Endocrine Abstracts

Introduction: The polyglandular autoimmune syndromes (PAS) are rare conditions characterised by the failure of several endocrine glands sometimes associated with other non-endocrine autoimmune diseases. There are four categories of PAS: PAS-I includes at least two out of: mucocutaneous candidiasis, hypoparathyroidism and adrenocortical failure. PAS-II comprises of Addison’s disease, autoimmune thyroid disease and/or type 1 diabetes (Carpenter’s syndrome). PAS-III is defined by the presence of other autoimmune disorders than Addison’s disease and hypoparathyroidism, while PAS IV includes non-endocrine autoimmune disorders and Addison’s disease, but not hypothyroidism.

Case reports: We present three cases of a larger series of PAS type II/III. The first case is of a 55-year-old woman, who was diagnosed with PAS-II (Addison’s disease, autoimmune thyroiditis and latent autoimmune diabetes in adults). The second case is of a 42-old man, so far diagnosed with Basedow’s disease, type 1 diabetes and vitiligo. The third case is of a 22-year-old woman, diagnosed with type 1 diabetes mellitus and primary hypothyroidism so far. The occurrence of autoimmune diseases can continue in the latter two cases, therefore PAS-III could evolve into PAS II.

Conclusion: We emphasise the importance of screening for PAS after the first autoimmune disease is diagnosed. The key to successfully managing patients with PAS is to identify and treat their disorders early before complications occur. This may be achieved by early screening for autoantibodies or subclinical endocrine failure. Patients should be educated to comply with the lifelong medical surveillance and encourage their family members to be screened for autoimmune diseases as about 50% of patients with PAI II have siblings with autoimmune diseases.

Disclosure: This work was supported by the ‘CERO – PROFIL DE CARIERA: CERCETATOR ROMAN’, contract no POSDRU/159/1.5/S/135760, project co-financed by the European Social Fund through Sectoral Operational Programme Human Resources Development 2007–2013.