open access

Ahead of print
Clinical vignette
Published online: 2021-04-08
Submitted: 2021-02-18
Accepted: 2021-02-23
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Autoimmune polyglandular syndrome type 3 with multiple genetic alterations in a young male patient with type 1 diabetes mellitus

Abel Decmann, Judit Tőke, Éva Csöregh, Géza Gáspárdy, Anikó Somogyi
DOI: 10.5603/EP.a2021.0035
·
Pubmed: 34010447

open access

Ahead of print
Clinical Vignette
Published online: 2021-04-08
Submitted: 2021-02-18
Accepted: 2021-02-23

Abstract

Introduction: Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases among young and adolescent patients. A genetically predisposed person develops autoantibodies against beta-cells after certain environmental stimuli. Patients with T1DM can develop other organ-specific autoantibodies, most often causing autoimmune thyroiditis, coeliac disease or pernicious anaemia. Patients with multiple autoimmune diseases might be diagnosed with one of the autoimmune polyglandular syndromes. Case presentation: We present a 32-year-old male patient with type 1 diabetes mellitus and Hashimoto-thyroiditis. The habitus and laboratory tests taken at admission led us to further investigations, tests were done to confirm pernicious anaemia, hyperhomocysteinemia and ankylosing spondylitis, as well. The latter disease raises the already higher cardiovascular risk of the diabetic patient. Conclusion: Patients with autoimmune type 1 diabetes mellitus should undergo screening for other autoimmune diseases, most importantly, autoimmune thyroid disease, pernicious anaemia and may be hyperhomocysteinaemia and primary adrenal insufficiency.

Abstract

Introduction: Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases among young and adolescent patients. A genetically predisposed person develops autoantibodies against beta-cells after certain environmental stimuli. Patients with T1DM can develop other organ-specific autoantibodies, most often causing autoimmune thyroiditis, coeliac disease or pernicious anaemia. Patients with multiple autoimmune diseases might be diagnosed with one of the autoimmune polyglandular syndromes. Case presentation: We present a 32-year-old male patient with type 1 diabetes mellitus and Hashimoto-thyroiditis. The habitus and laboratory tests taken at admission led us to further investigations, tests were done to confirm pernicious anaemia, hyperhomocysteinemia and ankylosing spondylitis, as well. The latter disease raises the already higher cardiovascular risk of the diabetic patient. Conclusion: Patients with autoimmune type 1 diabetes mellitus should undergo screening for other autoimmune diseases, most importantly, autoimmune thyroid disease, pernicious anaemia and may be hyperhomocysteinaemia and primary adrenal insufficiency.

Get Citation

Keywords

diabetes mellitus type 1; pernicious anaemia; Hashimoto-thyroiditis; homocysteine; autoimmune polyglandular syndrome

About this article
Title

Autoimmune polyglandular syndrome type 3 with multiple genetic alterations in a young male patient with type 1 diabetes mellitus

Journal

Endokrynologia Polska

Issue

Ahead of print

Article type

Clinical vignette

Published online

2021-04-08

DOI

10.5603/EP.a2021.0035

Pubmed

34010447

Keywords

diabetes mellitus type 1
pernicious anaemia
Hashimoto-thyroiditis
homocysteine
autoimmune polyglandular syndrome

Authors

Abel Decmann
Judit Tőke
Éva Csöregh
Géza Gáspárdy
Anikó Somogyi

References (5)
  1. Mayer-Davis EJ, Kahkoska AR, Jefferies C, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2018; 19 Suppl 27: 7–19.
  2. Morawiec-Szymonik E, Foltyn W, Marek B, et al. Pernicious anaemia and endocrine glands antibodies. Endokrynol Pol. 2019; 70(2): 143–150.
  3. Zalawadiya SK, Veeranna V, Mallikethi-Reddy S, et al. Homocysteine and reclassification of cardiovascular disease risk. J Am Coll Cardiol. 2011; 58(10): 1025–1033.
  4. Botto LD, Yang Q. 5,10-Methylenetetrahydrofolate reductase gene variants and congenital anomalies: a HuGE review. Am J Epidemiol. 2000; 151(9): 862–877.
  5. Clarke R, Bennett DA, Parish S, et al. MTHFR Studies Collaborative Group. Homocysteine and coronary heart disease: meta-analysis of MTHFR case-control studies, avoiding publication bias. PLoS Med. 2012; 9(2): e1001177.

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