This is a case of an adult female who presented with 1 year history of palpitations, heat intolerance, easy fatigability, hyperdefecation and proptosis. She was admitted to this institution due to 3 month history of nausea, vomiting, abdominal pain, flank pain and generalized weakness. During admission, she was diagnosed with hyperthyroidism supported by laboratory findings of suppressed thyroid stimulating hormone and elevated free thyroxine levels and was then treated with methimazole. However, patients condition did not improve. She remained hypotensive and tachycardic for 3 days which was initially attributed to septic shock secondary to urinary tract infection. Further work-up which includes serum cortisol level determination and co-syntropin test revealed adrenal insufficiency. She was given glucocorticoids, and eventually she became hemodynamically stable. Unfortunately, patient had abortion necessitating dilatation and curettage. With the presence of hyperthyroidism and adrenal insufficiency, she was then diagnosed with autoimmune polyglandular syndrome (APS) in Pregnancy. At present, there are very few published case reports of APS in pregnancy.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
05 - 09 May 2012
European Society of Endocrinology