Diverse clinical manifestations and management strategies in autoimmune polyglandular syndrome: a review of cases.

Autoimmune polyglandular syndrome (APS) is a rare autoimmune disease that affects multiple endocrine glands. It can lead to various clinical manifestations. The primary objective of this review was to provide a comprehensive analysis of the clinical features and management strategies used in managing APS, based on a review of case reports. We emphasize disease pattern recognition and detection of atypical clinical signs, as well as the outcomes of various treatment modalities. Case reports from credible journals were searched in PubMed, resulting in a systematic literature review adopting the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Of the 1173 records identified, 474 remained after duplicates were removed, and 49 full-text articles were reviewed. After further screening based on criteria such as associated disorders, patient age, follow-up, and treatment details, 12 articles were selected for the final analysis. The findings revealed that common endocrine dysfunctions in APS include Addison's disease and hypothyroidism, while non-endocrine manifestations, such as autoimmune encephalitis and pernicious anemia, can also occur. The most frequently adopted strategies were immunosuppressive and hormone therapies. The heterogeneity of APS indicates early diagnosis and individualized treatment strategies. Ultimately, this analysis identifies existing insufficiencies and provides recommendations for formulating standard operating procedures for the treatment of APS.