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CASE REPORT
Addison's disease in a patient with hypothyroidism: autoimmune polyglandular syndrome type 2
  1. Anna Bain1,
  2. Munro Stewart2,
  3. Peter Mwamure2,
  4. Kingsley Nirmalaraj2
  1. 1University of Auckland, Auckland, New Zealand
  2. 2Tauranga Hospital, Tauranga, Bay of Plenty, New Zealand
  1. Correspondence to Dr Peter Mwamure, peter.mwamure{at}doctors.org.uk

Summary

A 57-year-old Caucasian woman with known autoimmune hypothyroidism diagnosed in 2006 presented to hospital with flu-like symptoms and circulatory collapse. She reported weight loss and gradual increase in her skin pigmentation over a 1-year period. Aggressive fluid resuscitation was instituted. Hormonal tests showed primary adrenal insufficiency. Appropriate steroid replacement was started with rapid clinical response. Subsequent antibody tests confirmed the diagnosis of autoimmune polyglandular type 2 (Schmidt's) syndrome. The adrenal crisis had been precipitated by influenza virus type B infection.

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