Autoimmune Polyglandular Syndrome Type II: Epidemiological, Clinical and Immunological Data
Notice bibliographique
Résumé
Background: Autoimmune polyglandular syndrome (APS) is characterized by the coexistence of several autoimmune diseases, affecting predominantly the endocrine glands. APS type I is distinguished from type II in which autoimmune thyroiditis, Addison’s disease and diabetes type 1 predominate. This article summarizes extensive epidemiological, clinical, and immunological data of a large population of Tunisian patients with APS II. Methods: In a retrospective case finding study, we collected data from patients with APS type II who had been treated in our endocrine outpatient clinic between 1980 and 2007. One hundred and six patients fulfilled the criteria of APS II. Results: Among these patients, 73 were female and 33 were male (mean age 36 and 42 years, respectively; P = 0.04). The mean age at the onset was 38 ± 14.9 years. Of the 106 patients, 76 had hypothyroidism due to autoimmune thyroiditis while 23 had hyperthyroidism (Grave’s disease). Sixty-six patients had type I diabetes mellitus (60.6% females and 39.5% males; P = 0.01). Addison’s disease was diagnosed in 39 patients, primary hypogonadism in 12 cases (11 females and one male), and neuro-hypophysitis was less frequently noted (n = 6). The most frequent coexistence of APS component diseases was between type I diabetes and thyroid disease (56.2%). The time interval between the advent of the first and the second autoimmune endocrinopathies varied considerably with longest time intervals between diabetes type I and thyroid disease and shortest time intervals between Addison’s disease and thyroid disease. Regarding autoantibodies in patients with APS II, anti-thyroid peroxidase antibodies were detected in 67.6%, thyroid stimulating hormone-receptor antibodies in 58%, and anti-thyroglobulin were less frequently positive (43.3%). Type I diabetes-associated antibodies against islet cell (islet cell autoantibodies) and glutamic acid decarboxylase were found in 23.6% and 51.8%, respectively. Antibodies to adrenal cortex were observed in 9.7% and ovarian antibodies in 8.8%. Conclusion: The present study indicates that most patients with autoimmune thyroid disease will not develop additional endocrine disease. If they do, when a thyroid disease was as a first component disease, the time interval until the onset of a further autoimmune disease was relatively short and when thyroid disease was a second component disease a longer period of time elapsed. J Endocrinol Metab. 2014;4(4):101-109 doi: http://dx.doi.org/10.14740/jem227w
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».