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August 8, 1990


Author Affiliations

New York (NY) University

New York (NY) University

JAMA. 1990;264(6):694-695. doi:10.1001/jama.1990.03450060040021

To the Editor.—  Lymphyocytic hypophysitis, occasionally accompanied by adrenalitis, parathyroiditis, thyroiditis, or gastritis, has been strongly associated with the peripartum period. Speculation about the origin recently has focused on autoimmune mechanisms associated with pregnancy.1 Cardiomyopathy has also been observed as a rare occurrence in the peripartum period. With careful investigation, peripartum cardiomyopathy has often been found to be related to underlying previously quiescent cardiac disease, including myocarditis.2 Recently, a woman who presented with peripartum cardiomyopathy was found to have both entities. The similarity of the inflammatory infiltrates prompted a literature search for evidence of a common origin.

Report of a Case.—  Eight weeks after the unremarkable delivery of her third child, a 29-year-old woman with asthma and an unconfirmed history of hypertension developed an influenza-like upper respiratory tract infection followed by dyspnea, vomiting, and then congestive heart failure with severe hypotension. She was resuscitated from two cardiac