Choque refratário: Uma rara manifestação de síndrome poligladular autoimune tipo 2 em adolescente: relato de caso

Abstract

The article portrays a rare case of a 13-year-old girl admitted to our emergency department reporting weakness, inappetence, malaise and a lesion in her right hallux with difficulty in healing, in irregular treatment of Hashimoto's disease with recent dose increase, presenting hyponatremia, hyperkalemia, hypotension and that quickly progressed to severe shock, being transferred to the Pediatric Intensive Care Unit, keeping electrolyte disturbances, need for vasoactive drugs in high doses and start of corticosteroids in a stress dose, showing signs of adrenal insufficiency may be of autoimmune or infectious etiology. The presence of positive antibodies reinforced the hypothesis of autoimmune polyglandular syndrome type 2. This condition is observed when there is involvement of disease in two or more glands, with an autoimmune characteristic, which may manifest with large spectrum, but the presence autoantibodies can help in the preparation of the propaedeutics. This is a case report occurred in a military Hospital in Rio de Janeiro, retrospective, observational,and submitted to the Ethics Committee of the Intistuto Pesquisa Biomédica of the Hospital Naval Marcílio Dias in November 2021.