Emergence of Autoimmune Type 1 Diabetes and Acute Adrenal Crisis Following Coronavirus Disease 2019

A 60-year-old male presented with extreme fatigue and weight loss 3 weeks after testing positive for coronavirus disease 2019. The course of coronavirus disease 2019 was mild, without pulmonary involvement. The patient showed symptoms and laboratory signs of new-onset diabetes without ketoacidosis and acute primary adrenal insufficiency, the latter of which was confirmed with an adrenocorticotrophic hormone stimulation test. Glutamic acid decarboxylase-65 antibody and antibodies to the adrenal cortex were positive in high titers. Previous medical records of the patient revealed no hyperglycemia or electrolyte abnormalities prior to current admission, but an earlier test result was compatible with primary hypothyroidism which was associated with autoimmune thyroiditis. He was therefore diagnosed with autoimmune polyglandular syndrome type II. Clinical and laboratory findings improved after starting appropriate hormone replacement therapies along with insulin. Coronavirus disease 2019 may induce a variety of autoimmune disorders in susceptible subjects. In our case, coronavirus disease 2019 might have simply precipitated type 1 diabetes and adrenal insufficiency in whom autoimmune thyroiditis may have been the first manifestation of an undiagnosed autoimmune polyglandular syndrome type II. Coronavirus disease 2019 might have triggered autoimmunity in the patient who was possibly predisposed to autoimmune disorders. Anyhow, more research is required to evaluate the possible link between coronavirus disease 2019 and autoimmune disorders.

Cite this article as: Oğuz SH, Gürlek A. Emergence of autoimmune type 1 diabetes and acute adrenal crisis following coronavirus disease 2019. Endocrinol Res Pract. 2024;28(1):60-63.