# Allgrove Syndrome in Adults: A Case of an Atypical Presentation

## TL;DR

A 29-year-old woman was diagnosed with Allgrove syndrome after a decade of undiagnosed symptoms, emphasizing the need to consider this rare condition in adults with unexplained dysphagia.

## Contribution

This case highlights the atypical presentation of Allgrove syndrome in adults, which is often overlooked or delayed.

## Key findings

- Allgrove syndrome was diagnosed in a 29-year-old woman with chronic dysphagia, adrenal insufficiency, and alacrima.
- The patient's symptoms had persisted for over a decade before diagnosis, indicating a delay in recognition.
- Treatment with corticosteroids and pneumatic dilation led to a favorable outcome.

## Abstract

Allgrove syndrome, or "Triple A" syndrome, is a rare autosomal recessive disorder characterized by achalasia, alacrima, and adrenal insufficiency. Typically diagnosed in childhood or adolescence, its adult presentation remains under-recognized and challenging. We report the case of a 29-year-old Moroccan woman with chronic dysphagia, who was ultimately diagnosed with Allgrove syndrome following the discovery of type 1 achalasia, primary adrenal insufficiency, and alacrima. The diagnosis was delayed, and symptoms had persisted for over a decade before appropriate evaluation. Clinical, endoscopic, radiologic, and manometric findings confirmed the diagnosis. Therapeutic management included corticosteroids and pneumatic dilation, with a favorable outcome. This case highlights the importance of considering Allgrove syndrome in adults with unexplained dysphagia and systemic symptoms.