Peculiarities of the course and frequency of clinical manifestations of polyglandular syndrome type ІІІА in patients living in the iodine deficient Ternopil region
Keywords:autoimmune polyglandular syndrome, iodine deficiency, type 1 diabetes mellitus, hypothyroidism
Background. The problem of early diagnosis of endocrinopathies, such as type 1 diabetes mellitus, autoimmune thyroid disease, adrenal gland disorders on the background of other autoimmune pathologies, remains relevant. One of the manifestations of such combination of nosologies is autoimmune polyglandular syndrome, which is characterized by the sequential or simultaneous deficiency of several endocrine glands and includes a wide range of autoimmune disorders, within not only the endocrine system. The risk of developing polyglandular syndrome in patients with iodine deficiency is increasing several times, and this requires more careful examination and attention. The purpose of the study — to investigate the features of the course and frequency of clinical manifestations of polyglandular syndrome type IIIA in the residents of iodine deficient Ternopil region. Materials and methods. One hundred eightyfour women with polyglandular syndrome type ІІІА living in the iodine deficient territories of Ternopil region were examined. Their age ranged from 19 to 74 years. Results. In 73.14 % of the patients with polyglandular syndrome type IIIA who were examined at the Ternopil University Hospital, its manifestation began with diabetes mellitus type 1. Thyroid disease was diagnosed 5–8 years after the diagnosis of diabetes. Functional disorders of thyroid gland manifested in hypothyroidism in 31.77 % of cases, euthyroidism — in 48.96 % and hyperthyroidism — in 19.27 %. It was more difficult to achieve diabetes compensation in patients with thyroid pathology with its functional deficiency. The average level of thyroid peroxidase antibodies was 382.46 IU/ml. The highest index of thyroid peroxidase antibodies accounted for 873.12 IU/ml. It was found that in patients with higher level of thyroid peroxidase antibodies, it was more difficult to achieve the compensation of diabetes mellitus. Conclusions. Therefore, it is advisable to examine all patients with type 1 diabetes mellitus in the iodine deficient region in order to detect the symptoms of thyroid disorders and autoimmune polyglandular syndrome type IIIA.
Aung K. Type III Polyglandular Autoimmune Syndrome. Medscape. Available from: http://emedicine.medscape.com/article/124398-overview. Accessed: Sep 22, 2017.
Cihakova D. Polyglandular Autoimmune syndrome Type 3 (PAS 3). Johns Hopkins Medical Institutions: Autoimmune Disease Research Center. 2018. Available from: http://labs.pathology.jhu.edu/cihakova/about/about/endocrine-diseases/polyglandular-autoimmune-syndrome-type-3-pas-3/.
Barker JM. Polyglandular Deficiency Syndromes. The Merck Manual. Available from: https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/polyglandular-deficiency-syndromes/polyglandular-deficiency-syndromes. Accessed: Jan 2018.
Förster G, Krummenauer F, Kühn I, Beyer J, Kahaly G. Polyglandular autoimmune syndrome type II: epidemiology and forms of manifestation. Dtsch Med Wochenschr. 1999 Dec 10;124(49):1476-81. doi: 10.1055/s-2008-1035684.
Villano MJ, Huber AK, Greenberg DA, Golden BK, Concepcion E, Tomer Y. Autoimmune thyroiditis and diabetes: dissecting the joint genetic susceptibility in a large cohort of multiplex family. J Clin Endocrinol Metab. 2009 Apr;94(4):1458-66. doi: 10.1210/jc.2008-2193.
Huber A, Menconi F, Corathers S, et al. Join genetic susceptibility type 1 diabetes and autoimmune thyroiditis: from epidemiology to mechanisms. Endocr Rev. 2008 Oct;29(6):697-725. doi: 10.1210/er.2008-0015.
Pankiv IV. Effect of vitamin D supplementation on insulin resistance in patients with hypothyroidism. Mìžnarodnij endokrinologìčnij žurnal. 2017;13(6):455-458. doi: 10.22141/2224-0722.214.171.1247.112892.
Tronko MD, Kovalenko AYe, Tarashchenko YuM, Ostafiychuk M.V. Thyroid nodules in the population of Ukraine, protocol of diagnosis and treatment after the Chernobyl accident (literature review and own data). Mìžnarodnij endokrinologìčnij žurnal. 2018;14(7):677-683. doi: 10.22141/2224-07126.96.36.1998.148775.
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