title: A rare case of autoimmune polyglandular syndrome type 3.
abstract: A 57-year-old female was admitted to our hospital suffering from a lower lip tumor, small ulcers in the arms and alopecia of the head. Because she had type 2 diabetes mellitus (DM) for the past 3 years, she was referred to our department of internal medicine for its treatment. Her endogenous insulin secretion was much decreased despite the short duration of diabetes. Glutamic acid decarboxylase antibodies (GADA) and islet cell antibodies (ICA) were both positive. Therefore, she was diagnosed as having slowly progressive form of type 1 DM. Type 1 DM is sometimes complicated with autoimmune disorders. After further examinations, she was diagnosed as having Sjögren's syndrome, Graves' disease and autoimmune neutropenia (AIN). According to the histological examinations of the lip tumor and peripheral site of the skin ulcer, the patient was diagnosed as having carcinoma spinocellulare and chronic cutaneous lupus erythematosus. The examination also showed positive anti-intrinsic factor and anti-ribonucleoprotein (RNP) antibodies. She is a rare case of an autoimmune polyglandullar syndrome (APS) type 3 simultaneously manifesting these seven diseases with multiple autoimmune antibodies.
authors.affiliation: The 1st Department of Medicine, Wakayama University of Medical Science, 811-1 Kimiidera, Wakayama City 641-8509, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Shimomura
authors.forename: Yukiho
authors.initials: Y
authors.lastname: Nakase
authors.forename: Hiroto
authors.initials: H
authors.lastname: Furuta
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nishi
authors.forename: Taisei
authors.initials: T
authors.lastname: Nakao
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hanabusa
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sasaki
authors.forename: Katuyuki
authors.initials: K
authors.lastname: Okamoto
authors.forename: Fukumi
authors.initials: F
authors.lastname: Furukawa
authors.forename: Kishio
authors.initials: K
authors.lastname: Nanjo
mesh_terms: D000505:Alopecia / Q000175:diagnosis; D001323:Autoantibodies / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005968:Glutamate Decarboxylase / Q000097:blood; D006111:Graves Disease / Q000175:diagnosis; D006728:Hormones / Q000097:blood / Q000276:immunology; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology; D008179:Lupus Erythematosus, Discoid / Q000175:diagnosis; D008875:Middle Aged; D009503:Neutropenia / Q000175:diagnosis; D016884:Polyendocrinopathies, Autoimmune / Q000175:diagnosis* / Q000503:physiopathology; D012859:Sjogren's Syndrome / Q000175:diagnosis; D012878:Skin Neoplasms / Q000175:diagnosis
chemical_list: D001323:Autoantibodies; D006728:Hormones; D005968:Glutamate Decarboxylase