Recurrent hypoglycaemia in type-1 diabetes mellitus may unravel the association with Addison’s disease: a case report

BMC Research Notes

Manuela Caruso-Nicoletti¹  Donatella Lo Presti¹  Tiziana Timpanaro¹  Stefano Passanisi¹ 

[1]Department of Medical and Pediatric Sciences, University of Catania

[2] Azienda Ospedaliero Universitaria Policlinico-Vittorio Emanuele, Via Santa Sofia, n.78, 95123 Catania, Italy

关键词: Screening;    Hypoglycaemia;    Addison’s disease;    Type 1 diabetes mellitus;   

Others  :  1129556
DOI  :  10.1186/1756-0500-7-634

 received in 2014-02-18, accepted in 2014-09-08,  发布年份 2014

【 摘 要 】

Background

Primary adrenocortical insufficiency or Addison’s disease is caused by a progressive destruction of the adrenal cortex, resulting into a reduction of glucocorticoids, mineralocorticoids, and androgens. Autoimmune Addison’s disease is the most common etiological form, accounting for about 80% of all cases.

Case presentation

We describe the case of a 16-year-old Caucasian boy affected by type-1 diabetes mellitus and autoimmune thyroiditis, who experienced recurrent hypoglycaemia as presenting symptom of Addison’s disease.

Conclusions

Hypoglycaemia is not a common presenting feature of Addison’s disease, both in patients with type-1 diabetes mellitus and in non-diabetic patients. However, hypoglycaemia may occur in association with primary and secondary glucocorticoid deficiency as a result of an enhanced insulin sensitivity. Hypoglycaemia is the most common acute complication of insulin therapy in patients with type-1 diabetes mellitus. Addison’s disease has been described in approximately 0.5% of patients with type-1 diabetes mellitus, being more frequent in females and occurring in middle-aged patients. An association among type-1 diabetes mellitus, autoimmune thyroiditis, and Addison’s disease is found in the “Schmidt’s syndrome”, a rare disorder that may occur in the paediatric age. Our case suggests that the presence of Addison’s disease should be taken into consideration in patients with type-1 diabetes mellitus and frequent episodes of hypoglycaemia. We wish to highlight that there are no specific indications to screen for the association between Addison’s disease and type-1 diabetes mellitus, although an early diagnosis of Addison’s disease in diabetic patients would prevent the morbidity and potential mortality of this association.

【 授权许可】

   
2014 Passanisi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 2.

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