Autoimmune Addison's disease and thyrotoxic thyroiditis presenting as encephalopathy in twins

Abstract

An 11 year old boy who presented with neuropsychiatric symptoms including delirium and pronounced agitation was found to have simultaneous onset of autoimmune adrenocortical insufficiency and hyperthyroidism. His identical twin also had hyperthyroidism and six months later developed symptoms of adrenocortical insufficiency. In children presenting with neuropsychiatric symptoms, adrenal (or pituitary) and other endocrine disorders should be considered.