Type II polyglandular autoimmune syndrome: a case of Addison's disease precipitated by use of levothyroxine.
BMJ Case Rep
; 12(8)2019 Aug 21.
Article
em En
| MEDLINE
| ID: mdl-31439557
ABSTRACT
A 46-year-old woman was referred to the endocrinology clinic for evaluation of progressive fatigue, dizziness and treatment-resistant hypothyroidism. Initial laboratory results revealed hypothyroidism, hyponatraemia and hyperkalaemia. Liothyronine sodium (Cytomel) was initiated, which exacerbated her fatigue and dizziness. Suspecting adrenal insufficiency, an 0800 cortisol level was obtained and found to be low with failure to increase following cosyntropin stimulation test. Diagnosis of primary adrenal insufficiency was confirmed via CT abdomen and pelvis revealing diminutive adrenal glands and elevated 21-hydroxylase antibody. Treatment was initiated with hydrocortisone 10 mg every morning and 5 mg at 1600/day, with plan for patient follow-up in 3 weeks to assess need for mineralocorticoid replacement. Polyglandular syndromes are rare and have a wide variety of presentation. Thus, we recommend screening patients with a single autoimmune disorder who do not respond to conventional therapy to prevent possible life-threatening adrenal crisis.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tiroxina
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Poliendocrinopatias Autoimunes
Tipo de estudo:
Diagnostic_studies
Limite:
Female
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Humans
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Middle aged
Idioma:
En
Revista:
BMJ Case Rep
Ano de publicação:
2019
Tipo de documento:
Article