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Clinical case report: history of diagnosis and clinical features of type autoimmune polyglandular syndrome 1

https://doi.org/10.14341/probl10295

Abstract

Autoimmune polyglandular syndrome type 1 (APS-1) is a rare disease with autosomal recessive inheritance and it caused by mutations in the autoimmune regulator (AIRE) gene. This disease has clinical polymorphism that including besides endocrinopathies other organ-specific manifestations and that complicates to diagnose of this condition on time. However, most often APS-1 has a characteristic debut and a certain stage of clinical symptom manifestation. This article describes a case report of an 18-year-old patient with confirmed APS-1, in which the course of disease was erased over a long period of life and didn’t meet of clinical criteria for the diagnosis in this syndrome. A high quality of life for such patients is possible with timely, individually selected replacement therapy with subsequent follow-up. It is important to remember the need for screening in risk groups for the formation of clinical forms of APS among the subjects presenting with a single endocrine pathology. The continuity of medical supervision by pediatric and adult endocrinological service physicians must be respected that can be traced on the example of the case from our practice.

About the Authors

Viktoriya V. Troshina
Endocrinology Research Center
Russian Federation

resident



Natalia Yu. Romanova
Endocrinology Research Centre
Russian Federation

MD



Leila S. Sozaeva
Endocrinology Research Centre
Russian Federation

MD, PhD



Ekaterina A. Troshina
Endocrinology Research Centre
Russian Federation

MD, PhD, professor, corresponding member of the RAS



References

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2. Ларина А.А., Трошина Е.А., Иванова О.Н. Аутоиммунные полигландулярные синдромы взрослых: генетические и иммунологические критерии диагностики // Проблемы эндокринологии. ― 2014. ― Т.60. ― №3. ― С. 43−52. [Larina AA, Troshina EA, Ivanova ON. Autoimmune polyglandular syndromes in the adults: the genetic and immunological diagnostic criteria. Problemy endokrinologii. 2014;60(3):43-52. (In Russ).] doi: https://doi.org/10.14341/probl201460343-52

3. Орлова Е.М. Генетические основы и клинические варианты аутоиммунного полигландулярного синдрома 1 типа: Автореф. дис. … канд. мед. наук. ― М.: Эндокрин. науч. центр РАМН, 2005. ― 23 с. [Orlova EM. Geneticheskie osnovy i klinicheskie varianty autoimmunnogo poliglandulyarnogo sindroma 1 tipa. [dissertation abstract] Moscow: Endocrine Science Center of Medical Sciences; 2005, 23 р. (In Russ).] Доступно по: https://search.rsl.ru/ru/record/01003006402. Ссылка активна на 14.06.2019.

4. Солнцева А.В., Минкевич О.А., Сукало А.В. Аутоиммунный полигландулярный синдром 1 типа у детей: клинико-гормональные особенности // Медицинский журнал. ― 2007. ― №1. ― С. 83−85. [Solntseva AV, Minkevich OA, Sukalo AV. Autoimmunnyy poliglandulyarnyy sindrom 1 tipa u detey: kliniko-gormonal’nyye osobennosti. Meditsinskii zhurnal. 2007;1:83−85. (In Russ).]

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7. Husebye E, Anderson M. Autoimmune polyendocrine syndromes: clues to type 1 diabetes pathogenesis. Immunity. 2010;32(4): 479-487. doi: https://doi.org/10.1016/j.immuni.2010.03.016


Supplementary files

1. Fig. 1. Appearance of the patient.
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2. Fig. 2. Hyperpegmentation of palmar lines.
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3. Fig. 3. Hyperpigmentation of elbows and knees.
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4. Fig. 4. Candidiasis mucous language.
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Review

For citations:


Troshina V.V., Romanova N.Yu., Sozaeva L.S., Troshina E.A. Clinical case report: history of diagnosis and clinical features of type autoimmune polyglandular syndrome 1. Problems of Endocrinology. 2019;65(5):362-366. https://doi.org/10.14341/probl10295

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ISSN 0375-9660 (Print)
ISSN 2308-1430 (Online)