A Polyendocrine Puzzle: Unravelling Schmidt Syndrome (Autoimmune Polyendocrine Syndrome Type II) Presenting in Crisis

Schmidt syndrome is a rare autoimmune disorder with polygenic inheritance that results in damage to specific organs due to lymphocytic infiltration. It is characterised by the coexistence of at least two of the following: Addison's disease, autoimmune thyroid disease (Graves' disease or hypothyroidism) and type 1 diabetes mellitus (T1DM). We report such a rare case, in which a 34-year-old woman presented with symptoms of adrenal insufficiency and was diagnosed with Schmidt syndrome. Prompt recognition, patient education and long-term multidisciplinary follow-up are essential for optimal management of such conditions. Empirical glucocorticoid therapy before a definitive diagnosis was crucial in the management of such a crisis. This case highlights the rarity and diagnostic challenges of this syndrome, in which nonspecific symptoms, along with overlapping autoimmune conditions, may delay diagnosis and subsequent management.