Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old Woman
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 ketoac...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2015/960615 |
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| author | Stefano Benedini Antonietta Tufano Elena Passeri Marco Mendola Livio Luzi Sabrina Corbetta |
| author_facet | Stefano Benedini Antonietta Tufano Elena Passeri Marco Mendola Livio Luzi Sabrina Corbetta |
| author_sort | Stefano Benedini |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-35f9e10e97f1408ea77c8a0a4a5eff9c |
| institution | Kabale University |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-35f9e10e97f1408ea77c8a0a4a5eff9c2025-02-03T01:23:41ZengWileyCase Reports in Endocrinology2090-65012090-651X2015-01-01201510.1155/2015/960615960615Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old WomanStefano Benedini0Antonietta Tufano1Elena Passeri2Marco Mendola3Livio Luzi4Sabrina Corbetta5Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, San Donato Milanese, 20097 Milan, ItalyEndocrinology Unit, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, ItalyDepartment of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, San Donato Milanese, 20097 Milan, ItalyMetabolism Research Center, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, ItalyDepartment of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, San Donato Milanese, 20097 Milan, ItalyDepartment of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, San Donato Milanese, 20097 Milan, ItalyType 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.http://dx.doi.org/10.1155/2015/960615 |
| spellingShingle | Stefano Benedini Antonietta Tufano Elena Passeri Marco Mendola Livio Luzi Sabrina Corbetta Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old Woman Case Reports in Endocrinology |
| title | Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old Woman |
| title_full | Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old Woman |
| title_fullStr | Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old Woman |
| title_full_unstemmed | Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old Woman |
| title_short | Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old Woman |
| title_sort | autoimmune polyendocrine syndrome 3 onset with severe ketoacidosis in a 74 year old woman |
| url | http://dx.doi.org/10.1155/2015/960615 |
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