Schmidt syndrome mimicking depression and refractory hypotension in critically ill patient – Case Report and Literature Review

Abstract

Schmidt syndrome is a disorder of the endocrine system associated with both autoimmune thyroid disease and primary adrenal insufficiency. Nondistinctive nature and delayed appearance of the symptoms are difficult to diagnose. Moreover, an untreated adrenal insufficiency crisis may lead to a life-threatening condition requiring rapid treatment, which includes corticosteroids supplementation. We present a case of a 21-year-old male, with a history of thyroid disorder and depression, who was admitted to the intensive care unit due to COVID-19 with circulatory insufficiency including persistent hypotension and electrolyte imbalances. The patient was diagnosed with Schmidt syndrome and proper treatment was implemented. Although Schmidt syndrome is a rare condition, appropriate diagnosis is a key to introducing proper treatment, which despite being a lifetime commitment, can resolve all the symptoms.