title: An autoimmune polyglandular syndrome complicated with celiac disease and autoimmune hepatitis.
abstract: Autoimmune polyglandular syndrome (APS) is a combination of different autoimmune diseases. The close relationship between immune-mediated disorders makes it mandatory to perform serological screening periodically in order to avoid delayed diagnosis of additional autoimmune diseases. We studied a patient with type 1 diabetes (T1D) who later developed an autoimmune thyroid disease (ATD) and was referred to our hospital with a serious condition of his clinical status. The patient was suffering from an advance stage of celiac disease (CD), the delay in its diagnosis and in the establishment of a gluten-free dietled the patient to a severe proteincalorie malnutrition. Later, the patient developed an autoimmune hepatitis (AIH). We consider that clinical deterioration in patients with APS should alert physicians about the possible presence of other immune-mediated diseases. Periodic screening for autoantibodies would help to prevent delayed diagnosis and would improve patient's quality of life.
authors.affiliation: UGC de Inmunología Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: Romina
authors.initials: R
authors.lastname: Dieli-Crimi
authors.affiliation: UGC de Inmunología Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: Concepción
authors.initials: C
authors.lastname: Núñez
authors.affiliation: Servicio de Anatomía Patológica Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Estrada
authors.affiliation: Servicio de Aparato Digestivo. Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: López-Palacios
mesh_terms: D001323:Autoantibodies / Q000276:immunology; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy / Q000276:immunology; D057210:Delayed Diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D055050:Diet, Gluten-Free; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016884:Polyendocrinopathies, Autoimmune / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D011502:Protein-Energy Malnutrition / Q000175:diagnosis* / Q000209:etiology; D013967:Thyroiditis, Autoimmune / Q000150:complications / Q000175:diagnosis* / Q000276:immunology
chemical_list: D001323:Autoantibodies