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Autoimmune Polyglandular Syndrome Type II Presenting as an Endocrine Emergency: A Case Report.
Oman Med J 2013; 28(3):e048OM

Abstract

We describe the case of a 30-year-old male, a known patient of type 1 diabetes mellitus (DM) on insulin therapy, seeking medical attention for recent onset repeated attacks of hypoglycemia associated with generalized weakness and darkening of skin. Further evaluation and screening revealed autoimmune adrenal failure together with presence of Hashimoto's thyroiditis. The patient was diagnosed as a case of autoimmune polyglandular syndrome (APS) type II with complete triad of Addison's disease, type 1 DM and autoimmune thyroid disease. Anti-thyroid peroxidase, anti-glutamic acid decarboxylase and anti-endomysial antibodies were present in our patient. He was started on replacement therapy with physiological dose of prednisolone and thyroxine resulting in marked improvement in his symptoms. Recurrent hypoglycemia in a type 1 DM patient should raise a suspicion of underlying autoimmune adrenal insufficiency. Absence of obvious signs of thyroid dysfunction also poses a diagnostic challenge for the clinicians. This article aims at highlighting the importance of detailed evaluation together with long term followup of these patients and their relatives as overt clinical disease may only be the tip of the iceberg of other underlying organ-specific autoimmune diseases that may develop later in the course.

Authors+Show Affiliations

Department of General Medicine, Medical College and Hospital, Kolkata, India.Calcutta National Medical College and Hospital, Kolkata, West Bengal. India.Department of Endocrinology, Medical College and Hospital, Kolkata, India.Department of General Medicine, Medical College and Hospital, Kolkata, India.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31440356

Citation

Sonthalia, Nikhil, et al. "Autoimmune Polyglandular Syndrome Type II Presenting as an Endocrine Emergency: a Case Report." Oman Medical Journal, vol. 28, no. 3, 2013, pp. e048.
Sonthalia N, Ray S, Maiti A, et al. Autoimmune Polyglandular Syndrome Type II Presenting as an Endocrine Emergency: A Case Report. Oman Med J. 2013;28(3):e048.
Sonthalia, N., Ray, S., Maiti, A., & Maitra, S. (2013). Autoimmune Polyglandular Syndrome Type II Presenting as an Endocrine Emergency: A Case Report. Oman Medical Journal, 28(3), pp. e048. doi:10.5001/omj.2013.64.
Sonthalia N, et al. Autoimmune Polyglandular Syndrome Type II Presenting as an Endocrine Emergency: a Case Report. Oman Med J. 2013;28(3):e048. PubMed PMID: 31440356.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Autoimmune Polyglandular Syndrome Type II Presenting as an Endocrine Emergency: A Case Report. AU - Sonthalia,Nikhil, AU - Ray,Sayantan, AU - Maiti,Animesh, AU - Maitra,Subhasis, PY - 2019/8/24/entrez PY - 2013/5/1/pubmed PY - 2013/5/1/medline KW - Addison’s disease KW - Autoimmune polyglandular syndrome KW - Autoimmune thyroid disease KW - Hypoglycemia KW - Type 1 diabetes mellitus SP - e048 EP - e048 JF - Oman medical journal JO - Oman Med J VL - 28 IS - 3 N2 - We describe the case of a 30-year-old male, a known patient of type 1 diabetes mellitus (DM) on insulin therapy, seeking medical attention for recent onset repeated attacks of hypoglycemia associated with generalized weakness and darkening of skin. Further evaluation and screening revealed autoimmune adrenal failure together with presence of Hashimoto's thyroiditis. The patient was diagnosed as a case of autoimmune polyglandular syndrome (APS) type II with complete triad of Addison's disease, type 1 DM and autoimmune thyroid disease. Anti-thyroid peroxidase, anti-glutamic acid decarboxylase and anti-endomysial antibodies were present in our patient. He was started on replacement therapy with physiological dose of prednisolone and thyroxine resulting in marked improvement in his symptoms. Recurrent hypoglycemia in a type 1 DM patient should raise a suspicion of underlying autoimmune adrenal insufficiency. Absence of obvious signs of thyroid dysfunction also poses a diagnostic challenge for the clinicians. This article aims at highlighting the importance of detailed evaluation together with long term followup of these patients and their relatives as overt clinical disease may only be the tip of the iceberg of other underlying organ-specific autoimmune diseases that may develop later in the course. SN - 1999-768X UR - https://www.unboundmedicine.com/medline/citation/31440356/Autoimmune_Polyglandular_Syndrome_Type_II_Presenting_as_an_Endocrine_Emergency:_A_Case_Report L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31440356/ DB - PRIME DP - Unbound Medicine ER -