Incessant Pericarditis With Recurrent Cardiac Tamponade as the Manifestation of Autoimmune Polyglandular Syndrome Type II

Abstract

A 23-year-old man was admitted for acute pericarditis that evolved to cardiac tamponade and shock with need of emergent pericardiocentesis and inotropic support. Corticosteroid therapy was successful, but despite a gradual tapering, the patient relapsed. Incidentally, the patient developed hyperkalemia with hyponatremia. Subsequent hormonal measurements confirmed autoimmune polyglandular syndrome type-2. ( Level of Difficulty: Intermediate. )

A case report on autoimmune polyglandular syndrome type 2 with pernicious anemia

“…Primary adrenal insufficiency or Addison's disease results from damage to adrenal glands and disease intrinsic to the adrenal cortex. It is characterized by inadequate production or action of glucocorticoids 9 . Clinical manifestations include fatigue, weakness, fever, anorexia, nausea, vomiting, hyponatremia, hyperkalemia, metabolic acidosis, and less common symptoms like salt craving, secretory diarrhea, constipation, syncope, and hypoglycemia 10 .…”

“…It is characterized by inadequate production or action of glucocorticoids. 9 Clinical manifestations include fatigue, weakness, fever, anorexia, nausea, vomiting, hyponatremia, hyperkalemia, metabolic acidosis, and less common symptoms like salt craving, secretory diarrhea, constipation, syncope, and hypoglycemia. 10 Renal salt excretion, low volume, and excess of antidiuretic hormone (ADH) caused by aldosterone insufficiency are attributable to dilutional hyponatremia.…”