Autoimmune Polyglandular Syndrome Type 3: A Case Report.

Area of Science:

• Endocrinology and Immunology
• Autoimmune diseases and their complex presentations
• Syndromic associations of autoimmune conditions

Background:

• Autoimmune Polyglandular Syndromes (APS) involve multiple autoimmune diseases (AID).
• APS Type 3 is defined by autoimmune thyroid disease plus other AID, excluding adrenal involvement.
• Type 1 Diabetes Mellitus (T1DM) is an autoimmune disease that increases the risk of developing other AID.

Observation:

• A 64-year-old male with T1DM presented with poor metabolic control and was positive for anti-GAD65, anti-islet cell, and anti-insulin antibodies.
• He later developed vitiligo, macrocytic anemia with vitamin B12 deficiency, and chronic autoimmune gastritis.
• Screening revealed positive anti-thyroid peroxidase antibodies, indicating subclinical hypothyroidism.

Findings:

• The patient was diagnosed with T1DM, vitiligo, chronic autoimmune gastritis, and chronic autoimmune thyroiditis.
• Adrenal function tests were normal, confirming the absence of adrenal involvement.
• These findings collectively led to a diagnosis of Autoimmune Polyglandular Syndrome Type 3 (APS3).

Implications:

• This case highlights the importance of monitoring for additional autoimmune diseases in patients with T1DM.
• Early detection of AID through autoantibody screening can lead to timely diagnosis and management.
• Vigilance for co-existing autoimmune conditions is crucial for comprehensive patient care, even without overt symptoms.