Autoimmune polyglandular syndromes

Overview

A combination of endocrine and nonendocrine autoimmune diseases causing increased thyroid secretion and thyroid gland enlargement. 
The three types of APS are:

• APS I: autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED)
  • Characterized by hypoparathyroidism, Addison’s disease, and chronic mucocutaneous candidiasis
• APS II: Schmidt Syndrome
  • Characterized by diabetes mellitus type 1, Addison’s disease, autoimmune hypothyroidism/Hashimoto’s
• APS III: autoimmune polyglandular syndrome type 3
  • Characterized by autoimmune thyroiditis and either, diabetes mellitus type 1, pernicious anemia, vitiligo, and/or alopecia areata

Common Symptoms

Symptoms vary according to the type:

• APS I: oral thrush, diaper rash, cramping, spasms, weakness, diarrhea, nausea and vomiting, low blood pressure, and dehydration.
• APS II: frequent urination, extreme thirst, constant hunger, weight loss, itching of the skin, changes in vision, low blood pressure, severe dehydration, enlarged thyroid gland in the neck, dull facial expression, puffiness and swelling around the eyes, and drooping eyelids.
• APS III: puffy face, fatigue, enlarged thyroid gland in neck, puffiness and swelling around the eyes, drooping eyelids, weakness, extreme hunger, blurry vision, weight loss, shortness of breath, pins and needles sensations, patchy loss of skin color, and hair loss.

Coexisting Diseases and Conditions

Type 1 diabetes, Graves’ disease, Hashimoto thyroiditis, Addison’s disease, vitiligo, alopecia areata, hypogonadism, autoimmune liver disease, and pernicious anemia.

Risk Factors and Prevalence

Genetic factors have been associated with all three APS. Females have also been found to be more affected in APS II and APS III.