title: Addisonian crisis precipitated by thyroxine therapy: a complication of type 2 autoimmune polyglandular syndrome.
abstract: Hypothyroidism is a common condition. Rarely, it may occur in combination with autoimmune failure of other endocrine glands (autoimmune polyendocrinopathy syndrome type 2, previously known as Schmidt's syndrome). In such cases, restoring normal thyroid function may precipitate adrenal failure. Clinicians should have a high index of suspicion for this condition in patients with Addison's disease, those with a family history of autoimmune endocrine gland failure, patients with one autoimmune endocrine disease who develop nonspecific or serious illness, and patients with type 1 diabetes mellitus whose insulin requirements drop without obvious explanation.
mesh_terms: D000224:Addison Disease / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D000324:Adrenocorticotropic Hormone; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001324:Autoantigens / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology; D003937:Diagnosis, Differential; D016903:Drug Monitoring; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007037:Hypothyroidism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D007453:Iodide Peroxidase; D033862:Iron-Binding Proteins; D008297:Male; D016884:Polyendocrinopathies, Autoimmune / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D015985:Precipitating Factors; D013601:T-Lymphocytes / Q000276:immunology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000009:adverse effects* / Q000097:blood; D015431:Weight Loss
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D033862:Iron-Binding Proteins; C006606:anti-thyroglobulin; D000324:Adrenocorticotropic Hormone; D013972:Thyrotropin; C056658:TPO protein, human; D007453:Iodide Peroxidase; D013974:Thyroxine; D006854:Hydrocortisone