Autoimmune Polyglandular Syndrome Type 2 with Alopecia Universalis and Hypoparathyroidism.

A 46 years old female, presented with severe fatigue, hypotension and hyperpigmentation. Her basal serum cortisol level at 8 a.m. was <1.0 µg/ dl which suggested a diagnosis of Addison’s disease. An association with latent autoimmune diabetes of adult and autoimmune hypothyroidism led to a diagnosis of Polyglandular Autoimmune Syndrome type II (PAS II). She also had alopecia universalis and hypoparathyroidism which are very rare in PAS type II syndrome. On treatment with hydrocortisone and fludrocortisone there was drastic improvement in the clinical features.