Rarely seen autoimmune polyglandular syndrome; Type 3B complicated with celiac disease

Yıl 2018, Cilt: 2 Sayı: 1, 1 - 8, 11.02.2018

Hakan Aydın Zülfükar Bilge Abdullah Algın Hüseyin Avni Fındıklı Bünyamin Aydın

Öz

Autoimmune
polyglandular syndrome (APS) is a combination of different autoimmune diseases.
APS type 3 is defined by the presence of autoimmune thyroid disease (ATD)
without Addison’s disease and at least one autoimmune disease such as type 1
diabetes mellitus (type 3A), chronic atrophic gastritis, pernicious
anemia,autoimmune hepatitis or celiac disease (type 3B), vitiligo, alopecia, myasthenia
gravis (type 3C), autoimmune rheumatic disorders, vasculitis (type 3D). Celiac
disease (CD) is an immune-mediated disease with a strong genetic influence.
Type 1 diabetes mellitus (T1DM) and ATD are well established and people
suffering from these two diseases are considered at high risk of developing CD.
Here we present a rarely seen case of a 32-year-old woman with  T1 DM and ATD complicated with CD, which is
defined APS type 3B.

Anahtar Kelimeler

Autoimmune polyglandular syndrome, Celiac disease, Type 1 diabetes mellitus, Autoimmune thyroid disease

Çölyak hastalığı ile komplike nadir görülen otoimmün poliglandüler sendrom; tip3B

Öz

Otoimmün poliglandüler
sendrom (OPS) farklı otoimmün hastalıkların kombinasyonudur. Klinik kriterler
baz alınarak OPS'nin dört ana tipi tariflenmiştir.Tip 3 formu; Addison
hastalığı olmadan, otoimmün tiroid hastalıklarından birine Tip 1 diabetes mellitus
(Tip 3A) veya kronik atrofik gastrit, pernisiyöz anemi, çölyak hastalığı,
otoimmün hepatit (Tip 3B), vitiligo,alopesi,myastenia graves (Tip 3C), kollajen
hastalıklar, vaskülit (Tip 3D) gibi otoimmün hastalıkların eşlik ettiği
sendromdur. Çölyak hastalığı (CD), güçlü bir genetik etkiye sahip immün aracılı
bir hastalıktır. Tip 1 diabetes mellitus (T1DM) ve OTH, insanların bu
hastalıklardan etkilendiği ve Çölyak hastalığı gelişimi için yüksek risk
taşıyan iyi tanımlanmış iki hastalıktır. Burada T1DM ve OTH tanıları ile
beraber Çölyak hastalığı ile komplike olmuş 32 yaşında kadın bir hastayı yani
OPS Tip 3B sendromunu sunmaktayız.

Anahtar Kelimeler

Otoimmün poliglandüler sendrom, Çölyak hastalığı, Tip 1 diabetes mellitus, Otoimmün tiroid hastalığı

Kaynakça

• 1. Neufeld M, Maclaren N, Blizzard R. Autoimmune polyglandular syndromes. Pediatr Ann 1980; 9:154-62.
• 2. Cutolo M. Autoimmune polyendocrine syndromes. Autoimmune rev 2014; 13:85-9.
• 3. Michels AW, Gottlieb PA. Autoimmune polyglandular syndromes. Nat Rev Endocrinol 2010; 6: 270-7.
• 4. Betterle C. et al. Autoimmune Highlights 2014 5:27-31.
• 5. Current Medical Diagnosis and Treatment, fifty-fifth edition, 2016. Chapter 26, page: 1148.
• 6. Mahmud FH, Murray JA, Kudva YC, Zinsmeister AR, Dierkhising RA, Lahr BD, et al. Celiac disease in type 1 diabetes mellitus in a North American community: prevalence, serologic screening, and clinical features. Mayo Clin Proc. 2005;80(11):1429–34.
• 7. Dalgıc B, Sarı S, Özcan B, et al. Prevelance of cealiac disease in healthy Turkish school children. Am J Gastroenterol 2011;8:1512-7.
• 8. Bjorses P, Halonen M, Palvimo JJ, et al. Mutations in the AIRE gene: effects on subcellular location and transactivation function of the autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy protein. Am J Hum Genet. 2000 Feb. 66(2):378-92.
• 9. Rosatelli MC, Meloni A, Meloni A, et al. A common mutation in Sardinian autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy patients. Hum Genet. 1998 Oct. 103(4):428-34.
• 10. Zlotogora J, Shapiro MS. Polyglandular autoimmune syndrome type I among Iranian Jews. J Med Genet. 1992 Nov. 29(11):824-6.
• 11. Surendra Sivarajah, MD et al. Type 2 polyglandular autoimmune syndrome. Emedicine.medscape.com/article/124287. Updated Nov 08, 2016.
• 12. Ludvigsson JF, Bai JC, Biagi F, Card TR, Ciacci C, Ciclitira PJ, Green PH, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut 2014; 63: 1210-28.
• 13. Colin P, Kaukinen K, Valimaki M, Salmi J. Endocrinological disorders and celiac disease. Endocrine Rev. 2002;23(4):464-83.
• 14. Barker JM. Clinical review: Type 1 diabetes associated autoimmunity: natural history, genetic associations, and screening. J Clin Endocrinol Metab. 2006;91:1210-7.
• 15. Cosnes J, Cellier C, Viola S, Colombel JF, Michaud L, Saries J, Hugot JP, et al. Incidence of autoimmune diseases in celiac disease: protective effect of the gluten-free diet. Clin Gastroenterol Hepatol 2008; 6: 753-8.