Abad OJF, Rosas A

Language: Spanish
References: 16
Page: 152-158
PDF size: 231.33 Kb.

ABSTRACT

Background: Type 2 polyglandular autoimmune syndrome is a rare condition characterized by at least two glandular failures induced by autoimmunity, which always includes Addison’s disease, plus type 1 diabetes mellitus and/or autoimmune thyroid diseases.
Clinical case: A 38-year-old female patient with a history of type 1 diabetes mellitus who was admitted to Internal medicine service with a diagnosis of “septic shock of urinary origin”, without elevation of acute phase reactants or data of systemic inflammatory response, with gastrointestinal symptoms, plus hyperchromic lesions in mucosa, electrolyte disturbance sodium 119.13 mEq/L, potassium 6.1 mEq/L, cortisol levels 1.63 µg/dL and antithyroperoxidase titers greater than 2000 ng/dL, leading to a diagnosis of autoimmune polyglandular syndrome type II.
Conclusions: Autoimmune polyglandular syndrome should be considered in all patients with primary glandular disease, as in this case, with the purpose of perform a timely diagnosis, treatment, and follow-up of this affection to avoid fatal complications such as adrenal crises, present in this case.

REFERENCES

1. Ulises N. Síndrome poliglandular autoimmune. Rev MedHosp Gen Méx 2013; 76 (3): 143-152.

2. Husebye E., Anderson M., Kämpe O, Autoimmune polyendocrinesyndromes, N Engl J Med 2018; 378: 1132-41. DOI:10.1056/NEJMra1713301.

3. Lara F, George J. Autoimmune polyendocrinopathy. J ClinEndocrinol Metab 2019; 104 (10): 4769-4782. doi: 10.1210/jc.2019-00602.

4. Arya K, Kumar J, Unnikrishnan D, Raj R. Case of autoimmunepolyglandular syndrome type 2: how we uncovered thediagnosis. BMJ Case Rep 2019; 12: e227187. doi:10.1136/bcr-2018-227187.

5. Kahaly G, Frommer L. Polyglandular autoimmune syndromes.J Endocrinol Invest 2018; 41: 91-98. doi.org/10.1007/s40618-017-0740-9.

6. Husebye E, Pearce S, Krone N, Kämpe O. Adrenal insufficiency.Lancet 2021; 397: 613-29. doi.org/10.1016/ S0140-6736(21)00136-7.

7. Kumar MP, Thyagarajan B, Haller N, Ciltea D. A diagnosticconundrum of distributive shock: Autoimmune polyglandularsyndrome type II. Indian J Crit Care Med 2019; 23 (12):582-583. doi: 10.5005/jp-journals-10071-23297.

8. Kahaly GJ, Frommer L. Autoimmune polyglandular diseases.Best Pract Res Clin Endocrinol Metab 2019; 33 (6):101344. DOI: 10.1016/j.beem.2019.101344.

9. Manso J, Censi S, Iacobone M, Galuppini F, et al. First proofof association between autoimmune polyglandular syndromeand multiple endocrine neoplasia in humans. EndocrineJ 2020; 67 (9): 929-934 DOI: 10.1507/endocrj.EJ20-0099.

10. Dick M, Croxson M. A rare simultaneous manifestation ofpolyglandular autoimmune syndrome type II. EndocrinolDiabetes Metab Case Rep 2020; 20-0051. doi-org.pbidi.unam.mx:2443/10.1530/EDM-20-0051.

11. Kahaly G. Polyglandular autoimmune syndrome type II.Presse Med 2012; 41 (12 P 2): e663-70. doi: 10.1016/j.lpm.2012.09.011.

12. Murphy SA, Mohd Din FH, O’Grady MJ. Adolescent onsetof autoimmune polyglandular syndrome type 2. BMJ CaseRep 2022; 15 (5): e249839. doi: 10.1136/bcr-2022-249839.

13. Schulz L, Hammer E. Autoimmune polyglandular syndrometype II with co-manifestation of Addison’s and Graves’disease in a 15-year-old boy: case report and literaturereview. J Pediatr Endocrinol Metab 2020; 33 (4): 575-578.doi: 10.1515/jpem-2019-0506.

14. Pham G, Hanák L, Hegyi P, Márta K, et al. Prevalence ofother autoimmune diseases in polyglandular autoimmunesyndromes type II and III. J Endocrinol Invest 2020; 43 (9):1-9. doi: 10.1007/s40618-020-01229-1.

15. Staub K, Abrams P. Novel presentation of autoimmunepolyglandular syndrome II in a child with simultaneousAddison’s disease, type 1 diabetes, and Hashimoto’s thyroiditis:A case report. Clin Case Rep 2021; 9 (8): e04453. doi:10.1002/ccr3.4453.

16. Costa Martins S, Venade G, Teixeira M, Olivério J, et al.Autoimmune polyglandular syndrome type 2. Rev AssocMed Bras 2019; 65 (12): 1434-1437. doi: 10.1590/1806-9282.65.12.1434