{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T07:47:49Z","timestamp":1769154469626,"version":"3.49.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T00:00:00Z","timestamp":1649376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cardiac tamponade is a rare but serious manifestation of autoimmune polyglandular syndrome Type 2 (APS 2). Patients often present with symptoms of thyroid dysfunction and adrenal insufficiency, but the insidious onset of the disease may lead to delayed diagnosis, which can progress rapidly to haemodynamic instability requiring urgent intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 39-year-old previously healthy male was admitted with cardiac tamponade complicated by cardiac arrest requiring emergent pericardiocentesis. An extensive work up revealed primary adrenal insufficiency and Hashimoto\u2019s thyroiditis. His positive autoantibodies to thyroid peroxidase and 21-hydroxylase combined with rapid improvement with initiation of corticosteroids and levothyroxine confirmed a diagnosis of APS 2.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Although this disease is often difficult to diagnose given its vague symptoms, it should be considered in the differential diagnosis for young patients presenting with pericardial effusion or cardiac tamponade of unknown origin. Early diagnosis and management are critical and often result in rapid improvement after appropriate treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac145","type":"journal-article","created":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T09:23:25Z","timestamp":1649409805000},"source":"Crossref","is-referenced-by-count":5,"title":["Cardiac tamponade as the initial presentation of autoimmune polyglandular syndrome Type 2: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7832-1408","authenticated-orcid":false,"given":"Laura R.","family":"Glick","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4801-0147","authenticated-orcid":false,"given":"Daniel Z.","family":"Hodson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shreyak","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0438-2387","authenticated-orcid":false,"given":"Stella","family":"Savarimuthu","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,4,8]]},"reference":[{"key":"2022050521492142800_ytac145-B1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1365-2249.2004.02561.x","article-title":"Autoimmune polyglandular syndrome Type 2: the tip of an iceberg?","volume":"137","author":"Betterle","year":"2004","journal-title":"Clin Exp Immunol"},{"key":"2022050521492142800_ytac145-B2","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1210\/edrv.23.3.0466","article-title":"Autoimmune adrenal insufficiency and autoimmune polyendocrine syndromes: autoantibodies, autoantigens, and their applicability in diagnosis and disease prediction","volume":"23","author":"Betterle","year":"2002","journal-title":"Endocr Rev"},{"key":"2022050521492142800_ytac145-B3","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S0889-8529(01)00012-3","article-title":"Autoimmune polyglandular syndrome. II: clinical syndrome and treatment","volume":"31","author":"Schatz","year":"2002","journal-title":"Endocrinol Metab Clin North Am"},{"key":"2022050521492142800_ytac145-B4","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/00005792-198109000-00003","article-title":"Two types of autoimmune Addison's disease associated with different polyglandular autoimmune (PGA) syndromes","volume":"60","author":"Neufeld","year":"1981","journal-title":"Medicine"},{"key":"2022050521492142800_ytac145-B5","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1515\/JPEM.1996.9.S1.113","article-title":"Type 2 polyglandular autoimmune disease (Schmidt's syndrome)","volume":"9","author":"Betterle","year":"1996","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"2022050521492142800_ytac145-B6","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1530\/EJE-09-0044","article-title":"Polyglandular autoimmune syndromes","volume":"161","author":"Kahaly","year":"2009","journal-title":"Eu J Endocrinol"},{"key":"2022050521492142800_ytac145-B7","first-page":"667","article-title":"Autoimmune polyglandular syndrome, type II","volume":"75","author":"Majeroni","year":"2007","journal-title":"Am Fam Physician"},{"key":"2022050521492142800_ytac145-B8","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1056\/NEJM199610173351607","article-title":"Adrenal insufficiency","volume":"335","author":"Oelkers","year":"1996","journal-title":"N Engl J Med"},{"key":"2022050521492142800_ytac145-B9","doi-asserted-by":"crossref","first-page":"474","DOI":"10.4158\/EP.14.4.474","article-title":"Pericarditis with cardiac tamponade and addisonian crisis as the presenting features of autoimmune polyglandular syndrome type II: a case series","volume":"14","author":"Alkaabi","year":"2008","journal-title":"Endocr Pract"},{"key":"2022050521492142800_ytac145-B10","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3109\/17482941.2013.869344","article-title":"Cardiac tamponade due to low-volume effusive constrictive pericarditis in a patient with uncontrolled type II autoimmune polyglandular syndrome","volume":"16","author":"Palmer","year":"2014","journal-title":"Acute Card Care"},{"key":"2022050521492142800_ytac145-B11","doi-asserted-by":"crossref","first-page":"250","DOI":"10.14797\/mdcj-11-4-250","article-title":"Case report: autoimmune polyglandular syndrome type 2 complicated by acute adrenal crisis and pericardial tamponade in the setting of normal thyroid function","volume":"11","author":"Khalid","year":"2015","journal-title":"Methodist DeBakey Cardiovasc J"},{"key":"2022050521492142800_ytac145-B12","doi-asserted-by":"crossref","first-page":"e213","DOI":"10.1016\/j.amjmed.2016.12.026","article-title":"Effusive constrictive pericarditis in autoimmune polyglandular syndrome type II","volume":"130","author":"McNamara","year":"2017","journal-title":"Am J Med"},{"key":"2022050521492142800_ytac145-B13","first-page":"17-0097","article-title":"Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2","volume":"2017","author":"Vryonidou","year":"2017","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"2022050521492142800_ytac145-B14","doi-asserted-by":"crossref","first-page":"195","DOI":"10.4158\/EP171791.CR","article-title":"Cardiac tamponade as initial presentation of autoimmune polyglandular syndrome type 2","volume":"4","author":"Anne","year":"2018","journal-title":"AACE Clin Case Rep"},{"key":"2022050521492142800_ytac145-B15","first-page":"1536","article-title":"Incessant pericarditis with recurrent cardiac tamponade as the manifestation of autoimmune polyglandular syndrome type II","volume":"2","author":"Marinho","year":"2020","journal-title":"JACC: Case Rep"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytac145\/43325039\/ytac145.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/5\/ytac145\/43549308\/ytac145.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/5\/ytac145\/43549308\/ytac145.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T21:53:43Z","timestamp":1651787623000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytac145\/6565238"}},"subtitle":[],"editor":[{"given":"Davide","family":"Stolfo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Maria","family":"Mattioli","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Giacomo","family":"Mugnai","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Zhiyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ammenathul Mazaya","family":"Fawzy","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,8]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5,4]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytac145","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,5,1]]},"published":{"date-parts":[[2022,4,8]]},"article-number":"ytac145"}}