A clinical challenge: delayed diagnosis of autoimmune polyglandular syndrome type II in a patient with thyroid eye disease

Emma M Hartness; Arnulfo Garza Reyes; Rupin N Parikh; Nicholas J Lepa; Leili Rahimi; Erin M Shriver

doi:10.1080/01676830.2024.2433120

Back

A clinical challenge: delayed diagnosis of autoimmune polyglandular syndrome type II in a patient with thyroid eye disease

Journal article

Peer reviewed

A clinical challenge: delayed diagnosis of autoimmune polyglandular syndrome type II in a patient with thyroid eye disease

Emma M Hartness, Arnulfo Garza Reyes, Rupin N Parikh, Nicholas J Lepa, Leili Rahimi and Erin M Shriver

Orbit (Amsterdam), Vol.44(5), pp.584-587

09/03/2025

DOI: 10.1080/01676830.2024.2433120

PMID: 39772977

View Online

Abstract

A 35-year-old woman with thyroid eye disease (TED) was found to have autoimmune polyglandular syndrome type II (APS-II) 1 year after developing symptoms of this rare syndrome, during which she underwent 8 emergency department visits before receiving a targeted endocrinology workup. Thyroid disease is the second most common autoimmune syndrome associated with APS-II after primary adrenal insufficiency. Identification of this syndrome is critical as it can be life-threatening if left untreated. Additionally, if associated hypothyroidism is treated with levothyroxine, adrenal crisis can occur. The patient described symptoms, some of which overlapped with those of TED, and a significant delay in diagnosis occurred. Discussion of this patient's course highlights the importance of ophthalmologists keeping APS-II in mind when seeing patients with thyroid eye disease.

autoimmune thyroid disease

type I diabetes mellitus

autoimmune polyglandular syndrome type II

autoimmune primary adrenal insufficiency

Thyroid eye disease

Details

Title: Subtitle: A clinical challenge: delayed diagnosis of autoimmune polyglandular syndrome type II in a patient with thyroid eye disease
Creators: Emma M Hartness - University of Iowa
Arnulfo Garza Reyes - Department of Ophthalmology and Visual Sciences, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
Rupin N Parikh - University of Iowa
Nicholas J Lepa - Mercy Medical Center
Leili Rahimi - Mayo Clinic
Erin M Shriver - University of Iowa
Resource Type: Journal article
Publication Details: Orbit (Amsterdam), Vol.44(5), pp.584-587
DOI: 10.1080/01676830.2024.2433120
PMID: 39772977
NLM abbreviation: Orbit
ISSN: 0167-6830
eISSN: 1744-5108
Publisher: TAYLOR & FRANCIS INC
Grant note: Research to Prevent Blindness
This work was supported by the Research to Prevent Blindness [Unrestricted grant to the University of Iowa Department of Ophthalmology and Visual Sciences].
Language: English
Electronic publication date: 01/07/2025
Date published: 09/03/2025
Academic Unit: Otolaryngology; Ophthalmology and Visual Sciences
Record Identifier: 9984772249002771

Metrics

15 Record Views