IntroductionPatients may present with autoimmune conditions abruptly or, more commonly, slowly over time requiring increased vigilance on part of their physician. Though many combinations have been previously described and linked to genetic etiologies, most physicians deal with one problem at a time until there is a realization that a polyglandular process is ongoing. Obviously, one of the most feared autoimmune syndromes is adrenal insufficiency, since unrecognized, it can lead to death. A question that is commonly asked on board exams for primary care providers. We present a case of a patient with a variety of autoimmune diseases presenting over time and on occasion with a complete surprise.
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