The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2018

A rare case of Meningococcal sepsis induced testicular failure, primary hypothyroidism and hypoadrenalism – is there a link? (#193)

Caroline Bachmeier 1 , Usman Malabu 1
  1. Endocrinology and Diabetes, Queensland Health, Townsville Hospital, QLD, Australia

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 IGF-1 levels and hypogonadism.

We report the case of a 24 year old man with meningococcal sepsis with multiple end-organ complications who developed severe transient hypoparathyroidism, 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.