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Diagnostic Dilemma

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A CASE OF POLYGLANDULAR SYNDROME
Author: Sibi Thirunavukkarasu
Question
A 14 yrs and 4 months old boy , a known case of type 1 diabetes mellitus got admitted in our hospital for hypoglycemia. His height was 130 cms , weight - 37 cms, BMI-21.89 , us, ls ratio was normal, father`s height - 166cms and mother`s height - 148 cms. No obvious malformations, fundus examination was normal. Dental age corresponds to chronological age. IQ is normal. Sexual maturity corresponded to TANNER 2. Bone age delayed, corresponds to less than 11 years. He is a second born sibling of the four. His elder sister is suffering from type 1 diabetes mellitus and his younger brother is suffering from type 1 diabetes, hypothyroidism. His mother is also a known case of primary hypothyroidism.

INVESTIGATIONS:
Fasting serum c peptide levels - Less than 0.1 ng, dl.
T3 – 21.65 ng , dl ` T4 – 1.2 microgram , dl ` TSH – 163.00 mIU , ml
FSH – 4.45 Miu, ml
LH – 0.10 mIU , ml
PRL – 23.42 ng , ml
TESTOSTERONE – 0.01 ng , ml
8.00AM CORTISOL – 13.44 microgram , dl
PTH – 4.6 pg , ml


 
Answer For Question
 1  
Author:-Sabri Sakrana
>>> congenital polyglandular deficiency

Author:-Ashraf Soliman
>>> A case of polyendocrine failure syndrome that need to be investigated for adrenal function, calcium homeostasis and antibodies for different endocrine glands {thyroid, adrenal} and GH-IGF-I axis.

Author:-Fernando Figueiredo
>>> Secondary pituit

Author:-aylaguv
>>> Treat with L-Thyroxine and you have to performed GhRH stimulating test

Author:-zohdi alhanouty
>>> serum endocrine antibodies,ACTH and cosyntropin test,plasma renin,CBC,MCV,Vit B12 for pernicios anemia,endoscopy and biopsy for pernicious anemia and associated celiac disease and start replacement therapy

Author:-najwa
>>> multiglanduler failure

 1  



 
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