Reyhanoglu Gizem, Madhavarapu Divya, Kafrouni Antoni
Internal Medicine, Tallahassee Memorial HealthCare, Tallahassee, USA.
Endocrinology, Albany Medical Center, New York, USA.
Cureus. 2025 Aug 12;17(8):e89936. doi: 10.7759/cureus.89936. eCollection 2025 Aug.
The first case describes a patient who underwent genetic testing for autoimmune polyendocrine syndrome (APS), revealing a change in the autoimmune regulator (AIRE) gene, c.1066C>T. To diagnose classical APS-1, two of the following endocrinopathies are required: hypoparathyroidism, adrenal insufficiency, and mucocutaneous candidiasis. Due to the patient's genetic mutation and high susceptibility to developing other endocrinopathies later in life, he is presumed to have a nonclassical APS-1 presentation given his genetic testing. The second case discusses APS-2. This patient has a history of autoimmune diabetes, primary hypogonadism, and hypothyroidism. APS-2 is diagnosed when a patient has two of the following endocrinopathies: adrenal insufficiency, autoimmune thyroid disease, and type 1 diabetes. This patient has a strong family history of autoimmune endocrinopathies. With more knowledge and recognition of APS, complications and detrimental outcomes can be more easily predicted and prevented.
第一个病例描述了一名接受自身免疫性多内分泌腺综合征(APS)基因检测的患者,结果显示自身免疫调节因子(AIRE)基因发生了c.1066C>T突变。要诊断经典的APS-1,需要具备以下两种内分泌疾病:甲状旁腺功能减退、肾上腺功能不全和黏膜皮肤念珠菌病。由于该患者存在基因突变且在生命后期发生其他内分泌疾病的易感性较高,鉴于其基因检测结果,推测他患有非经典的APS-1表现。第二个病例讨论的是APS-2。该患者有自身免疫性糖尿病、原发性性腺功能减退和甲状腺功能减退病史。当患者具备以下两种内分泌疾病时可诊断为APS-2:肾上腺功能不全、自身免疫性甲状腺疾病和1型糖尿病。该患者有自身免疫性内分泌疾病的家族史。随着对APS的了解和认识增加,并发症和不良后果可以更容易地被预测和预防。