Endocrine Abstracts

Polyglandular autoimmune syndromes (PAS) are rare group of diseases, which characterised by association of two or more autoimmune endocrine disorders in a single patient. Often PAS is combined with autoimmune damage of non-endocrine organs. Type 3 PAS includes combination of autoimmune thyroid disease and other autoimmune conditions. The adrenal cortex is not involved. This type of PAS typically affects middle aged women. The cause is still unclear. In this case study I describe a patient with Hashimoto’s thyroiditis, latent autoimmune diabetes in adults, vitiligo, miasthenia gravis. Case study: A 68-year old female presented to the endocrinology outpatient department with complains of high blood glucose level, dropping of one eyelid, weakness in the hands in the last 3 month. She also noticed that antidiabetic drugs were not effective about 2-3 month. The patient had been diagnosed with Hashimoto’s thyroiditis about 5 years before, and with diabetes mellitus type 2 about 1 year before. It was suggested as a latent autoimmune diabetes in adults and initiated insulin therapy. Laboratory tests showed high level of acetylcholine receptor antibody, anti-insulin antibody, GADA, IAA, ICA. So patient had diagnosed with PAS type 3. Treatment of PAS type 3 includes lifelong hormone replacement of any glandular failure. It is very important that patients with PAS type 3 are monitored closely to detect any glandular problems early.

Keywords: polyglandular autoimmune syndrome, Hashimoto’s thyroiditis, miasthenia gravis, latent autoimmune diabetes in adults.