Email this article Latent forms of adult-onset autoimmune polyglandular syndrome: Diagnosis and management of patients
- Authors: Larina AA1, Troshina EA1
-
Affiliations:
- ФГБУ "Эндокринологический научный центр" Минздрава России, Москва
- Issue: Vol 86, No 10 (2014)
- Pages: 73-76
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/31597
- ID: 31597
Cite item
Full Text
Abstract
Autoimmune polyglandular syndromes (APS) are an autoimmune involvement of two or more endocrine glands, which are characterized by multiple organ dysfunction. Four major types of APS are presently identified. There are APS types 2, 3, and 4 in adults. There are also latent and incomplete forms of adult-onset APS, the prevalence of which in the population is well above that of clinically apparent diseases. Latent disease may strongly affect the compensation and risk of complications of the underlying condition. The examination of APS risk-group patients includes the detection of genetic (HLA Class II haplotypes, CTLA-4, PTPN22, and FOXP3 genes, etc.) and immunological (antibodies) markers in autoimmune diseases and the determination of the residual function of the target organ. The treatment of autoimmune diseases in adult-onset APS is based on general principles; however, there are a number of specific features of using drugs for the concurrence of a few endocrine diseases. In this connection, the timely identification of risk groups for developing the clinical forms of APS in patients with one autoimmune endocrine disease.
Full Text
##article.viewOnOriginalSite##About the authors
A A Larina
ФГБУ "Эндокринологический научный центр" Минздрава России, Москва
Email: Doc.larina@gmail.com
E A Troshina
ФГБУ "Эндокринологический научный центр" Минздрава России, Москва
References
- Орлова Е.М. Аутоиммунные полигландулярные синдромы. В кн.: Эндокринология: национальное руководство. Под ред. И.И. Дедова, Г.А. Мельниченко. М: ГЭОТАР-Медиа 2008: 937-943.
- Betterle C., Zanchetta R. Update on autoimmune polyendocrine syndromes (APS). Clinical Immunology and Allergology. Acta Bio Medica 2003; 74: 9-33.
- Kahaly G.J. Polyglandular autoimmune syndromes. Eur J Endocrinol 2009; 161 (1): 11-20.
- Neufeld M., Blizzard R.M. Polyglandular autoimmune diseases. In: Pinchera A., Doniach D., Fenzi G.F., Baschieri L. (eds). Symposium on Autoimmune Aspects of Endocrine Disorders. New York: Academic Press 1980: 357-365.
- Förster G., Krummenauer F., Kühn I. et al. Polyglandular autoimmune syndrome type II: epidemiology and forms of manifestation. Deutsche Medizinische Wochenschrift 1999; 124: 1476-1481.
- Falorni A., Laurenti S., Santeusanio F. Autoantibodies in autoimmune polyendocrine syndrome type II. Endocrinol Metab Clin North Am 2002; 31: 369-389.
- Betterle C., Lazzarotto F., Presotto F. Autoimmune polyglandular syndrome Type 2: the tip of an iceberg? Clin Exp Immunol 2004; 137 (2): 225-233.
- Driessche A., Eenkhoorn V., Gaal L., Block C. Type 1 diabetes and autoimmune polyglandular syndrome: a clinical review. Netherlands J Med 2009; 67 (11): 376-387.
- Ajaz F., Kudva Y.C., Erwin P.J. Residual dysphasia after severe hypoglycemia in a patient with immune-mediated primary adrenal insufficiency and type 1 diabetes mellitus: case report and systematic review of the literature. Endocr Pract 2007; 13 (4): 384-388.
- McAulay V., Frier B.M. Addison's disease in type 1 diabetes presenting with recurrent hypoglycaemia. Postgrad Med J 2000; 76 (894): 230-232.
- Elbelt U., Hahner S. Altered insulin requirement in patients with type 1 diabetes and primary adrenal insufficiency receiving standard glucocorticoid replacement therapy. Allolio B Eur J Endocrinol 2009; 160 (6): 919-924.
- Prazny M., Skrha J., Limanova Z. et al. Screening for Associated Autoimmunity in Type 1 Diabetes Mellitus With Respect To Diabetes Control. Physiol Res 2005; 54: 41-48.
- Mohn A., Di Michele S., Di Luzio R. et al. The effect of subclinical hypothyroidism on metabolic control in children and adolescents with Type 1 diabetes mellitus. Diabet Med 2002; 19 (1): 70-73.
- Solá E., Morillas C., Garzón S., Gómez-Balaguer M. Association between diabetic ketoacidosis and thyrotoxicosis. Acta Diabetol 2002; 39 (4): 235-270.
- Vondra K., Vrbikova J., Dvorakova K. Thyroid gland diseases in adult patients with diabetes mellitus. Minerva Endocrinol 2005; 30 (4): 217-236.
- Tomkins G.M., McGuire J.S. Jr. The effect of thyroid hormones on adrenal steroid metabolism. Ann N Y Acad Sci 1960; 86: 600-604.
- Gambelunghe G., Falorni A., Ghaderi M. et al. Microsatellite polymorphism of the MHC class I chain-related (mic-a and mic-b) genes marks the risk for autoimmune Addison's disease. J Clin Endocrinol Metab 1999; 84: 3701-3707.
- Erichsen M., Løvås K., Skinningsrud B. et al. Clinical, Immunological, and Genetic Features of Autoimmune Primary Adrenal Insufficiency: Observations from a Norwegian Registry. J Clin Endocrinol Metab 2009; 94 (12): 4882-4890.
- Villano M.J., Huber A.K., Greenberg D.A. et al. Autoimmune thyroiditis and diabetes: dissecting the joint genetic susceptibility in a large cohort of multiplex families. J Clin Endocrinol Metab 2009; 94 (4):1458-1466.
- Golden B., Levin L., Ban Y. et al. Genetic analysis of families with autoimmune diabetes and thyroiditis: evidence for common and unique genes. J Clin Endocrinol Metab 2005; 90 (8):4904-4911.
- Brozzetti A., Marzotti S., Tortoioli C. et al. Cytotoxic T lymphocyte antigen-4 Ala17 polymorphism is a genetic marker of autoimmune adrenal insufficiency: Italian association study and meta-analysis of European studies. Eur J Endocrinol 2010; 162 (2): 361-369.
- Barker J.M., Ide A., Hostetler C. et al. Endocrine and immunogenetic testing in individuals with type 1 diabetes and 21-hydroxylase autoantibodies: Addison's disease in a high-risk population. J Clin Endocrinol Metab 2005; 90: 128-134.
- De Block C.M.E., De Leeuw I.H., Van Gaal L.F. Autoimmune Gastritis in Type 1 Diabetes: A Clinically Oriented Review. J Clinl Endocrinol Metab 2008; 93 (2): 363-371.
Supplementary files
