ADRENAL INSUFFICIENCY AFTER RECURRENT POSTPARTUM THYROIDITIS (POSTPARTUM SCHMIDT-SYNDROME) - A CASE-REPORT

Polyglandular autoimmune syndrome (PGAS) type 2 (Schmidt syndrome) is characterized by the association of primary adrenocortical insufficien cy with autoimmune thyroid disease, and/or insulin-dependent diabetes mellitus (IDDM). In this report we describe the occurrence of two epis odes of post-partum thyroiditis (PPT) after a first and second pregnan cy as well the development acutely of adrenal insufficiency after a se cond pregnancy. A family history of autoimmune thyroid disease and IDD M as well as positive antiadrenal and antithyroid antibodies and HLA t yping is evidence for an underlying polyendocrine autoimmune syndrome. This case report provides further evidence that the immune system tha t is suppressed in pregnancy to tolerate the fetal allograft can rebou nd post-partum to unmask polyendocrine autoimmune disorders such as ad renalitis and PPT in susceptible women.