Autoimmune Polyglandular Syndrome Type 2 In A Patient With Peripartum Cardiomyopathy

Abstract

ABSTRACT Objective: To present a case of concomitant peripartum cardiomyopathy and autoimmune polyglandular syndrome type 2 during pregnancy. Methods: Clinical presentation during pregnancy and literature review. Results: A 32-year-old woman at 34 weeks gestational age was referred to our hospital out of concern for pre-eclampsia. She had been diagnosed with autoimmune hypothyroidism during pregnancy. During induction of labor, the patient was intubated for impending respiratory failure. An echocardiogram performed that day revealed a reduced ejection fraction (EF) of 45% and global cardiomyopathy. Post-partum, the patient was noted to be hypotensive and hypoglycemic. Random serum cortisol was 1.2 μg/dL. The patient improved clinically after a course of corticosteroids. Subsequently, a cosyntropin stimulation test confirmed adrenal insufficiency. Plasma adrenocorticotropic hormone was elevated >1,250 pg/mL, confirming primary adrenal insufficiency. Conclusion: Despite its rarity, adrenal insufficiency dur...