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Related Concept Videos

Type I Diabetes II: Pathophysiology01:26

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...
Type I Diabetes I: Introduction01:12

Type I Diabetes I: Introduction

Type 1 diabetes mellitus is a chronic metabolic disorder characterized by an absolute deficiency of insulin resulting from the autoimmune destruction of pancreatic β-cells. Although it can occur at any age, it is most commonly diagnosed in childhood, adolescence, or early adulthood. The loss of insulin production impairs cellular glucose uptake, resulting in persistent hyperglycemia and necessitating lifelong insulin therapy.Autoimmune Destruction of β-CellsThe hallmark of type 1 diabetes is an...
Type II Diabetes I: Introduction01:26

Type II Diabetes I: Introduction

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
Gastritis-II: Pathophysiology01:17

Gastritis-II: Pathophysiology

Gastritis is marked by disruption of the mucosal barrier that usually protects the stomach tissue from digestive juices and manifests in acute and chronic forms.
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.

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A High-Throughput Electrochemiluminescence 7-Plex Assay Simultaneously Screening for Type 1 Diabetes and Multiple Autoimmune Diseases
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Autoimmune polyglandular syndrome, type II.

Barbara A Majeroni1, Parag Patel

  • 1Dept. of Family Medicine, State University of New York at Buffalo, Buffalo, New York 14215, USA. BAMajeroni@aol.com

American Family Physician
|March 23, 2007
PubMed
Summary

Autoimmune polyglandular syndrome type II combines autoimmune adrenal insufficiency with thyroid disease or type 1 diabetes. Early diagnosis and treatment, especially of adrenal insufficiency, are crucial to prevent life-threatening complications.

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Published on: May 6, 2013

Area of Science:

  • Endocrinology
  • Autoimmunology

Background:

  • Autoimmune polyglandular syndrome type II (APS II) involves autoimmune adrenal insufficiency, autoimmune thyroid disease, and/or type 1 autoimmune diabetes mellitus.
  • Symptoms of adrenal insufficiency and hypothyroidism are nonspecific, complicating diagnosis.
  • APS II typically presents in midlife, predominantly affecting women, and can have severe, life-threatening consequences if overlooked.

Purpose of the Study:

  • To define autoimmune polyglandular syndrome type II.
  • To highlight diagnostic challenges and the importance of prompt recognition.
  • To outline appropriate management strategies.

Main Methods:

  • Diagnosis relies on the presence of autoimmune adrenal insufficiency, confirmed by the cosyntropin test.
  • Associated conditions include autoimmune thyroid disease and type 1 autoimmune diabetes mellitus.
  • Clinical presentation and epidemiological data were considered.

Main Results:

  • Autoimmune adrenal insufficiency is a mandatory criterion for APS II diagnosis.
  • The cosyntropin test is the recommended diagnostic tool for adrenal insufficiency.
  • Hormone replacement therapy is individualized, with adrenal insufficiency treatment prioritized before thyroid therapy.

Conclusions:

  • Autoimmune polyglandular syndrome type II requires careful diagnosis due to nonspecific symptoms.
  • Prompt identification and management, particularly of adrenal insufficiency, are critical for patient outcomes.
  • Integrated hormone therapy, prioritizing adrenal support, is essential for managing coexisting autoimmune conditions.