ABSTRACT
A 57-year-old Caucasian woman with known autoimmune hypothyroidism diagnosed in 2006 presented to hospital with flu-like symptoms and circulatory collapse. She reported weight loss and gradual increase in her skin pigmentation over a 1-year period. Aggressive fluid resuscitation was instituted. Hormonal tests showed primary adrenal insufficiency. Appropriate steroid replacement was started with rapid clinical response. Subsequent antibody tests confirmed the diagnosis of autoimmune polyglandular type 2 (Schmidt's) syndrome. The adrenal crisis had been precipitated by influenza virus type B infection.
Subject(s)
Addison Disease/etiology , Adrenal Glands , Autoantibodies/blood , Hashimoto Disease/etiology , Hypothyroidism/etiology , Polyendocrinopathies, Autoimmune/diagnosis , Thyroid Gland , Thyroiditis, Autoimmune/etiology , Female , Fluid Therapy , Humans , Influenza, Human/complications , Influenza, Human/virology , Middle Aged , Polyendocrinopathies, Autoimmune/blood , Polyendocrinopathies, Autoimmune/pathology , Steroids/therapeutic use , SyndromeABSTRACT
Post-traumatic hypopituitarism (PTHP) is defined as pituitary hormonal deficiency occurring after head injury. PTHP has recently been increasingly recognised as an important medical condition among survivors of head trauma. It can be fatal if undiagnosed, and may contribute to the morbidity and mortality associated with traumatic brain injury (TBI). Although about 75% of PTHP cases are diagnosed within a year of TBI,1 delayed development of PTHP can also occur.
