[An unusual clinical presentation of the autoimmune polyendocrine syndrome].
Organ-specific autoimmune endocrine disorders may occur together in autoimmune polyendocrine syndromes (APS). The diverse names given to APS and the underestimation of their real frequency reflect the large number of studies and case reports concerning these patients and heterogeneity in their clinical presentation. In this article we report the case of a 64-year-old man, initially diagnosed with Addison's disease and type 2 diabetes mellitus. Clinical examination, laboratory tests and radiological examination revealed the presence of co-existing Graves' disease and enabled us to classify the type of his diabetes as latent autoimmune diabetes in adults (LADA). Taking into account all his disorders, we assume that our patient suffers from a variant of type 2 APS. In the described state of the examined patient, accurate diagnosis, modification of hitherto treatment and implementation of new treatment strategies not only improved his clinical status but also allowed avoiding unnecessary administration of some drugs. This case illustrates the need for clinical awareness of APS in patients with any diagnosed autoimmune endocrine disorder.
Krysiak
Robert
R
Katedra Farmakologii, Zakład Farmakologii Klinicznej Sl. AM, Katowice. r.krysiak@pharmanet.com.pl
Okopień
Bogusław
B
Herman
Zbigniew Stanisław
ZS
D000224:Addison Disease / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D003937:Diagnosis, Differential; D005968:Glutamate Decarboxylase / Q000276:immunology / Q000378:metabolism; D006111:Graves Disease / Q000276:immunology; D006801:Humans; D007011:Hypoparathyroidism / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D007515:Islets of Langerhans / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016884:Polyendocrinopathies, Autoimmune / Q000175:diagnosis* / Q000276:immunology*; D011877:Radionuclide Imaging; D013577:Syndrome; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000276:immunology; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis / Q000276:immunology / Q000628:therapy
D001323:Autoantibodies; D005968:Glutamate Decarboxylase