Type II Autoimmune Polyglandular Syndrome: Case Report and Review of Literature

摘要

Autoimmune polyglandular syndromes include involvement of multiple endocrine glands. In patients with these syndromes, hypofunction of multiple endocrine glands is induced by autoimmunity and occurs in well-described patterns. Features of type I autoimmune polyglandular syndrome include hy-poparathyroidism, recurrent mucocutaneous can-didiasis, and adrenal insufficiency. Major features of type II autoimmune polyglandular syndrome are type 1 diabetes mellitus, adrenocortical insufficiency, and primary hypothyroidism. Commonly, patients present with one component of the syndrome and the other components do not become evident clinically for a number of years.We report the case of a 39-year-old woman with type II autoimmune polyglandular syndrome.This patient presented with simultaneous onset of all three major features of this syndrome: type 1 diabetes mellitus, adrenocortical insufficiency, and hypothyroidism. We review literature and describe current classification of polyglandular syndromes. Consequences of untreated adrenocortical insufficiency can be dire. Detection of autoantibodies and or measurement of elevated tropic hormones can help us diagnose hypofunction of a variety of endocrine glands at an asymptomatic stage. When a clinician diagnoses one or more features of autoimmune polyglandular syndrome, she/he should be on the look out for deficiencies of other endocrine glands in the preclinical or clinical stage.