A 60-year-old male patient, weighing 40 kg and with a BMI of 13, was admitted to the Orthopaedic Ward last month after falling and developing an intertrochanteric fracture in the femur. He was also a known case of Diabetes Mellitus Type II. While the patient's fracture therapy was underway, his diabetes was found to be poorly controlled, with his blood glucose levels continually monitored, ranging from severe hypoglycemia to slightly elevated levels of blood glucose.
The patient's
examination revealed that he was very emaciated. On the palmar sides of his
hands, he had wrinkles, and his buccal mucosa showed hyperpigmentation.
Furthermore,
practically every lab test he ordered found anomalies, according to his lab
results. Not only did he have high ACTH levels, but he also had a Cortisol
stimulation failure. His DEXA scan revealed that he was predisposed to severe
osteoporosis, and his emaciated state aided in the progression of that
condition.
Autoimmune
Polyglandular Syndrome, Type II, was discovered to be the patient's condition.
Women were impacted more than males. This is a one-of-a-kind disorder in which
autoimmune adrenal insufficiency is present along with either autoimmune
thyroid illness or autoimmune diabetes mellitus. Because this condition is
rare, it is frequently overlooked at diagnosis, leading to misdiagnosis because
almost all of the presenting features or symptoms of the prevalent
endocrinological disorders present in this condition mimic either
hypothyroidism, diabetes, or adrenal insufficiency alone, leading to further
consequences when the condition does not resolve despite persistent treatment,
as in this patient's case.
Author(S) Details
Rania Alsayed Murad
Department of Endocrinology, Madinat Zayed Hospital, UAE.
Ashraf Alakkad
Department of Internal Medicine, Madinat Zayed Hospital, UAE.
Anwar Adwan
Department of Internal Medicine, Madinat Zayed Hospital, UAE.
Mikdam Al Ramahi
Department of Orthopedic, Madinat Zayed Hospital, UAE.
View Book:- https://stm.bookpi.org/IDMMR-V3/article/view/5484
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