[Postpartum thyroiditis as the first clinical manifestation of autoimmune polyendocrine syndrome type 2 – case report].

Przeglad lekarski Pub Date : 2017-01-01
Robert Krysiak, Karolina Kowalcze, Bogusław Okopień
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Abstract

Postpartum thyroiditis is a form of autoimmune thyroiditis developing during the first 12 months postpartum in 5-10% of women as a consequence of the immunologic flare following the immune suppression of pregnancy. Autoimmune polyendocrine syndromes are rarely diagnosed conditions characterized by the association of at least two organspecific autoimmune disorders, and on the basis of their clinical picture, they may be divided into four different types. The underestimation of their real frequency probable results from physicians’ inadequate knowledge of these clinical entities and sometimes their atypical clinical picture. Although autoimmune thyroid disease may be a component of both type 2 and 3 autoimmune polyendocrine syndromes, but the association between postpartum thyroiditis and autoimmune conditions of other endocrine organs has very rarely been described in literature. We report a case of a young woman, who after two subsequent pregnancies developed postpartum thyroiditis of different clinical pictures. After her second pregnancy, postpartum thyroiditis was followed by the development of autoimmune adrenal failure and premature ovarian failure, which allowed to diagnose type 2 autoimmune polyendocrine syndrome. Our case study suggests that every person with postpartum thyroiditis, particularly if this disorder is accompanied by atypical clinical manifestation, should be assessed for the possible presence of autoimmune polyendocrine syndrome.

产后甲状腺炎为首发临床表现的自身免疫性多内分泌综合征2型1例报告。
产后甲状腺炎是一种自身免疫性甲状腺炎,发生在产后12个月,5-10%的妇女因妊娠免疫抑制后出现免疫症状。自身免疫性多内分泌综合征很少被诊断为至少两种器官特异性自身免疫性疾病相关的疾病,根据其临床表现,它们可分为四种不同的类型。对其真实频率的低估可能是由于医生对这些临床实体的知识不足,有时是他们的非典型临床表现。虽然自身免疫性甲状腺疾病可能是2型和3型自身免疫性多内分泌综合征的一个组成部分,但产后甲状腺疾病与其他内分泌器官自身免疫性疾病之间的关系很少有文献报道。我们报告一例年轻妇女,谁后两次妊娠发展产后甲状腺炎不同的临床表现。在她第二次怀孕后,产后甲状腺炎随后发展为自身免疫性肾上腺功能衰竭和卵巢早衰,从而诊断为2型自身免疫性多内分泌综合征。我们的病例研究表明,每个患有产后甲状腺炎的人,特别是如果这种疾病伴有不典型的临床表现,应该评估是否存在自身免疫性多内分泌综合征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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