Synonym: Schmidt's Syndrome with Addison's Disease plus hypothyroidism
Onset: variable, evolves with age
First degree family members show multiple endocrine disorders, but the type and severity may differ between individuals.
Endocrine disorders:
(1) Addison's disease
(2) chronic thyroiditis
(3) type 1A diabetes mellitus and/or intermittent hypoglycemia
Some patients present with one endocrine disorder, with other disorders appearing as the patient gets older.
Clinical findings:
(1) hypotension (associated with Addison's disease)
(2) hyperpigmentation and/or vitiligo
(3) intermittent, severe fatigue
HLA types: HLA-DQ2, HLA-DQ8, HLA-DRB1*0404
Autoantibodies may include (and may appear before clinically symptomatic):
(1) 21-hydroxylase autoantibodies
(2) related to autoimmune diabetes
(3) related to autoimmune thyroiditis
Exclusions:
(1) autoimmune polyendocrinopathy type I
(2) other polyendocrine disorders
