AUTOIMMUNE POLYGLANDULAR SYNDROME TYPE 2 PRESENTING AS PANCYTOPENIA: A RARE CASE REPORT

Autoimmune Polyglandular Syndrome Type 2 (APS-2) is a rare autoimmune disorder characterized by the coexistence of primary adrenal insufciency (Addison's disease), autoimmune thyroid disease, and type 1 diabetes mellitus. It can also be associated with other autoimmune conditions, such as pernicious anemia. Early recognition and timely intervention are crucial to prevent life-threatening complications. We report the case of a 40-year-old male who presented with progressive fatigue, dyspnea, jaundice, and bleeding tendencies. Initial laboratory ndings revealed pancytopenia with vitamin B12 deciency, leading to a provisional diagnosis of pernicious anemia secondary to chronic alcohol use. However, further evaluation revealed autoimmune thyroiditis, adrenal insufciency, and type 1 diabetes mellitus, ultimately leading to a conrmed diagnosis of APS-2. The patient was promptly treated with hydrocortisone for adrenal insufciency, vitamin B12 supplementation, levothyroxine for hypothyroidism, and insulin for glycemic control. Early intervention resulted in symptom resolution. This case highlights a rare and atypical presentation of APS-2, initially manifesting as pancytopenia due to pernicious anemia. It underscores the importance of a high index of suspicion and thorough diagnostic evaluation in patients with multiple autoimmune conditions. Early diagnosis and appropriate treatment are essential to prevent severe complications such as Addison's crisis and myxedema coma.