Endocrine Abstracts

Introduction: Autoimmune polyglandular syndromes (APS) are a heterogeneous group of disorders characterised by autoimmune activity against endocrine and non-endocrine organs. APS type depends on the combination of the diseases (APS1, APS2, and APS3).

Methods: The study was conducted in 89 patients (70F and 19M) with APS aged mean 50.00±14.80 years, treated at Endocrinology Department between 2003 and 2015. We analysed clinical manifestations, results of laboratory tests and imaging to determine the components of APS.

Results: The most common syndrome was APS3 (69.66%). 24.72% of patients had APS2, only five subjects (5.62%) suffered from APS1. Autoimmune thyroid disease was found in 84.27% of cases, i.e. Hashimoto’s thyroiditis (58.43%) and Graves’s disease (25.84%), and in 100, 86.36, and 82.26% of APS1, APS2, and APS3 cases respectively. Type 1 diabetes had been diagnosed in 61.80% of participants (in 20.00, 27.27, and 77.42% of APS1, APS2, and APS3 cases respectively). Besides patients with APS2, all subjects with APS1 were treated due to Addison’s disease which was found in 29.21% of APS patients. Other problems such as: vitiligo (17.98%), psoriasis (12.36%), Addison-Biermer anemia (10.12%), alopecia areata (5.62%), asthma (3.37%) and in individuals – rheumatoid arthritis, myasthenia gravis, coeliac disease, ulcerative colitis, and autoimmune hepatitis were observed. In APS1, three to six diseases were noted, mostly the coexistence of Addison’s disease and hypoparathyroidism. Two to three diseases were found in APS2. Schmidt’s syndrome was determined in 63.64% of patients with APS2, Carpenter syndrome only in two cases. The most common diseases in APS2 were: Hashimoto’s disease, type 1 diabetes, Graves’s disease (72.73, 27.27, and 13.64% respectively). In APS3, two to four diseases were found. Type 1 diabetes, Hashimoto’s disease, and Graves’ disease were the most common disorders (77.42, 50.00, and 32.26% respectively). The most common coexistence in APS3 was type 1 diabetes with Hashimoto’s disease.

Conclusions: Although, some diseases occur more frequently than others, it should be remembered about various APS components during follow-up such patients.