Endocrine Abstracts

Introduction: Autoimmune polyglandular syndromes are characterized by the coexistence of two or more autoimmune endocrine diseases, however, coexistence of various non-endocrine disorders is also possible. Autoimmune polyglandular syndrome type 3 (APS-3), is the co-occurrence of autoimmune thyroid disease (AITD) with diabetes type 1, but without Addison disease. The coincidence of AITD and latent autoimmune diabetes of the adult (LADA) is relatively less described.

Case Report: We present the case of a 50-year-old female patient with APS-3 associated with Hashimoto’s thyroiditis, latent autoimmune diabetes of adult and vitiligo. A 50-year old woman presented to the clinic with a few months history of complaints: Increased thirst, frequent urination, weight loss. Hyperglycemia was revealed. HbA1c - 12.7%. C peptide was very low. Glutamic acid decarboxylase antibodies (GAD 65-Ab) were measured- >250 IE/ml (n<10); Latent autoimmune diabetes of the adult (LADA) was diagnosed and insulin therapy was started. Personal history revealed vitiligo within the past 5 years. With additional studies patient was also diagnosed with Hashimoto’s thyroiditis: TSH, FT4- within normal reference ranges, the level of anti-TPO - 1685 (N 0-5.61 IU/ml), anti-TG- also elevated- 6.76 (N 0-4.11 IU/ml). Dyslipidemia was also diagnosed. Currently, the patient is on regular follow-up. LADA and dyslipidemia are well controlled; She still remains euthyroid.

Conclusion: APSs are rare conditions characterized by autoimmune disorder of multiple endocrine glands, with or without autoimmune disease of non-endocrine organs. The hypothesis of APS should be raised in patients with one autoimmune endocrine disease.