Suh Junghwan, Choi Han Saem, Kwon Ahreum, Chae Hyun Wook, Lee Jin-Sung, Kim Ho-Seong
Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Division of Clinical Genetics, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Ann Pediatr Endocrinol Metab. 2019 Dec;24(4):248-252. doi: 10.6065/apem.2019.24.4.248. Epub 2019 Dec 31.
Autoimmune polyendocrine syndrome type 1 (APS-1), or autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy is a rare, autosomal recessive autoimmune disease caused by a mutation of the autoimmune regulator (AIRE) gene. The main symptom triad in APS-1 comprises chronic mucocutaneous candidiasis, adrenal insufficiency, and hypoparathyroidism. Various autoimmune diseases and ectodermal abnormalities are also commonly associated with the syndrome. The treatment of APS-1 includes hormone replacement and symptom control. It is important to monitor such patients for clinical manifestations of their disease through regular follow-up. We report the case of a 10-year-old Korean girl with APS-1 due to a novel compound heterozygous mutation of the AIRE gene. This patient's main clinical manifestations were adrenal insufficiency and chronic mucocutaneous candidiasis. The patient had a previously known pathogenic variant of c.1513delG (p.Ala505ProfsTer16), and a newly discovered variant of c.1360dupC (p.His454ProfsTer50).
1型自身免疫性多内分泌腺综合征(APS-1),即自身免疫性多内分泌病-念珠菌病-外胚层营养不良,是一种由自身免疫调节因子(AIRE)基因突变引起的罕见常染色体隐性自身免疫性疾病。APS-1的主要三联征症状包括慢性黏膜皮肤念珠菌病、肾上腺功能不全和甲状旁腺功能减退。各种自身免疫性疾病和外胚层异常也常与该综合征相关。APS-1的治疗包括激素替代和症状控制。通过定期随访监测此类患者的疾病临床表现很重要。我们报告了一名10岁韩国女孩因AIRE基因的一种新的复合杂合突变而患APS-1的病例。该患者的主要临床表现为肾上腺功能不全和慢性黏膜皮肤念珠菌病。该患者先前已知有c.1513delG(p.Ala505ProfsTer16)的致病变体,以及新发现的c.1360dupC(p.His454ProfsTer50)变体。