DOI: 10.12890/2024_004627

A silent cause of shock: autoimmune polyglandular syndromes

Authors

  • Mark Colantonio Department of Medicine, West Virginia University, Morgantown, USA
  • Michelle Hartzell Department of Medicine, West Virginia University, Morgantown, USA
  • Brooke Shannon Department of Medicine, West Virginia University, Morgantown, USA
  • Apoorva Iyer Department of Medicine, Division of Endocrinology, Morgantown, USA

macolantonio@hsc.wvu.edu

Keywords

Adrenal insufficiency, Addison’s disease, Hashimoto’s disease, autoimmune polyglandular syndromes, autoimmune polyendocrine syndrome type 2

Abstract

Addison’s disease is a rare, autoimmune condition leading to the destruction of the adrenal gland. Autoimmune conditions are known to commonly co-occur. When Addison’s disease presents in the setting of autoimmune thyroid disease and/or type 1 diabetes, this condition is termed autoimmune polyendocrine syndrome type II, a rare endocrinopathy found in roughly 1.4-4.5 per 100,000 individuals. Here, we describe a clinical case presenting with hypotension refractory to fluid resuscitation and electrolyte derangements later diagnosed as autoimmune polyendocrine syndrome type II.

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References

  1. Anaya JM, Shoenfeld Y, Rojas-Villarraga A, Levy RA, Cervera R. Autoimmunity: from bench to bedside. First edition. Bogota, Colombia: Center for Autoimmune Diseases Research, School of Medicine and Health Sciences, El Rosario University; 2013.
  2. Huecker MR, Bhutta BS, Dominique E. Adrenal Insufficiency. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 May 10]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK441832/
  3. Michels A, Michels N. Addison disease: early detection and treatment principles. Am Fam Physician 2014;89:563–568.
  4. Alexandraki KI, Grossman A. Diagnosis and Management of Adrenal Insufficiency. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000 [cited 2024 May 10]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK279122/
  5. Burke CW. Adrenocortical insufficiency. Clin Endocrinol Metab. 1985 Nov;14(4):947–76.
  6. Mathara Diddhenipothage SAD, Beck KJ, Loo H, Amiyangoda GK, Pofi R, Tomlinson JW, et al. “A morning cortisol is the most effective clinical predictor of short synacthen test outcome”: A tertiary care centre experience. Clin Endocrinol (Oxf) 2023;99:142–51.
  7. Fragoso Perozo AFD, Fontes R, Lopes FP, Araújo PB, Scrank Y, Gomes DMV, et al. Morning serum cortisol role in the adrenal insufficiency diagnosis with modern cortisol assays. J Endocrinol Invest 2023;46:2115–2124.
  8. Le Roux CW, Meeran K, Alaghband-Zadeh J. Is a 0900-h serum cortisol useful prior to a short synacthen test in outpatient assessment? Ann Clin Biochem 2002;39:148–50.
  9. Pazderska A, Pearce SH. Adrenal insufficiency - recognition and management. Clin Med Lond Engl 2017;17:258–262.
  10. Bornstein SR, Allolio B, Arlt W, Barthel A, Don-Wauchope A, Hammer GD, et al. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2016;101:364–89.
  11. Betterle C, Lazzarotto F, Presotto F. Autoimmune polyglandular syndrome Type 2: the tip of an iceberg? Clin Exp Immunol 2004;137:225–233.
  12. Elshimy G, Chippa V, Kaur J, Jeong JM. Adrenal Crisis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 May 10]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK499968/
  13. Majeroni BA, Patel P. Autoimmune polyglandular syndrome, type II. Am Fam Physician 2007;75:667–70.
  14. Nelson LM, Anasti JN, Kimzey LM, Defensor RA, Lipetz KJ, White BJ, et al. Development of luteinized graafian follicles in patients with karyotypically normal spontaneous premature ovarian failure. J Clin Endocrinol Metab 1994;79:1470–1475.
  15. Morrissey K, Winkel C, Hild S, Premkumar A, Stratton P. Struma ovarii coincident with Hashimoto’s thyroiditis: an unusual cause of hyperthyroidism. Fertil Steril 2007;88:497.e15-17.
  16. Dulcey I, Céspedes MU, Ballesteros JL, Preda O, Aneiros-Fernández J, Clavero PA, et al. Necrotic mature ovarian teratoma associated with anti-N-methyl-D-aspartate receptor encephalitis. Pathol Res Pract 2012;208:497–500.

Published

2024-05-27

How to Cite

1.
Colantonio M, Hartzell M, Shannon B, Iyer A. A silent cause of shock: autoimmune polyglandular syndromes. EJCRIM [Internet]. 2024 May 27 [cited 2026 Nov. 3];11(6). Available from: https://ejcrim.com/index.php/ejcrim/article/view/4627