Endocrine Abstracts

Autoimmune polyglandular syndromes (APS) are characterized by the association of two or more endocrine and/or nonendocrine autoimmune diseases with different immunologic features of their pathogenesis.

Based on the clinical picture is divided into four different types. Type I APS comprises mucocutaneous candidiasis, hypoparathyroidism and Addison’s disease. Type II APS is defined by autoimmune Addison’s disease in association with chronic autoimmune thyroiditis and/or type one diabetes mellitus. Type III APS is composed of autoimmune thyroid diseases associated with other autoimmune conditions, excepting Addison’s disease. The rest of autoimmune combinations not included in the previous groups, belong to type IV APS.

We present a 40 years old woman who was diagnosed with chronic autoimmune thyroiditis and Addison’s disease four years ago, with subsequent development of hipoparathyroidism (possibly autoimmune mechanism?). At age 37, she became first time pregnant with twins. We discuss clinical, diagnostic, evolutive aspects and especially those of treatments during pregnancy, taking into consideration the number of co morbidities who requiring carefully medication with possible drug interactions and adverse effects.