Clinical polymorphism of autoimmune polyglandular syndrome of type 1. Role of molecular genetic diagnosis

Abstract

Autoimmune polyglandular syndrome type 1 (APS-1) is a rare monogenous disease with autosomal-recessive inheritance. The gene responsible for the development of this disease is designated as the gene AIRE and encodes for the protein autoimmune regulator whose function is unknown. The disease more frequently manifests itself in childhood. Its typical manifestations are chronic cutaneous and mucous candidiasis, hypoparathyroidism, and chronic adrenal insufficiency. The presence of 2 of these signs gives ground to establish its clinical diagnosis. However, the clinical manifestations of this disease are highly polymorphic. Thirty-nine patients with the established diagnosis of APS-1 were followed up. There was a high frequency of R2S7X mutation in the gene AIRE. Its clinical picture is untypical in 26% of cases despite the presence of the identical R257X mutation. The molecular genetic diagnosis permits diagnosis of untypical cases of APS-1.