Lee Seung-Hwan, Kim Mee-Ran, Kim Ji-Hyun, Kwon Hyuk-Sang, Yoon Kun-Ho, Son Ho-Young, Cha Bong-Yun
Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, South Korea.
Gynecol Endocrinol. 2007 May;23(5):252-6. doi: 10.1080/09513590701297658.
We report a patient with combined polycystic ovary syndrome (PCOS) and autoimmune polyglandular syndrome (APS) type 2. A 26-year-old female presented with polyuria, polydipsia and acute weight loss. She was diagnosed with: (1) type 1 diabetes, with hyperglycemia, impaired insulin secretion, and positive autoantibodies for GAD-65 and IA-2; (2) autoimmune thyroiditis, with hypothyroidism, positive anti-microsomal and antithyroglobulin antibodies; and (3) PCOS, with hyperandrogenic signs that had developed 5 years earlier, amenorrhea for the previous 6 months, and characteristic multiple microcystic appearance of both ovaries on ultrasonography. She is being treated with multiple subcutaneous insulin injections, thyroxine replacement, and cyclic medroxyprogesterone for the aforementioned diseases, respectively. Although several investigations have reported a relationship between PCOS and the individual components of APS, this is the first report of both syndromes occurring simultaneously. Potential mechanisms for their interrelation and the possibility that PCOS is an autoimmune disease are discussed.
我们报告了一名患有多囊卵巢综合征(PCOS)合并2型自身免疫性多腺体综合征(APS)的患者。一名26岁女性出现多尿、多饮和急性体重减轻。她被诊断为:(1)1型糖尿病,伴有高血糖、胰岛素分泌受损以及GAD - 65和IA - 2自身抗体阳性;(2)自身免疫性甲状腺炎,伴有甲状腺功能减退、抗微粒体和抗甲状腺球蛋白抗体阳性;(3)PCOS,具有5年前出现的高雄激素体征、过去6个月闭经以及超声检查显示双侧卵巢典型的多个微囊性外观。她正在分别接受皮下多次注射胰岛素、甲状腺素替代治疗以及周期性甲羟孕酮治疗上述疾病。尽管多项研究报告了PCOS与APS的各个组成部分之间的关系,但这是两种综合征同时发生的首例报告。文中讨论了它们相互关联的潜在机制以及PCOS是一种自身免疫性疾病的可能性。