A rare case of autoimmune polyglandular syndrome type 3.
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.
Shimomura
Hiroko
H
The 1st Department of Medicine, Wakayama University of Medical Science, 811-1 Kimiidera, Wakayama City 641-8509, Japan.
Nakase
Yukiho
Y
Furuta
Hiroto
H
Nishi
Masahiro
M
Nakao
Taisei
T
Hanabusa
Tadashi
T
Sasaki
Hideyuki
H
Okamoto
Katuyuki
K
Furukawa
Fukumi
F
Nanjo
Kishio
K
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
D001323:Autoantibodies; D006728:Hormones; D005968:Glutamate Decarboxylase