(English) Autoimmune Polyglandular Syndrome Type III – A in Patients with Thyroid Autoimmune Diseases

Clinical Center of Endocrinology and Gerontology Medical University-Sofia

 

Abstract:

Autoimmune polyendocrine syndrome type lll-A (APS lll-A) represents a constellation of autoim-mune thyroid disease (ATD) and diabetes mellitus type 1. The aim of the study is to gain better insight into the characteristic features and clinical course of ATD and diabetes mellitus as components of APS 11 l-A. Twenty-four patients presenting ATD + dia-betes mellitus type 1 (21 women and 3 men at mean age 41,2 ± 7 years) – 8 with Craves' disease and 16 with Hashimoto's thyroiditis – are covered by the study. There is a markedly expressed predomi-nance of the female gender among APS lll-A pa-tients (7-to-1 female-to-male ratio). The peak inci-dence in terms of manifestation of the conditions making part of the syndrome is recorded in the age group 30 to 40 years. In most instances (90%) autoimmune hyperthyroidism precedes diabetes mellitus, whereas euthyroid and hypothyroid forms of Hashimoto's thyroiditis usually succeed diabe¬tes. The earliest clinically expressed condition in APS lll-A runs a much severer course compared to the ensuing diseases which become manifest at an older age. Autoimmune endocrinopathies are usu¬ally preceded by non-endocrine diseases – vitiligo and/or alopecia – which may be concidered as a clinical marker of impending APS development. As shown by the obtained results, ATD and diabetes mellitus type 1, as components of APS Ill-А, ex¬hibit a number of clinical features and specificity of expression at variance from the ones in diabetes and ATD running an independent course.

 

Keywords: autoimmune polyendocrine syndromes, autoimmune thyroid disease, diabetes mellitus.