Clinical case of Carpenter syndrome (autoimmune-polygundularsyndrome 2) in the practice of an endocrinologist
DOI:
https://doi.org/10.3329/bjms.v18i3.41642Keywords:
Carpenter syndrome; autoimmune poluglandular syndrome; diabetes mellitus type 1; primary hypogonadism.Abstract
Presentation of case: patient 36 years old, appealed to complaints about changing the color of the skin, reducing body weight by 10 kg in 2 months, expressed general weakness, lowering blood pressure, reducing sexual desire.
Discussion: prescribed treatment: insulin therapy (aspart, degludec) day dose 42 OD, levothyroxine 100 mcgr/day, vitamin E, selenium 100 mcgr, chorionic gonadotrophin 1500 OD intramuscularly once per week, monthly courses with the same break. After the therapy, the patient’s condition improved. Repeatedly the patient appeared on the review 6 months after treatment. Hyperpigmentation of the skin and natural areas of pigmentation are reduced, there is a stabilization of blood pressure at a level of 120 / 70-110 / 70 mm Hg, reduction of clinical symptoms, achieved target level of glycemia and hormonal blood parameters the target glycemia level was reached (4.6-5.1 mmol / L), glycosylated hemoglobin (8.1%) and hormonal blood parameters (TTG 3.4 mmol / L) cortisol serum 1.7 μg / dl (norm 6.2-19.4 μg / dl), testosterone free 3.4 pg / ml (N 1.7-8.2), total testosterone - 12.28 (N 8.64 - 29 nmol / l), sex steroid binding globulin (CHD) (67 nmol / l, at the rate of 13-71 nmol / l, ), testosterone free 8.9 pg / ml (N 8.8 - 42.5 pg / ml).
Conclusions: Decomposition of adrenal insufficiency (decrease in glucocorticoids as contrinsular hormone) can lead to untypical cours of diabetes with steaolyhipoglicemia in autumne-summer period and normalizabionglycemia glycemia in winter-autumne period. Presents of 2-3 decompensate, endocrine diseases in the same moment suppresses pronounced typical symptomatics each of them precedes with erased or disguised picture.
Bangladesh Journal of Medical Science Vol.18(3) 2019 p.646-650
Downloads
19
39
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish in the Bangladesh Journal of Medical Science agree to the following terms that:
- Authors retain copyright and grant Bangladesh Journal of Medical Science the right of first publication of the work.
Articles in Bangladesh Journal of Medical Science are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.- Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.
