Autoimmune Polyglandular Syndrome (APS) Type II, A Case Report
Schmidt syndrome is a polyendocrinopathy characterized by multiple organ failures. Patients with two or more of the following characteristics are diagnosed with this syndrome: Graves' disease, adrenal insufficiency, autoimmune thyroiditis, and type I diabetes. The present case report concerns a...
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| 语言: | English |
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Mazandaran University of Medical Sciences
2023-11-01
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| 丛编: | Journal of Mazandaran University of Medical Sciences |
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| 在线阅读: | http://jmums.mazums.ac.ir/article-1-19879-en.pdf |
| _version_ | 1827615132251848704 |
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| author | Narges Mirzaei Ilali Mohammad Abedi samakoosh Zeinab sheidai Somayeh sheidaei |
| author_facet | Narges Mirzaei Ilali Mohammad Abedi samakoosh Zeinab sheidai Somayeh sheidaei |
| author_sort | Narges Mirzaei Ilali |
| collection | DOAJ |
| description | Schmidt syndrome is a polyendocrinopathy characterized by multiple organ failures. Patients with two or more of the following characteristics are diagnosed with this syndrome: Graves' disease, adrenal insufficiency, autoimmune thyroiditis, and type I diabetes. The present case report concerns a Schmidt syndrome patient (polyglandular autoimmune syndrome type II). The patient is a 42-year-old woman with type I diabetes and complaints of imbalance, weakness and lethargy, weight loss, darkened skin, blood pressure drop, hypoglycemia, and hyperkalemia who visited the Hospital frequently and was discharged every time after intravenous potassium chloride and dextrose injections and orders to reduce insulin consumption at home. Her blood cortisol level was measured in her last visit with suspicion of adrenal insufficiency, which was revealed to be low (less than 0.5 μg/dL). A high ACTH, low aldosterone, and normal renin were also reported, indicating secondary adrenal insufficiency. Furthermore, T4 and TSH tests were performed, reporting a TSH lower than 0.2 in the initial TSH test, which was revealed to be normal after the test was repeated. Subclinical hyperthyroidism was indicated, given the high TRAb figure. The patient underwent treatment with fludrocortisone and prednisolone, which improved her condition. This report accentuates that diabetic patients with reduced insulin requirements must be checked for adrenal insufficiency immediately to prevent potential complications. |
| first_indexed | 2024-03-09T09:06:45Z |
| format | Article |
| id | doaj.art-19b85efdeed54befbadf540328dc6905 |
| institution | Directory Open Access Journal |
| issn | 1735-9260 1735-9279 |
| language | English |
| last_indexed | 2024-03-09T09:06:45Z |
| publishDate | 2023-11-01 |
| publisher | Mazandaran University of Medical Sciences |
| record_format | Article |
| series | Journal of Mazandaran University of Medical Sciences |
| spelling | doaj.art-19b85efdeed54befbadf540328dc69052023-12-02T10:14:03ZengMazandaran University of Medical SciencesJournal of Mazandaran University of Medical Sciences1735-92601735-92792023-11-0133227345349Autoimmune Polyglandular Syndrome (APS) Type II, A Case ReportNarges Mirzaei Ilali0Mohammad Abedi samakoosh1Zeinab sheidai2Somayeh sheidaei3 Assistant Professor, Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran Assistant Professor, Department of Internal Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Assistant Professor, Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran Assistant Professor of Pathology, Department of Pathology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Schmidt syndrome is a polyendocrinopathy characterized by multiple organ failures. Patients with two or more of the following characteristics are diagnosed with this syndrome: Graves' disease, adrenal insufficiency, autoimmune thyroiditis, and type I diabetes. The present case report concerns a Schmidt syndrome patient (polyglandular autoimmune syndrome type II). The patient is a 42-year-old woman with type I diabetes and complaints of imbalance, weakness and lethargy, weight loss, darkened skin, blood pressure drop, hypoglycemia, and hyperkalemia who visited the Hospital frequently and was discharged every time after intravenous potassium chloride and dextrose injections and orders to reduce insulin consumption at home. Her blood cortisol level was measured in her last visit with suspicion of adrenal insufficiency, which was revealed to be low (less than 0.5 μg/dL). A high ACTH, low aldosterone, and normal renin were also reported, indicating secondary adrenal insufficiency. Furthermore, T4 and TSH tests were performed, reporting a TSH lower than 0.2 in the initial TSH test, which was revealed to be normal after the test was repeated. Subclinical hyperthyroidism was indicated, given the high TRAb figure. The patient underwent treatment with fludrocortisone and prednisolone, which improved her condition. This report accentuates that diabetic patients with reduced insulin requirements must be checked for adrenal insufficiency immediately to prevent potential complications.http://jmums.mazums.ac.ir/article-1-19879-en.pdfadrenal insufficiencyautoimmune polyglandular syndrome type iidiabeteshyperthyroidisschmidt syndrome |
| spellingShingle | Narges Mirzaei Ilali Mohammad Abedi samakoosh Zeinab sheidai Somayeh sheidaei Autoimmune Polyglandular Syndrome (APS) Type II, A Case Report Journal of Mazandaran University of Medical Sciences adrenal insufficiency autoimmune polyglandular syndrome type ii diabetes hyperthyroidis schmidt syndrome |
| title | Autoimmune Polyglandular Syndrome (APS) Type II, A Case Report |
| title_full | Autoimmune Polyglandular Syndrome (APS) Type II, A Case Report |
| title_fullStr | Autoimmune Polyglandular Syndrome (APS) Type II, A Case Report |
| title_full_unstemmed | Autoimmune Polyglandular Syndrome (APS) Type II, A Case Report |
| title_short | Autoimmune Polyglandular Syndrome (APS) Type II, A Case Report |
| title_sort | autoimmune polyglandular syndrome aps type ii a case report |
| topic | adrenal insufficiency autoimmune polyglandular syndrome type ii diabetes hyperthyroidis schmidt syndrome |
| url | http://jmums.mazums.ac.ir/article-1-19879-en.pdf |
| work_keys_str_mv | AT nargesmirzaeiilali autoimmunepolyglandularsyndromeapstypeiiacasereport AT mohammadabedisamakoosh autoimmunepolyglandularsyndromeapstypeiiacasereport AT zeinabsheidai autoimmunepolyglandularsyndromeapstypeiiacasereport AT somayehsheidaei autoimmunepolyglandularsyndromeapstypeiiacasereport |