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BEFORE After Normal Range
Blood test Treatment may 2016 Treatment October 2016
WBC 5.81X109/L 4.5X109/L 4.0—12.0
RBC 5.51X1012/L 5.9X1012/L 3.85.80
HGB 16.9 g/dL 16.4 g/dL 11.0—16.5
HCT 35% 51.6% 30.0—50.0
PLT 216x109/L 133X109/L 100—300
MCV 68.5 fL 87 fL 80.0—99.0
MCH 30.7 pg 27.6 pg 26.5—33.5
MCHC 483g/L 31.7 g/L 320—360
GLYCEMIA 72 mg/dL 79 mg/dL 70—110
UREA 40 mg/dL 30 mg/dL 15—40
CREATINEMIA 1.1 mg/dL 1.0 mg/dL 0.7—1.2
URIC ACID 4.1 mg/dL 5.8 mg/dl 4.0—8.5
CHOLESTEROL 170 mg/dL 147 mg/dl 150—200
TRIGLYCERIDES 108 mg/dL 64 mg/dl 50—150
TOTAL PROTEIN 6.4 g/dL 6.8 g/dL 6.4—8.3
Na+ 127 mmol/l 134 mmol/l 135.37—145.00
Cl- 102 mmol/l 114 mmol/l 96.00—106.00
Ca++ 1.8 mmol/l 2.3 mmol/l 2.2—2.7
K+ 8.3 mmol/l 5.1 mmol/l 3.48—5.50
Albumin 3.6 g/dL 3.8 g/dL 3.5—5.5
CORTISOLI 8.00 A.M 0.34^g/dL 2.41 ^g/dL 5—25
ACTH 8.00 A.M 712.9 522.3 6—80 pg/Ml
TSH 6 3.63 0,4—4 ^IU/ml
ANTI TPO 381 105 3—45 ^IU/ml
ANTI 21-HYDROXILAZA 48.5 40.1 <0.1
used was 15—25 mg per day given as 2/3 in the morning (20 mg) and 1/3 in the evening (10 mg). Usual mineralo-corticoid regimen is fludorcortisone 0.1 mg/day with monitoring of blood pressure, volume status, weight, plasma rein activity, sodium and potassium. Discussion. Type 2 Polyglandulare Syndrome typically occurs in early adulthood with a peak during the third or fourth decades and is three times more common in females than in males. This patient with, autoimmune thyroid disease and Addison disease has two major components of Schmidt's Syndrome. 10% of Schimidt's Syndrome patients have all three major DM, Addison and Hashimoto. Patients with autoimmune thyroiditis disease are prone to develope other autoimmune disease .In this case the patient with Addison is associated with Hashimoto thy-roiditis.
KEYWORDS: polyglandular autoimmune syndrome, Schmidt syndrome, case report.
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A CASE OF HYPOPITUITARISM AND A SPONTANEOUS REGRESSION OF MASSIVE LESION OF HYPOTHALAMIC AREA
A.V. Belyaeva, D.O. Ladygina
Central Clinical Hospital, Moscow, Russia
Introduction. Hypopituitarism is a complex of one or more pituitary hormone deficiency due to diversity of
underlying etiology, including rare poor studied forms. Clinical case presentation: we present a case of 57 years old woman with intracranial and extracranial mass lesions localized in medial part of the middle cranial fossa, skull base, third ventricle walls, chiasma opticum, sphenoid sinus and panhypopituitarism. The disease debut was associated with reactivation of chronic polypous sinusitis and left side otitis. It was suggested as a neoplasm due to aggressive progress of neurologic signs such as dip-lopia, vertigo, facial numbness and typical visualization feature with high contrast accumulation by MRI and positron emission tomography. But histological examination of sphenoid sinus mass, cytological liquor assessment did not reveal any tumor cells and alpha fetoprotein level was normal in contradiction to malignant lesion. Compensation of vital functions by substitution therapy by hydrocortisone 10—15 mg per day, L-thyroxine 75 mkg and desmopressin 0.1 mg twice a day improved overall health of the patient. Spontaneous regression of the vast majority of mass lesion within 6 months confirmed inflammatory process as a probable cause of this accident. Conclusions. Infection process could mimic tumor. Clear understanding of etiology of pathologic process in each case is necessary for accurate prognosis and treatment individualization.
KEYWORDS: hypopituitarism, case report. ★ ★ ★
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PROBLEMS OF ENDOCRINOLOGY, 1, 2017, SUPPL. 2
