Case report on peripartum cardiomyopathy in a patient with Schmidt syndrome with twin pregnancy for emergency lower segment cesarean section
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20212681Keywords:
Peripartum cardiomyopathy, Lower segment cesarean section, Schmidt syndrome, Diagnosis, Treatment, Heart failureAbstract
Peripartum and autoimmune cardiomyopathy is an uncommon rare disorder associated with pregnancy. When it occurs association with autoimmune thyroid disorder and autoimmune adrenal insufficiency, it is eponymously referred to as Schmidt syndrome or autoimmune polyendocrine syndrome type 2 (APS type 2). Peripartum cardiomyopathy (PPCM) can be difficult to diagnose as the symptoms can be masked or misinterpreted due to the normal physiological changes during pregnancy, as the symptoms of heart failure can mimic those of pregnancy. PPCM is associated with considerable morbidity and mortality and so should not be underestimated. In this report, we are discussing the management of 32-years-old female with hypothyroidism and Addison’s disease (polyglandular syndrome type 2- Schmidt syndrome) who came for emergency lower segment cesarean section (LSCS) due to twin pregnancy (abnormal doppler of the second twin) and during the period developed pulmonary edema and was diagnosed as peripartum cardiomyopathy.
References
Givertz MM. Cardiology patient page: peripartum cardiomyopathy. Circulation. 2013;127(20):622-6.
Seol MD, Lee YS, Kim DK, Choi YH, Kim DJ, Park SH, et al. Dilated cardiomyopathy secondary to hypothyroidism: case report with a review of literatures. J Cardiovasc Ultrasound. 2014;22(1):32-5.
Madan N, Tiwari N, Stampfer M, Schubart U. Hypothyroid heart: myxoedema as a cause of reversible dilated cardiomyopathy. Bio Med J Case Rep. 2015;2015212045.
Mozolevska V, Schwartz A, Cheung D, Shaikh B, Bhagirath KM, Jassal DS. Addison's Disease and Dilated Cardiomyopathy: A Case Report and Review of the Literature. Case Rep Cardiol. 2016;4362514.
Mehboob H, Mayala H, Kisenge P. Challenges in management of peripartum cardiomyopathy with diuretic resistance, hypoalbuminemia and hypothyroidism. IOSR J Pharmacy. 2015;2250-3013.
Kumar KV, Pushkaraj SG, Krishnaleela BL, Modi KD. Peripartum cardiomyopathy in type II autoimmune polyendocrine syndrome. Int J Cardiol. 2011;149(1):14-5.
Daniel CR, Patricia P, Christine AR. Autoimmune polyglandular syndrome Type2 in a patient with peripartum cardiomyopathy.; AACE. Clinical case reports. 2017;3(2):126-8.
Sahay RK, Nagesh VS. Hypothyroidism in pregnancy. Indian J Endocrinol Metab. 2012;16(3):364-70.
Ansari AA, Fett JD, Carraway RE, Mayne AE, Onlamoon N, Sundstrom JB. Autoimmune mechanisms as the basis for human peripartum cardiomyopathy. Clin Rev Allergy Immunol. 2002;23(3):301-24.
Jolobe OMP. PPCM and type II autoimmune polyglandular syndrome. Am J Emerg Med. 2018;36(12):2333.
Nielsen TD, Steenbergen C, Russell SD. Nonischemic cardiomyopathy associated with autoimmune polyglandular syndrome type II. Endocr Pract. 2007;13(1):59-62.
Jolobe O. Postpartum cardiomyopathy and endocrinopathy. Heart. 2019;105(13):1047.
