[Autoimmune polyglandular syndrome type 2 and osteoporosis in a 69 years old patient]

We present a case of a 69 year old female with autoimmune polyglandular syndrome type 2 or Schmidt's syndrome. The syndrome consists of primary autoimmune adrenocortical insufficiency (Addison's disease), autoimmune hypothyroidism, and type 1 diabetes. In the presented case Addison's disease was diagnosed on the basis of clinical symptoms, low serum cortisol level: at 8 am 129,1 nmol/l (reference range 220,70-689,70), and high ACTH level: 1540,8 pg/ml (reference range 0-50). Hypothyroidism was diagnosed with serum TSH of 4,46 microU/ml (rr 0,20-3,50), aTPO antibodies titer was 117 U/ml (rr 0-60). The patient also presented insulin dependent diabetes treated with insulin and osteoporosis with a compressive vertebral fracture and a hip fracture in the past (hip T-score = -2,62). After substitutional pharmacotherapy was implemented, the patient was discharged in good health. Possible correlation between bone metabolism disorders and autoimmune polyglandular syndrome needs further investigation.