Pregnancy in a woman suffering from type 1 diabetes associated with Addison's disease and Hashimoto's thyroiditis (fully developed Autoimmune Polyglandular Syndrome Type 2).
In this article the pregnancy of a woman suffering from the complete triad typical of Autoimmune Polyglandular Syndrome Type 2 (Addison's disease + type 1 diabetes + Hashimoto's thyroiditis) is reported. By using insulin pump therapy with insulin lispro, it was possible to balance diabetes control with changes of steroid replacement therapy. Pregnancy was uneventful until week 27, when signs of preeclampsia occurred. The boy was born without difficulty at gestational age 37 weeks by planned cesarean section but signs of diabetic fetopathy (macrosomia, hypoglycaemia and hypocalcaemia) were expressed. He required a short course of hydrocortisone therapy. He made a good and rapid recovery. The mother made a good post-operative recovery too, but 4 months after the delivery microalbuminuria as well as mild hyperuricemia are still present. Interdisciplinary approach and very careful observation of the mother as well as of the child enabled successful outcome of this highly risky pregnancy.
Stechova
K
K
2nd Department of Paediatrics, University Hospital Motol in Prague, V Uvalu 84, Prague 5, Czech Republic. KaterinaStechova@seznam.cz
Bartaskova
D
D
Mrstinova
M
M
Cerny
M
M
Snajderova
M
M
Cinek
O
O
Sumnik
Z
Z
Vavrinec
J
J
D000224:Addison Disease / Q000150:complications*; D000328:Adult; D002585:Cesarean Section; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D006996:Hypocalcemia / Q000209:etiology; D007003:Hypoglycemia / Q000209:etiology; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007332:Insulin Infusion Systems; D061268:Insulin Lispro; D011225:Pre-Eclampsia / Q000150:complications; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D013967:Thyroiditis, Autoimmune / Q000150:complications*
D007328:Insulin; D061268:Insulin Lispro; D006854:Hydrocortisone