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Autoimmune polyglandular syndrome type 2 and autoimmune hepatitis with thymoma-associated myasthenia gravis: case

Hidefumi Inaba¹, Hiroyuki Ariyasu², Hiroshi Iwakura²

¹The First Department of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, Japan. inaba@wakayama-med.ac.jp.

BMC Endocrine Disorders

|April 9, 2020

Abstract

Background:

Autoimmune polyglandular syndrome type 2 (APS-2) is a rare and complex clinical entity, and little is known about its etiology and progression.

Case Presentation:

A 52-year-old woman with autoimmune hepatitis (AIH) and bronchial asthma was diagnosed with APS-2; autoimmune Addison's disease (AD), and Hashimoto's thyroiditis (HT), and she underwent prednisolone (PSL) treatment. Five months later, she presented ptosis and was diagnosed with thymoma-associated myasthenia gravis (MG). Thymectomy and PSL treatment with immuno-suppressants appeared to ameliorate MG, AD, AIH, HT, and bronchial asthma. HLA typing analysis revealed that the patient had susceptible HLA alleles to MG, AIH, and HT in a Japanese population.

Conclusions:

This case suggests common endocrinological and autoimmune aspects of APS-2 and AIH with thymoma-associated MG, which are considered to be extremely rare complications.

Keywords:

Autoimmune Addison’s disease Autoimmune hepatitis Autoimmune polyglandular syndrome type 2 (APS-2)Bronchial asthma Hashimoto’s thyroiditis Thymoma-associated myasthenia gravis

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