End-Stage Renal Disease in a Patient With Schmidt's Syndrome: A Case Report

Abstract

Schmidt's syndrome constitutes Addison's disease in conjunction with autoimmune hypothyroidism or type 1 diabetes mellitus. It has misleading symptomology and an unclear order of presentation of symptoms. This often results in missed and late diagnosis. Chronic kidney disease is a rarely reported phenomenon in Schmidt's syndrome. Multiple factors may have the potential to cause renal failure, such as Addison's disease and/or hypothyroidism, the understanding of which is still evolving. A 45-year-old gentleman who is a known case of Schmidt's syndrome presented to us with fatigue, anorexia, and weight gain. Further evaluation revealed a picture of chronic kidney disease. We would like to alert fellow peers of this potential complication and the importance of screening as well as timely diagnosis.

Keywords: addison's disease; end-stage renal disease (esrd); endocrinology; polyendocrine autoimmune syndromes; schmidt syndrome.

Figure 1. A) Image showing abdominal distention, striations (arrow), and hyperpigmentation; B) Patch of hyperpigmentation visible on the patient's forehead

Figure 2. Bilateral shrunken kidneys (sizes 6.69 and 7.52 cm, respectively)