• Bonnie Stahn and Lorenz Scheit.
• Sanitätsversorgungszentrum Rotenburg/ Wümme.
• Dtsch. Med. Wochenschr. 2019 Dec 1; 144 (24): 1741-1744.

History And Clinical FindingsWe report the case within a 22-year-old patient, initially seen because of fatigue, weight loss and discoloration of the skin. A Hashimoto-Thyroditis had been diagnosed a few months prior to the clinical presentation.DiagnosticsBlood samples showed a hyponatremia and hyperkalemia. Addison's disease was diagnosed by management of cortisol, ACTH and adrenal antibodies. In combination with the previously diagnosed Autoimmune thyreoiditis the criteria for a Schmidt's Syndrome were fulfilled.Treatment And Clinical CourseWe initiated the substitution of Hydrocortisone (20 mg/d) and Fludrocortisone (0.1 mg/d) in combination with an increased levothyroxin-dosage (100 µg/d). The patient's condition improved over the course of a few days.ConclusionThe presented case underlines the importance of focused examinations and diagnostics when dealing with a patient with unspecific symptoms and a pre-existing autoimmune disease. This also applies to patients with a positive family history for autoimmune disorders.© Georg Thieme Verlag KG Stuttgart · New York.

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