{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:30:26Z","timestamp":1790829026157,"version":"4.1.0"},"reference-count":26,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,5,12]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>An adolescent female was evaluated for fatigue, anorexia and unintentional weight loss of 7\u2009kg. Initial investigations revealed subclinical autoimmune thyroid dysfunction, which progressed to overt hypothyroidism necessitating thyroxine replacement. She had entered early puberty, but this did not appear to be progressing. A high index of suspicion for coexisting endocrinopathies resulted in a diagnosis of Addison\u2019s disease and consequently autoimmune polyglandular syndrome type 2 (Schmidt syndrome). While basal gonadotropins were normal, anti-Mullerian hormone was low and ovarian autoantibodies were positive, consistent with preclinical premature ovarian failure. Glucocorticoid and mineralocorticoid replacement were instituted. Puberty progressed and menarche was subsequently attained. Screening for other autoantibodies was undertaken; however, none are positive to date.<\/jats:p>","DOI":"10.1136\/bcr-2022-249839","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T07:41:34Z","timestamp":1653291694000},"page":"e249839","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Adolescent onset of autoimmune polyglandular syndrome type 2"],"prefix":"10.1136","volume":"15","author":[{"given":"Siobhan A","family":"Murphy","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Midland Regional Hospital, Mullingar, Westmeath, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fazly Helmi","family":"Mohd Din","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Midland Regional Hospital, Mullingar, Westmeath, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5997-0560","authenticated-orcid":false,"given":"Michael Joseph","family":"O'Grady","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Midland Regional Hospital, Mullingar, Westmeath, Ireland"},{"name":"Women\u2019s & Children\u2019s Health, University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,20]]},"reference":[{"key":"2025082709044875000_15.5.e249839.1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021845"},{"key":"2025082709044875000_15.5.e249839.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2249.2004.02561.x"},{"key":"2025082709044875000_15.5.e249839.3","doi-asserted-by":"publisher","DOI":"10.1136\/adc.66.3.350"},{"key":"2025082709044875000_15.5.e249839.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-543X.2004.00056.x"},{"key":"2025082709044875000_15.5.e249839.5","doi-asserted-by":"publisher","DOI":"10.1159\/000178698"},{"key":"2025082709044875000_15.5.e249839.6","first-page":"196","article-title":"Autoimmune polyglandular syndrome type 2: an unusual presentation","volume":"48","author":"Karamifar","year":"2010","journal-title":"Acta Med Iran"},{"key":"2025082709044875000_15.5.e249839.7","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1515\/jpem.2010.189","article-title":"21-Hydroxylase autoantibody-negative Addison's disease in a 5-year-old boy with adrenal crisis and type 1 diabetes mellitus","volume":"23","author":"Chang","year":"2010","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2025082709044875000_15.5.e249839.8","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1515\/JPEM.2010.23.7.725","article-title":"Six year old with autoimmune polyglandular syndrome: can genetics tell us the story?","volume":"23","author":"Ghanny","year":"2010","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2025082709044875000_15.5.e249839.9","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1515\/jpem-2013-0201","article-title":"Acute mental status change as the presenting feature of adrenal insufficiency in a patient with autoimmune polyglandular syndrome type II and stroke","volume":"27","author":"Watson","year":"2014","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2025082709044875000_15.5.e249839.10","doi-asserted-by":"crossref","DOI":"10.1186\/1756-0500-7-634","article-title":"Recurrent hypoglycaemia in type-1 diabetes mellitus may unravel the association with Addison's disease: a case report","volume":"7","author":"Passanisi","year":"2014","journal-title":"BMC Res Notes"},{"key":"2025082709044875000_15.5.e249839.11","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2014-206344"},{"key":"2025082709044875000_15.5.e249839.12","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.endonu.2015.07.001","article-title":"Hyponatremic rhabdomyolysis in Addison's disease in a child with autoimmune polyglandular syndrome type 2","volume":"62","author":"Mart\u00edn-Campagne","year":"2015","journal-title":"Endocrinol Nutr"},{"key":"2025082709044875000_15.5.e249839.13","first-page":"199","article-title":"Autoimmune polyglandular syndrome type II - 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