| Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc |
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Case Report
Volume 3, Number 1, February 2012, pages 1-3
A Significant Discrepancy Between Endocrinological and Clinical Phenotype and Immunological Phenotype in Autoimmune Polyglandular Syndrome Type 3
Tables
| Autoantibodies | Titer | Suspected diseases | Endocrinological findings | Symptoms and other data |
|---|---|---|---|---|
| ab: antibody; BS: blood sugar; CCP: cyclic citrullinated peptide; CRP: C-reactive protein; GAD: glutamic acid decarboxylase; IA-2: insulinoma-associated protein-2; NR: normal range; RF: rheumatoid arthritis; T3: triiodothyronine; T4: thyroxine; TG: thyroglobulin; TPO: thyroid peroxidase; TSH: thyroid stimulating hormone. | ||||
| anti-TPO ab | > 600 IU/mL (NR < 16) | Hashimoto’s disease | TSH 3.62 µIU/mL (NR, 0.54 - 4.26) free T3 3.51 pg/mL (NR, 2.39 - 4.06) | asymptomatic |
| anti-TG ab | 298 IU/mL (NR < 28) | free T4 1.11 ng/dL (NR, 0.71 - 1.52) | ||
| anti-GAD ab | 10 000 U/Ml (NR < 1.5) | type 1 diabetes | urinary C-peptide 70 µg/day (NR, 29.2 - 167) | BS 335 mg/dL HbA1c 8.8% |
| anti-IA-2 ab | 11.0 U/mL (NR < 0.4) | |||
| anti-SSA/Ro ab | > 500 U/mL (NR < 10) | Sjögren's syndrome | dry eye and dry mouth | |
| anti-SSB/La ab | 139 U/Ml (NR < 10) | |||
| RF | 320 IU/mL (NR < 20) | rheumatoid arthritis | asymptomatic anti-CCP ab (-) CRP (-) | |
| Type 1 | Type 2 | Type 3 | Type 4 | |
|---|---|---|---|---|
| major component diseases | Addison disease | Addison disease | thyroid autoimmune diseases | Addison disease |
| hypoparathyroidism | thyroid autoimmune diseases | 3A-type 1 diabetes | ||
| candidiasis | type 1 diabetes | 3B-pernicious anemia 3C-vitiligo, alopecia, other organ-specific autoimmune diseases | ||
| minor autoimmune diseases | type 1 diabetes gonadal failure pernicious anemia malabsorption vitiligo alopecia | myasthenia gravis gonadal failure vitiligo alopecia pernicious anemia | Celiac disease malabsorption gonadal failure sarcoidosis Sjögren's syndrome rheumatoid arthritis myasthenia gravis | gonadal failure malabsorption hypophysitis autoimmune hepatitis pernicious anemia myasthenia gravis vitiligo alopecia |