Type 2 Autoimmune Polyglandular Syndrome Presenting with Hyperpigmentation and Amenorrhea

A 36-year-old female presented with lethargy, anorexia, nausea, hyperpigmentation, weight loss and amenorrhea for six months. On examination, she had hyperpigmentation of face, hands and oral mucosa. Investigations revealed adrenal insufficiency and subclinical hyperthyroidism with elevated anti-thy...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2020-04, Vol.12 (4), p.e7772
Main Authors: Gaba, Nayana, Gaba, Saurabh, Singla, Mandeep, Gupta, Monica
Format: Article
Language:English
Subjects:
Abdomen
Adrenal glands
Alopecia
Amenorrhea
Anemia
Anorexia
Antifungal agents
Baldness
Case reports
Diabetes
Drug dosages
Eye diseases
Hemoglobin
Hepatitis
Hormones
Hypoglycemia
Hypotension
Hypothyroidism
Internal Medicine
Mutation
Obstetrics/Gynecology
Pain
Pituitary gland
Thyroid diseases
Vitiligo
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Summary:A 36-year-old female presented with lethargy, anorexia, nausea, hyperpigmentation, weight loss and amenorrhea for six months. On examination, she had hyperpigmentation of face, hands and oral mucosa. Investigations revealed adrenal insufficiency and subclinical hyperthyroidism with elevated anti-thyroid peroxidase antibodies. Adrenal insufficiency in combination with Grave's disease and/or type 1 diabetes mellitus occurs in type 2 autoimmune polyglandular syndrome. It is a polygenic disorder occurring due to mutations in the human leukocyte antigen complex on chromosome 6. The patient was treated with oral hydrocortisone which led to improvement in all the symptoms.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.7772