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Slow evolution of non-familial autoimmune polyglandular syndrome type II in a 54-year-old female, first presenting with Addison’s disease, then Hashimoto’s thyroiditis, which then transitioned to Graves’ disease and then the development of type 1 diabetes

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Case report reveals disease progression from Addison's to Hashimoto's thyroiditis and then Graves' disease, highlighting challenges in management.

This patient's diagnosis of Addison’s disease led to steroid replacement therapy, and she remained stable for nearly a decade.
In 2019, her condition transitioned to Hashimoto’s thyroiditis with elevated thyroid-stimulating hormone levels and positive antibodies.
By 2023, she developed Graves’ disease, confirmed by ultrasound and lab results including positive thyroid-stimulating immunoglobulin.
Screening indicated a risk for type 1 diabetes due to positive GAD65 antibodies and a 6.2% haemoglobin A1c, despite no overt hyperglycaemia.

E’leimat et al. (2025) studied this question.

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Case report reveals disease progression from Addison's to Hashimoto's thyroiditis and then Graves' disease, highlighting challenges in management.