A PATIENT WITH ADDISON’S AND GRAVES’ DISEASE AS MANIFESTATION OF AUTOIMMUNE POLYGLANDULAR SYNDROME TYPE 2

Abstract

Addison's disease is a rare disease caused by insufficient production of glucocorticoids, mineralocorticoids, and androgens in the adrenal cortex. It occurs more frequently in women and develops most often between the ages of 30 and 50. About two-thirds of patients with Addison's disease may develop other autoimmune disorders in the context of autoimmune polyglandular syndrome (APS), including autoimmune thyroid disease (ATD), autoimmune gastritis, type 1 diabetes, premature ovarian failure (POF), vitiligo, or celiac disease. We reported a case of 51-year-old woman with complaints of weakness, nausea, vomiting, weight loss, frequent bowel movements, and hyperpigmentation. Laboratory examinations showed decreased level of morning cortisol, increased ACTH, increased FT4, decreased TSH, increased thyrotropin receptor antibody (TRab), and positive glutamic acid decarboxylase (GAD) 65. Patient was diagnosed with Addison's disease accompanied by autoimmune thyroid disease-causing' disease and type 1 diabetes mellitus, leading to autoimmune polyglandular syndrome (APS) type 2. After being given steroid, insulin, and anti-thyroid drugs therapy, the patient's condition improved.