Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2
We describe a case of a 40-year-old woman who was admitted to the intensive care unit with a rapid onset of dyspnea and orthopnea. She presented progressive weakness, weight loss and secondary amenorrhea during last year, while intermittent fever was present for the last two months. Initial biochemi...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2017-10-01
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| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-17-0097 |
| _version_ | 1811226608386703360 |
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| author | Andromachi Vryonidou Stavroula A Paschou Fotini Dimitropoulou Panagiotis Anagnostis Vasiliki Tzavara Apostolos Katsivas |
| author_facet | Andromachi Vryonidou Stavroula A Paschou Fotini Dimitropoulou Panagiotis Anagnostis Vasiliki Tzavara Apostolos Katsivas |
| author_sort | Andromachi Vryonidou |
| collection | DOAJ |
| description | We describe a case of a 40-year-old woman who was admitted to the intensive care unit with a rapid onset of dyspnea and orthopnea. She presented progressive weakness, weight loss and secondary amenorrhea during last year, while intermittent fever was present for the last two months. Initial biochemical evaluation showed anemia, hyponatremia and increased C-reactive protein levels. Clinical and echocardiographic evaluation revealed cardiac tamponade, which was treated with pericardiocentesis. Pleural fluid samples were negative for malignancy, tuberculosis or bacterial infection. Hormonal and serologic evaluation led to the diagnosis of autoimmune polyglandular syndrome (APS) type 2 (including primary adrenal insufficiency and autoimmune thyroiditis), possibly coexisting with systemic lupus erythematosus. After symptomatic rheumatologic treatment followed by replacement therapy with hydrocortisone and fludrocortisone, the patient fully recovered. In patients with the combination of polyserositis, cardiac tamponade and persistent hyponatremia, possible coexistence of rheumatologic and autoimmune endocrine disease, mainly adrenal insufficiency, should be considered. Early diagnosis and non-invasive treatment can be life-saving. |
| first_indexed | 2024-04-12T09:27:58Z |
| format | Article |
| id | doaj.art-74ae8cac4c844f0ebdc5a481cbfb03d4 |
| institution | Directory Open Access Journal |
| issn | 2052-0573 2052-0573 |
| language | English |
| last_indexed | 2024-04-12T09:27:58Z |
| publishDate | 2017-10-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-74ae8cac4c844f0ebdc5a481cbfb03d42022-12-22T03:38:25ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732017-10-01111410.1530/EDM-17-0097Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2Andromachi Vryonidou0Stavroula A Paschou1Fotini Dimitropoulou2Panagiotis Anagnostis3Vasiliki Tzavara4Apostolos Katsivas5Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, GreeceDepartment of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, GreeceDepartment of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, GreeceUnit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece3rd Department of Internal Medicine, Hellenic Red Cross Hospital, Athens, Greece1st Department of Cardiology, Hellenic Red Cross Hospital, Athens, GreeceWe describe a case of a 40-year-old woman who was admitted to the intensive care unit with a rapid onset of dyspnea and orthopnea. She presented progressive weakness, weight loss and secondary amenorrhea during last year, while intermittent fever was present for the last two months. Initial biochemical evaluation showed anemia, hyponatremia and increased C-reactive protein levels. Clinical and echocardiographic evaluation revealed cardiac tamponade, which was treated with pericardiocentesis. Pleural fluid samples were negative for malignancy, tuberculosis or bacterial infection. Hormonal and serologic evaluation led to the diagnosis of autoimmune polyglandular syndrome (APS) type 2 (including primary adrenal insufficiency and autoimmune thyroiditis), possibly coexisting with systemic lupus erythematosus. After symptomatic rheumatologic treatment followed by replacement therapy with hydrocortisone and fludrocortisone, the patient fully recovered. In patients with the combination of polyserositis, cardiac tamponade and persistent hyponatremia, possible coexistence of rheumatologic and autoimmune endocrine disease, mainly adrenal insufficiency, should be considered. Early diagnosis and non-invasive treatment can be life-saving.https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-17-0097 |
| spellingShingle | Andromachi Vryonidou Stavroula A Paschou Fotini Dimitropoulou Panagiotis Anagnostis Vasiliki Tzavara Apostolos Katsivas Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2 Endocrinology, Diabetes & Metabolism Case Reports |
| title | Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2 |
| title_full | Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2 |
| title_fullStr | Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2 |
| title_full_unstemmed | Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2 |
| title_short | Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2 |
| title_sort | cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2 |
| url | https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-17-0097 |
| work_keys_str_mv | AT andromachivryonidou cardiactamponadeinapatientwithautoimmunepolyglandularsyndrometype2 AT stavroulaapaschou cardiactamponadeinapatientwithautoimmunepolyglandularsyndrometype2 AT fotinidimitropoulou cardiactamponadeinapatientwithautoimmunepolyglandularsyndrometype2 AT panagiotisanagnostis cardiactamponadeinapatientwithautoimmunepolyglandularsyndrometype2 AT vasilikitzavara cardiactamponadeinapatientwithautoimmunepolyglandularsyndrometype2 AT apostoloskatsivas cardiactamponadeinapatientwithautoimmunepolyglandularsyndrometype2 |