A novel case of congenital fetal heart block in a mother with Addison's disease

Addison’s disease or primary adrenocortical insufficiency is a rare endocrine disorder. In the majority of cases, pathogenesis lies in idiopathic autoimmune adrenalitis, and 21-hydroxylase autoantibodies have been found in 80–90% of patients with idiopathic Addison’s disease. Addison’s disease can have a varied presentation from non-specific symptoms of weakness, fatigue, nausea and abdominal pain to classic skin pigmentation and hypotensive shock associated with an Addisonian crisis. This case demonstrates the first documented case of a woman with Addison’s disease with antenatally diagnosed complete fetal heart block. This may help to guide the management of future cases of fetal heart block with Addison’s and other autoimmune conditions.