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Autoimmune polyglandular syndrome type 2 — SCE Endocrinology MCQ

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ModerateAdrenalAutoimmune polyglandular syndrome type 2SCE Endocrinology

A 37-year-old woman has fatigue, hyperpigmentation and primary adrenal insufficiency. Anti-21-hydroxylase antibodies are positive. TSH is 11 mU/L and free T4 is low. What is the underlying pathophysiology?

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Correct answer: C — Autoimmune polyglandular syndrome type 2

Autoimmune Addison's disease with autoimmune hypothyroidism is typical of autoimmune polyglandular syndrome type 2. MEN syndromes cause endocrine tumours rather than autoimmune adrenal failure. Recognition prompts screening for other autoimmune diseases such as type 1 diabetes and coeliac disease.

Reference: Society for Endocrinology Guidance; NICE NG243