa
Rocha, Isilda
Madruga, Isabel
Mello e Silva, Alberto
author_role author
author2 Mendes, Rita
Santos, Eugénia
Mesquita, Teresa
Rocha, Isilda
Madruga, Isabel
Mello e Silva, Alberto
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Malheiro, Filipa
Mendes, Rita
Santos, Eugénia
Mesquita, Teresa
Rocha, Isilda
Madruga, Isabel
Mello e Silva, Alberto
dc.subject.por.fl_str_mv Síndroma poliglandular autoimune tipo 2
tiroidite autoimune
doença de Addison
Polyglandular autoimmune syndrome type 2
autoimmune thyroiditis
Addison disease
topic Síndroma poliglandular autoimune tipo 2
tiroidite autoimune
doença de Addison
Polyglandular autoimmune syndrome type 2
autoimmune thyroiditis
Addison disease
description We describe the clinical case of a 32-year-old woman with the previous diagnosis of thyroiditis, medicated with levothiroxin and with family history of hipothiroidism (sister).During the first trimester of pregnancy she begins the clinical picture of worsening weakness, incapability of weight gain (3Kg during whole pregnancy), alopecia and hyperpigmentation of the skin and mucosal surfaces. These symptoms persisted after delivery and weight loss become worse (about 20%). Hypotension was also noticed by this time. Laboratory tests showed hyponatremia and hypocloremia, very high plasma ACTH levels and very low levels of plasma cortisol and plasma aldosterona. Other hormonal plasma levels were within normal range. The computerized tomographies of the adrenals and of the pituitary gland were also normal. The autoantibodies study revealed positive anti-thyroid antibodies. Diabetes mellitus wasn’t present. After hydrocortisone was started the clinical and laboratory changes described improved.We discuss the polyglandular autoimmune syndrome type 2 in the context of the reported clinical case, reminding the rarity of presentation of symptoms during pregnancy.
publishDate 2009
dc.date.none.fl_str_mv 2009-06-30
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://revista.spmi.pt/index.php/rpmi/article/view/1394
url https://revista.spmi.pt/index.php/rpmi/article/view/1394
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://revista.spmi.pt/index.php/rpmi/article/view/1394
https://revista.spmi.pt/index.php/rpmi/article/view/1394/952
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Medicina Interna
publisher.none.fl_str_mv Sociedade Portuguesa de Medicina Interna
dc.source.none.fl_str_mv Internal Medicine; Vol. 16 No. 2 (2009): Abril/ Junho; 83-85
Medicina Interna; Vol. 16 N.º 2 (2009): Abril/ Junho; 83-85
2183-9980
0872-671X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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