[Anogenital condylomata acuminata, mucocutaneous candidiasis, vitiligo, keratopathy and primary hypoparathyroidism in an autoimmune polyglandular syndrome type 1].
METHODS
6 months before admission a 21-year-old woman had developed anogenital condylomata acuminata (CA). Since early childhood she had been treated for primary hypoparathyroidism (PHPT) and recurrent mucocutaneous candidiasis. 5 years before admission corneal clouding had caused visual impairment. Recently, mainly truncal vitiligo with occipital poliosis had developed.


METHODS
PHPT was confirmed (parathormone level 7.7 mg/l). In addition, liver transaminases were raised (GOT 105.8 U/l, GPT 145.6 U/l, gamma-GT 56.8 U/l), pointing to noninfectious hepatitis. An ACTH stress test could not exclude manifest adrenocortical insufficiency, and thyroid function was also normal. The Merieux Multitest indicated an anergy.


METHODS
The constellation of test results suggested autoimmune polyglandular syndrome type I. The condylomata were treated by electrocautery and the intestinal candidiasis with amphotericin B suspension. Calcitriol capsules, 0.5 microgram, and calcium gluconate or lactate, 500 and 300 mg respectively, 3 times daily each, were given for the PHPT.


CONCLUSIONS
This case demonstrates a complex syndrome which can be recognized early by simple clinical tests. Early diagnosis prevents possible life-threatening complications.
Oblinger
E
E
Abteilung Dermatologie, Universität Ulm, Stuttgart, New York, USA.
Cibis
A
A
Peter
R U
RU
Proebstle
T M
TM
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001004:Anus Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D002117:Calcitriol / Q000627:therapeutic use; D002125:Calcium Gluconate / Q000627:therapeutic use; D002178:Candidiasis, Chronic Mucocutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002214:Capsules; D003218:Condylomata Acuminata / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003318:Corneal Opacity / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004359:Drug Therapy, Combination; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D007011:Hypoparathyroidism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007773:Lactates / Q000627:therapeutic use; D016884:Polyendocrinopathies, Autoimmune / Q000150:complications*; D012535:Scalp; D013535:Suspensions; D014623:Vaginal Diseases / Q000209:etiology / Q000601:surgery; D014820:Vitiligo / Q000175:diagnosis / Q000209:etiology*
D000935:Antifungal Agents; D002214:Capsules; D007773:Lactates; D013535:Suspensions; D000666:Amphotericin B; D002117:Calcitriol; D002125:Calcium Gluconate