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      Schmidt Syndrome in Pregnancy: A Hormonal Potpourri to a Happy Pregnancy

      case-report

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          ABSTRACT

          Autoimmune polyglandular syndrome type 2 (APS-2) or Schmidt syndrome is defined as a coexistence of autoimmune thyroid disease, primary adrenal insufficiency, and/or type 1 diabetes mellitus. The presentation of APS-2 is rarely encountered during pregnancy since there is reduced fertility owing to the adrenal and thyroid insufficiency individually and can present with multiple complications. We present a case of a 25-year-old G2A1, who is a known case of Schmidt syndrome diagnosed preconceptionally when presented with nausea, vomiting, diffuse and progressive hyperpigmentation spots over palmar creases, soles with elevated ACTH and decreased level of cortisol, and resolution of symptoms when started on steroid replacement therapy. The patient was followed up regularly throughout the pregnancy and delivered by cesarean section and developed gestational hypertension, which was treated. We present this case to conclude that pregnancy with Addison's disease can be managed successfully with proper monitoring and multidisciplinary management approach.

          How to cite this article

          Vilashini V, Rohini G, Senathirajah T. Schmidt Syndrome in Pregnancy: A Hormonal Potpourri to a Happy Pregnancy. J South Asian Feder Obst Gynae 2023;15(3):332–334.

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          Most cited references7

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          Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline.

          This clinical practice guideline addresses the diagnosis and treatment of primary adrenal insufficiency.
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            Adrenal diseases during pregnancy: pathophysiology, diagnosis and management strategies.

            : Adrenal diseases--including disorders such as Cushing's syndrome, Addison's disease, pheochromocytoma, primary hyperaldosteronism and congenital adrenal hyperplasia--are relatively rare in pregnancy, but a timely diagnosis and proper treatment are critical because these disorders can cause maternal and fetal morbidity and mortality. Making the diagnosis of adrenal disorders in pregnancy is challenging as symptoms associated with pregnancy are also seen in adrenal diseases. In addition, pregnancy is marked by several endocrine changes, including activation of the renin-angiotensin-aldosterone system and the hypothalamic-pituitary-adrenal axis. The aim of this article was to review the pathophysiology, clinical manifestation, diagnosis and management of various adrenal disorders during pregnancy.
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              Perioperative Steroid Management

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                Author and article information

                Contributors
                URI : https://orcid.org/0000-0001-6402-9935
                URI : https://orcid.org/0000-0003-4561-3305
                Journal
                JSAFOG
                Journal of South Asian Federation of Obstetrics and Gynaecology
                JSAFOG
                Jaypee Brothers Medical Publishers
                0974-8938
                0975-1920
                May-June 2023
                : 15
                : 3
                : 332-334
                Affiliations
                [1–3 ]Department of Obstetrics and Gynecology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
                Author notes
                Vinu Vilashini, Department of Obstetrics and Gynecology, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India, Phone: +91 9894349344 e-mail: vinu.vilashini@ 123456gmail.com
                Article
                10.5005/jp-journals-10006-2230
                6675ab42-8d94-41b6-88bf-33df35015329
                Copyright © 2023; The Author(s).

                © The Author(s). 2023 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 14 February 2023
                : 25 March 2023
                : 31 July 2023
                Categories
                CASE REPORT
                Custom metadata
                jsafog-15-332.pdf

                Obstetrics & Gynecology
                Case report,Autoimmune polyglandular syndrome,Addison's disease,Schmidt syndrome

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