[Asymptomatic Addison disease: cause of striking reduction of insulin requirements in a patient with diabetes, Hashimoto thyroiditis and Basedow disease]

Rev Med Chil. 1996 Nov;124(11):1374-6.
[Article in Spanish]

Abstract

We report a 30 years old woman with sporadic poliglandular autoimmune syndrome type II, first seen with an insulin-dependent diabetes mellitus and a Graves-Basedow disease that became spontaneously hypothyroid with positive antimicrosomal antibodies. Six years later she presented with persistent vomiting and a remarkable reduction in insulin requirements. She had low basal and stimulated-cortisol levels and the diagnosis of severe adrenal failure was reached. A CT scan showed normal adrenal glands, she did not have cutaneous hyperpigmentation nor evidences of mineralocorticoid deficit. A selective autoimmune damage of the fascicular zone was assumed but a selective damage of ACTH producing pituitary cells cannot be discarded. The importance of investigating adrenal function in cases of unexplained reduction of insulin requirements is emphasized.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Addison Disease / complications*
  • Adult
  • Diabetes Complications*
  • Diabetes Mellitus / drug therapy
  • Female
  • Graves Disease / complications*
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Insulin / administration & dosage*
  • Thyroiditis, Autoimmune / complications*

Substances

  • Hypoglycemic Agents
  • Insulin