Autoimmune polyglandular syndrome: a case report

Abstract

Autoimmune diseases are a chronic heterogeneous group of diseases which develop a humoral immune response against different tissues. It is an autoimmune dysfunction of multiple organs. These are more than one organ autoimmune dysfunction. Here we present a patient with the diagnoses of type-1 Diabetes Mellitus (DM) and Obsessive Compulsive Disorder (OCD) together with iron, vitamin B and vitamin D deficiencies. Elevated anti-endomysium antibody and tissue transglutaminase IgA levels were found which led to the diagnosis of celiac disease established via endoscopy. The patient had hyperparathyroidism due to vitamin D deficiency with normal values of cortisol, ACTH and thyroid functions. Increased levels of anti-TPO, antithyroglobulin antibody levels and ultrasound findings compatible with thyroiditis showed that there was also an autoimmune thyroiditis. Autoimmune polyglandular syndrome (APS) is divided into four sub groups. APS Type 3B sub-group is compatible with Type 1 DM, autoimmune thyroiditis and celiac disease. This case is an example of APS type 3B together with OCD.