Rare case of meningococcal sepsis-induced testicular failure, primary hypothyroidism and hypoadrenalism: is there a link?

Bachmeier, Caroline Annette Erika, and Malabu, Usman (2018) Rare case of meningococcal sepsis-induced testicular failure, primary hypothyroidism and hypoadrenalism: is there a link? BMJ Case Reports. (In Press)

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Abstract

Severe illness can lead to multiple transient endocrinopathies. In adult patients, neuroendocrine alterations include sick euthyroid syndrome, an increase in corticosteroid levels, increase in prolactin levels, decreased insulin growth factor 1 levels and hypogonadism. We report the case of a 24-year-old man with meningococcal sepsis with multiple end-organ complications who developed persistent non-autoimmune hypothyroidism, adrenal insufficiency and primary hypogonadism all requiring hormone replacement. While adrenal insufficiency as part of the Waterhouse-Friderichsen syndrome is well described, reports of primary hypothyroidism and persistent primary hypogonadism in severe illness are exceedingly rare. Multiple combined endocrinopathies as in this case have not been reported previously. This case highlights the necessity of screening for endocrine abnormalities in severe illness and the need for treatment if persistent. It also raises a novel concept of meningococcal sepsis causing multiple endocrinopathies possibly via disseminated intravascular coagulopathy-related ischaemic damage.

Item ID: 55854
Item Type: Article (Case Study)
Copyright Information: Copyright © BMJ publishing Group Limited 2018. No commercial re-use. see rights and permissions.
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ISSN: 1757-790X
Date Deposited: 15 Oct 2018 04:30
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110306 Endocrinology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 100%
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