A patient with recurrent attacks of drowsiness and lethargy--a diagnosis not to be missed.
Polyglandular auto-immune syndromes are uncommon constellation of organ specific auto-immune diseases, characterised by the existence of two or more endocrinopathies. Polyglandular autoimmune type II syndrome also known as Schmidt's syndrome is more common, comprising Addison's disease, auto-immune thyroid disease, type 1 diabetes mellitus and/or hypogonadism, pernicious anaemia, coeliac disease, vitiligo, hypophysitis, etc. Here a case of a 56-year-old man is reported with a prior history of hypothyroidism who presented with adrenal crisis. Further laboratory investigations revealed primary auto-immune hypothyroidism, primary adrenal insufficiency, hypogonadism and he was diagnosed as a case of polyglandular auto-immune type II syndrome or Schmidt's syndrome. Early recognition of the syndrome and replacement therapy can be life saving, particularly when there is adrenal or thyroid insufficiency.
Department of Medicine, RG Kar Medical College and Hospital, Kolkata.
Susanta Kumar
SK
Das
Amritava
A
Ghosh
Niloy
N
Banerjee
Sudarshan
S
Khaski
Sabyasachi
S
Mukherjee
D020249:Hormone Replacement Therapy; D006801:Humans; D053609:Lethargy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016884:Polyendocrinopathies, Autoimmune / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D012894:Sleep Stages