Autoimmune Polyglandular Syndrome Type 3-D
A Case Report
DOI:
https://doi.org/10.21467/preprints.367Abstract
Background: Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease characterized by the presence of autoantibodies against cell nuclei and involves many organ systems in the body. The etiopathology of SLE is thought to involve complex and multifactorial interactions between genetic variation and environmental factors. Hyperthyroidism is a disease due to increased thyroid hormone function followed by signs and symptoms that affect the body's metabolic system. Graves' disease is an autoimmune disease characterized by the presence of antibodies to TSHR (TRAb). Several coexisting autoimmune diseases have been classified under different syndromes.
Case Presentation: A woman, 29 years-old, came to office with complaint of chest palpitation. Patient had history of fever, joint pain, hair loss, and malar rash. Patient had been diagnosed with hyperthyroidism for 4 years and regularly taking propylthiouracil 100 mg and propranolol 10 mg. Titer ANA Test 1/100, Anti ds-DNA 68.08, C3-Complement 93 (N: 83-193), C4-Complement 11.2 (N: 15-57), Free T3 7.79 (N: 1.71-3.71), Free -T4 2.50 (N: 0.70-1.48), TSHs 0.0001 (N: 0.350-4.94), TRAb 3.38 (N: < 1.75). Patient was diagnosed with systemic lupus erythematosus (SLE) and graves’ disease. Patient treated with methimazole 10 mg, propranolol 10 mg, myfortic 360 mg, and methylprednisolone 4 mg.
Conclusion: Autoimmune Polyendocrine Syndromes (APS) was at first characterized as different endocrine organ diseases related to an immune system disease in a subject. Hence, affiliation between illnesses in APS was noted not to be irregular but in specific combinations in which a few non-endocrine immune system diseases were moreover portion of the disorders.
Keywords:
Autoimmune polyglandular syndrome, systemic lupus erythematosus, Graves’ diseaseDownloads
References
Suntoko B. Gambaran Klinik dan Diagnosis Lupus Eritematosus Sistemik. In : Setiati S, Alwi I, Setyohadi B, Syam AF, Sudoyo AW, Simadibrata M, editors. Buku Ajar Ilmu Penyakit Dalam Jilid Lengkap, edisi 6. Jakarta: Pusat Penerbitan Ilmu Penyakit Dalam; 2015: p3353-3361.
Alwi I, Salim S, Hidayat R, Kurniawan J, Tahapary D. Panduan Praktis Klinis Penatalaksanaan di Bidang Ilmu Penyakit Dalam. Jakarta : Pusat Penerbitan Ilmu Penyakit Dalam; 2019.
Hahn BH. Systemic Lupus Erythematosus in: Jameson JL, Kasper DL, Longo DL, Fauci AS, Stephen L. Hauser SL, Loscalzo J. Harrison’sPrinciples of Internal Medicine. 20th ed. Newyork: McGraw-Hill; 2018.p.2515-2525.
Pengendalian Gangguan Tiroid di FKTP. Kementerian Kesehatan RI. Jakarta. 2017.
Melmed, S., Polonsky, K. S., Larsen, P. R., & Kronenberg, H. M. (2016). William Text book of endocrinology. Philadelphia: Elsevier.
Gottlieb PA, Michels AW. Autoimmune Polyendocrine Syndrome in: Jameson JL, Kasper DL, Longo DL, Fauci AS, Stephen L. Hauser SL, Loscalzo J. Harrison’sPrinciples of Internal Medicine. 20th ed. Newyork: McGraw-Hill; 2018.p.2756-2760.
Jaume JC. Endocrine Autoimmunity in Gardner DG, Shoback D Greenspan’s basic and clinical endocrinology. 10th ed. Newyork: McGraw- Hill; 2018.p.29-48.
Aringer M et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis & Rheumatology Vol. 71. 2019.
Gordon C et al. The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults. Oxford University Press on behalf of the British Society for Rheumatology. 2017.
Petri M et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 64:267786. 2012.
Diagnosis dan Pengelolaan Lupus Eritematosus Sistemik. Perhimpunan Reumatologi Indonesia. 2019.
Betterle C, Zanchetta R. Update on autoimmunepolyendocrine syndromes (APS). Acta Bio Medica. 2003 ; 74 : 9-33.
Aldasouqi SA. Polyglandular Autoimmune Syndrome, Type I.
Betterle C, Zanchetta R. Update on autoimmunepolyendocrine syndromes (APS). Acta Bio Medica. 2003 ; 74 : 9-33.
Aung K. Polyglandular Autoimmune Syndrome, Type III.
Djokomoeljanto R. Kelenjar tiroid, hipotiroidisme dan hipertiroidisme. Dalam : Sudoyo AW, Setiyohadi B, Simadibrata M, Setiati S editor. Buku Ajar Ilmu Penyakit Dalam.Edisi V. Jilid III. Cetakan ke-2. Jakarta : Internal Publishing ; 2010.p.1993-2008.
Downloads
Posted
Section
Categories
License
Copyright (c) 2022 Fadel Fikri Suharto, RM Dewi Anggraini, Ardianto Tamin, Della Fitricana, Nova Kurniati, Yenny Dian Andayani
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Any non-commercial use, distribution, adaptation, and reproduction in any medium is permitted as long as the original work is properly cited. However, caution and responsibility are required when reusing as the articles on the preprint server are not peer-reviewed. Readers are advised to check for the availability of any updated or peer-reviewed version.
