Martínez López Ma M, González Casado I, Alvarez Doforno R, Delgado Cerviño E, Gracia Bouthelier R
Servicio de Endocrinología Pediátrica, Hospital Universitario La Paz, Melchior Fernández Almagro 16, 11B, 28029 Madrid, Spain.
An Pediatr (Barc). 2006 Jun;64(6):583-7. doi: 10.1157/13089925.
Autoimmune polyglandular syndrome type 1 (APS-1) is an autosomal recessive disorder characterized by chronic mucocutaneous candidiasis, autoimmune hypoparathyroidism, and primary adrenal insufficiency. It has recently been associated with mutations of a single gene found on chromosome 21, designated AutoImmune Regulator (AIRE). We report two patients with APS-1 referred to our hospital for evaluation. The first patient was an 11-year-old girl with hypoparathyroidism, infectious or immunological malabsorption, and autoimmune hepatitis. Hypoparathyroidism associated with other processes with a probable autoimmune origin suggested APS-1. Genetic study was performed revealing deletion of 13 base pairs in exon 8 of the AIRE gene. The second patient was a 17-year-old girl with autoimmune hepatitis, hypoparathyroidism, mucocutaneous candidiasis, nail dystrophy, and obliterating bronchiolitis with a probable autoimmune origin. We suspected APS-1 and genetic study was performed. The only finding was an AIRE gene polymorphism. In conclusion, the presence of a single disease criterion is sufficient to suspect APS-1 and to indicate genetic study. Further studies are required to confirm the involvement of other genes in the development of this disease.
1型自身免疫性多腺体综合征(APS-1)是一种常染色体隐性疾病,其特征为慢性黏膜皮肤念珠菌病、自身免疫性甲状旁腺功能减退和原发性肾上腺功能不全。最近发现它与位于21号染色体上的一个名为自身免疫调节因子(AIRE)的单基因突变有关。我们报告了两名因评估而转诊至我院的APS-1患者。第一名患者是一名11岁女孩,患有甲状旁腺功能减退、感染性或免疫性吸收不良以及自身免疫性肝炎。甲状旁腺功能减退与其他可能源于自身免疫的病症相关,提示为APS-1。进行基因研究后发现AIRE基因第8外显子有13个碱基对缺失。第二名患者是一名17岁女孩,患有自身免疫性肝炎、甲状旁腺功能减退、黏膜皮肤念珠菌病、甲营养不良以及可能源于自身免疫的闭塞性细支气管炎。我们怀疑是APS-1并进行了基因研究。唯一的发现是AIRE基因多态性。总之,单一疾病标准的存在足以怀疑APS-1并提示进行基因研究。需要进一步研究以证实其他基因在该疾病发生发展中的作用。