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1型自身免疫性多内分泌腺病(或自身免疫性多内分泌腺综合征)1例

[One case of type 1 auto-immune polyendocrinopathy or APECED].

作者信息

Puzenat E, Pepin L, Bertrand A-M, Pelletier F, Monnier D, Levang J, Mermet I, Humbert P, Aubin F

机构信息

Service de Dermatologie, CHU Saint-Jacques, 4, place Saint-Jacques, 25030 Besançon Cedex, France.

出版信息

Ann Dermatol Venereol. 2010 Dec;137(12):794-8. doi: 10.1016/j.annder.2010.08.014. Epub 2010 Sep 28.

Abstract

INTRODUCTION

autoimmune polyendocrinopathy with candidiasis and ectodermal dystrophy (APECED) is a rare autosomal recessive disorder caused by mutations in the autoimmune regulator gene (AIRE). We report the case of a young girl with APECED.

CASE REPORT

an 18 year-old girl born to consanguineous parents consulted for diffuse alopecia. Dermatological examination showed nail and dental enamel dystrophy and angular cheilitis. She had a history of mineralocorticoid deficiency (Addison's disease), hypoparathyroidism, hypogonadism and Biermer's disease, and she had also had chronic mucocutaneous candidiasis since childhood. She was presenting APECED with autoimmune endocrine failure, chronic mucocutaneous candidiasis and abnormalities of ectoderm-derived tissue. Analysis of mutation in the AIRE gene showed the c.769C>T homozygous mutation in exon 6.

DISCUSSION

APECED, a rare autosomal recessive disorder, is a potentially life-threatening autoimmune disease. Chronic mucocutaneous candidiasis is a common and early feature in children. Dermatologists are likely to be the first physicians to diagnose this syndrome.

摘要

引言

自身免疫性多内分泌腺病合并念珠菌病和外胚层营养不良(APECED)是一种罕见的常染色体隐性疾病,由自身免疫调节基因(AIRE)突变引起。我们报告一例患有APECED的年轻女孩病例。

病例报告

一名18岁女孩,父母为近亲结婚,因弥漫性脱发前来就诊。皮肤科检查显示指甲和牙釉质营养不良以及口角炎。她有盐皮质激素缺乏(艾迪生病)、甲状旁腺功能减退、性腺功能减退和恶性贫血病史,并且自童年起就患有慢性黏膜皮肤念珠菌病。她表现出APECED的症状,伴有自身免疫性内分泌衰竭、慢性黏膜皮肤念珠菌病和外胚层来源组织异常。对AIRE基因的突变分析显示外显子6存在c.769C>T纯合突变。

讨论

APECED是一种罕见的常染色体隐性疾病,是一种潜在的危及生命的自身免疫性疾病。慢性黏膜皮肤念珠菌病是儿童常见的早期特征。皮肤科医生很可能是首批诊断该综合征的医生。

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