Anesthetic experience of Cesarean section in a patient with coexistence of Addison's disease with autoimmune thyroiditis: A case report

You, Dong Geun; Lee, Sang Hoon; Lee, Jeong Hyun; Lee, Mi Hyeon; Chung, Mi Hwa; Choi, Young Ryong; Choi, Eun Mi

Case Report

Obstetric Anesthesia

Anesthesia and Pain Medicine 2013;8(4):258-260.
Published online October 30, 2013.

Anesthetic experience of Cesarean section in a patient with coexistence of Addison's disease with autoimmune thyroiditis: A case report

Dong Geun You, Sang Hoon Lee, Jeong Hyun Lee, Mi Hyeon Lee, Mi Hwa Chung, Young Ryong Choi, Eun Mi Choi

Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. emchoi96@hallym.or.kr

Abstract

Addison's disease is a rare chronic endocrine disorder which results from progressive destruction of the adrenal glands. It is kind of autoimmune polyendocrine syndrome type 2 with autoimmune thyroiditis, and can lead to fatal outcomes when complicated in pregnancy. We report on an anesthetic experience with 38-year-old primigravida with Addison's disease and hypothyroidism who was followed up from the early stage of pregnancy to delivery by a multidisciplinary medical board. Great attention was given to steroid replacement therapy as well as fetal surveillance in order to lower the risk of maternal and fetal mortality. This report describes our experience of the spinal anesthetic management for Cesarean section of a patient with Addison's disease and hypothyroidism.

Key Words: Addison's disease, Autoimmune polyendocrine syndrome, Cesarean section, Hypothyroidism, Spinal anesthesia