scholarly journals Pulmonary artery hypertension and type 1 diabetes mellitus with suspected autoimmune polyendocrine syndrome in a pediatric patient

2015 ◽  
Vol 6 (1) ◽  
pp. 1-4 ◽  
Author(s):  
H Koves Ildiko ◽  
Yung Delphine
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Pulmonary Artery ◽  
Type 1 Diabetes Mellitus ◽  
Pediatric Patient ◽  
Pulmonary Artery Hypertension ◽  
Autoimmune Polyendocrine Syndrome

scholarly journals Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old Woman

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Stefano Benedini ◽  
Antonietta Tufano ◽  
Elena Passeri ◽  
Marco Mendola ◽  
Livio Luzi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Cobalamin Deficiency ◽  
Gastric Parietal Cell ◽  
Autoimmune Thyroid ◽  
Autoimmune Polyendocrine Syndrome

Type 1 diabetes mellitus (T1D), autoimmune thyroid disease, and autoimmune gastritis often occur together forming the so-called autoimmune polyendocrine syndrome type 3 (APS3). We here report a clinical case of a 74-year-old woman who presented for the first time with severe hyperglycemia and ketoacidosis diagnosed as T1D. Further clinical investigations revealed concomitant severe hypothyroidism with autoimmune thyroid disease and severe cobalamin deficiency due to chronic atrophic gastritis. The diagnosis of type 1 diabetes mellitus was confirmed by the detection of autoantibodies against glutamic acid decarboxylase 65, islet cell antibodies, and anti-insulin autoantibodies. Anti-thyroperoxidase, anti-thyroglobulin, and anti-gastric parietal cell antibodies were also clearly positive. The case emphasized that new onset diabetic ketoacidosis, hypothyroidism, and cobalamin deficiency may simultaneously occur, and one disease can mask the features of the other, thereby making diagnosis difficult. It is noteworthy that an APS3 acute episode occurred in an asymptomatic elder woman for any autoimmune diseases.

scholarly journals The altered circadian pattern of basal insulin requirements – an early marker of autoimmune polyendocrine syndromes in type 1 diabetes mellitus

2020 ◽  
Vol 54 (2) ◽  
pp. 126-132
Author(s):  
Maria Pallayova ◽  
Dagmar Breznoscakova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Basal Insulin ◽  
Late Afternoon ◽  
Early Marker ◽  
Insulin Requirements ◽  
Autoimmune Polyendocrine Syndrome ◽  
Immune Mediated

AbstractObjectives. The purpose of the present paper is to propose and introduce novel biomarkers of autoimmune polyendocrine syndromes that are relevant to the early diagnosis and optimal medical management of the patients who already suffer from type 1 diabetes mellitus.Methods. We hypothesize and demonstrate on a case study that various organ-specific autoimmune endocrinopathies can result in lowered basal insulin requirements, leading to unexplained hypoglycemia.Results. It can be hypothesized that hypothyroidism in patients with type 1 diabetes mellitus may deteriorate glycemic control and can lead to an increased rate of hypoglycemia, particularly the overnight and morning hypoglycemia. Thus, the decreased requirements for particularly overnight basal insulin can be an early marker of the autoimmune polyendocrine syndrome-3 with subclinical autoimmune thyroiditis in immune-mediated type 1 diabetes mellitus. Further, it could be proposed that unexplained hypoglycemia during the late afternoon or evening could be an early marker of the autoimmune polyendocrine syndrome-2 with subclinical autoimmune Addison disease in immune-mediated type 1 diabetes mellitus. As a result, an altered circadian pattern of basal insulin requirements can occur, characterized by a decreased late afternoon basal insulin rate.Conclusions. After exclusion of other causes, the unexplained reoccurring hypoglycemia can be a remarkable feature of autoimmune polyendocrine syndromes in immune-mediated type 1 diabetes mellitus on intensive insulin replacement therapy.

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