Cardiac tamponade as the initial presentation of autoimmune polyglandular syndrome Type 2: a case report

Abstract

Background Cardiac tamponade is a rare but serious manifestation of autoimmune polyglandular syndrome type 2. Patients often present with symptoms of thyroid dysfunction and nonspecific symptoms of adrenal insufficiency but the insidious onset of the disease may lead to delayed diagnosis, which can progress rapidly to hemodynamic instability that requires urgent intervention. Case Summary A 39-year-old previously healthy male was admitted with cardiac tamponade complicated by cardiac arrest requiring emergent pericardiocentesis. An extensive work-up revealed primary adrenal insufficiency and Hashimoto’s thyroiditis. His positive autoantibodies to thyroid peroxidase and 21-hydroxylase combined with rapid improvement with initiation of corticosteroids and levothyroxine confirmed a diagnosis of autoimmune polyglandular syndrome type 2. Discussion While this disease is often difficult to diagnose given its vague symptoms, it should be considered in the differential diagnosis for young patients presenting with pericardial effusion or cardiac tamponade of unknown origin. Early diagnosis and management are critical and often result in rapid improvement after initiation of corticosteroids.

Addison’s Disease: Diagnosis and Management Strategies

“… 17 So was a 39-year-old previously healthy male confirmed with APS (autoimmune poly-glandular syndrome)−2. 18 …”

“…17 So was a 39-year-old previously healthy male confirmed with APS (autoimmune poly-glandular syndrome)−2. 18 We identified several articles on adrenal location of a lymphoma. One case of a 66-year-old female with primary adrenal lymphoma (bilateral adrenal masses) was reported with AD and very aggressive evolution.…”