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__NOTOC__
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{{Autoimmune polyendocrine syndrome}}
{{Autoimmune polyendocrine syndrome}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}}{{Akshun}}


==Overview==
==Overview==
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
If left untreated, [[patients]] with autoimmune polyendocrine syndrome (APS) may progress to involve other [[endocrine]] and non-[[endocrine]] [[organs]]. APS can be a life-threatening condition if vital [[hormone]] producing [[organs]] of the body are involved such as [[adrenal glands]], [[thyroid]], [[parathyroid glands]]. The complications of APS depend upon the subtype and [[organ system]] involved. Common complications of APS include those arising from [[hypoparathyroidism]], [[Addison's disease]] and [[autoimmune thyroiditis]]. The [[prognosis]] of APS is variable and depends upon the duration and severity of [[endocrine]]/non-[[endocrine]] organ involved. Patients of APS with [[endocrine]] involvement generally require lifelong [[hormone replacement therapy]].
 
OR
 
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
 
OR
 
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.


==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==


===Natural History===
===Natural History===
*The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.  
*If left untreated, patients with autoimmune polyendocrine syndrome (APS) may progress to involve other [[endocrine]] and nonendocrine organs.  
*The symptoms of (disease name) typically develop ___ years after exposure to ___.  
*In APS, involvement of one [[Organ (biology)|organ]] is followed by [[autoimmune disorder]] of other [[endocrine]]-nonendocrine organs. Thus presentation of APS is highly [[variable]] and can lead to involvement of wide variety of [[organs]].  
*If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*If untreated, APS can be life threatening condition since it may involve vital [[hormone]] producing [[endocrine glands]] such as [[adrenal glands]], [[thyroid]], [[Parathyroid gland|parathyroid]] or [[pancreas]].


===Complications===
===Complications===
The complications of autoimmune polyendocrine syndrome (APS) depends upon the endocrine/non-endocrine organ involved.
The complications of autoimmune polyendocrine syndrome (APS) depends upon the subtype and [[endocrine]]/non-[[endocrine]] organ involved.
 
'''APS type 1'''
*Common complications of APS type 1 include those arising from hypoparathyroidism such as:<ref name="pmid23043192">{{cite journal |vauthors=Mitchell DM, Regan S, Cooley MR, Lauter KB, Vrla MC, Becker CB, Burnett-Bowie SA, Mannstadt M |title=Long-term follow-up of patients with hypoparathyroidism |journal=J. Clin. Endocrinol. Metab. |volume=97 |issue=12 |pages=4507–14 |year=2012 |pmid=23043192 |pmc=3513540 |doi=10.1210/jc.2012-1808 |url=}}</ref><ref name="pmid26943719">{{cite journal |vauthors=Brandi ML, Bilezikian JP, Shoback D, Bouillon R, Clarke BL, Thakker RV, Khan AA, Potts JT |title=Management of Hypoparathyroidism: Summary Statement and Guidelines |journal=J. Clin. Endocrinol. Metab. |volume=101 |issue=6 |pages=2273–83 |year=2016 |pmid=26943719 |doi=10.1210/jc.2015-3907 |url=}}</ref><ref name="pmid24806578">{{cite journal |vauthors=Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L |title=Postsurgical hypoparathyroidism--risk of fractures, psychiatric diseases, cancer, cataract, and infections |journal=J. Bone Miner. Res. |volume=29 |issue=11 |pages=2504–10 |year=2014 |pmid=24806578 |doi=10.1002/jbmr.2273 |url=}}</ref><ref name="pmid28138323">{{cite journal |vauthors=Abate EG, Clarke BL |title=Review of Hypoparathyroidism |journal=Front Endocrinol (Lausanne) |volume=7 |issue= |pages=172 |year=2016 |pmid=28138323 |pmc=5237638 |doi=10.3389/fendo.2016.00172 |url=}}</ref>
**Renal complications ([[nephrolithiasis]], [[nephrocalcinosis]], [[impaired renal function]], symptomatic [[hypocalcemia]])
**[[Posterior]] subcapsular [[cataracts]]
**[[Basal ganglia calcification|Basal ganglia calcifications]]<ref name="pmid22288727">{{cite journal |vauthors=Goswami R, Sharma R, Sreenivas V, Gupta N, Ganapathy A, Das S |title=Prevalence and progression of basal ganglia calcification and its pathogenic mechanism in patients with idiopathic hypoparathyroidism |journal=Clin. Endocrinol. (Oxf) |volume=77 |issue=2 |pages=200–6 |year=2012 |pmid=22288727 |doi=10.1111/j.1365-2265.2012.04353.x |url=}}</ref>
**Complications of [[intravenous]] [[calcium]] extravasation
**[[Hypocalcemia|Hypocalcemic]] [[seizure]]
**[[Dilated cardiomyopathy]]
**Pathological [[fractures]]
**[[Depression]] and other types of [[neuropsychiatric]] diseases
**Increased risk of [[infections]]
* Other common complications of the APS type 1 include [[Addison's disease]]
 
'''APS type 2'''
*Common complications of APS type 2 include those arising from [[Addison's disease]] such as:<ref name="pmid22907517">{{cite journal |vauthors=Quinkler M |title=[Addison's disease] |language=German |journal=Med Klin Intensivmed Notfmed |volume=107 |issue=6 |pages=454–9 |year=2012 |pmid=22907517 |doi=10.1007/s00063-012-0112-3 |url=}}</ref>
**[[Hypoglycemia]]
**[[Addisonian crisis]]
**[[Hypoxia]]
**[[Hypovolemic shock]]
**[[Cardiac arrest]]
**[[Stroke]]
*Other common complications of the APS type 2 include [[autoimmune thyroiditis]] and [[type 1 diabetes mellitus]]


*Common complications of APS type 3 include those arising from autoimmune thyroiditis such as:<ref name="pmid24434360">{{cite journal |vauthors=Caturegli P, De Remigis A, Rose NR |title=Hashimoto thyroiditis: clinical and diagnostic criteria |journal=Autoimmun Rev |volume=13 |issue=4-5 |pages=391–7 |year=2014 |pmid=24434360 |doi=10.1016/j.autrev.2014.01.007 |url=}}</ref><ref name="pmid25027262">{{cite journal |vauthors=Kirshner HS |title=Hashimoto's encephalopathy: a brief review |journal=Curr Neurol Neurosci Rep |volume=14 |issue=9 |pages=476 |year=2014 |pmid=25027262 |doi=10.1007/s11910-014-0476-2 |url=}}</ref><ref name="pmid23300224">{{cite journal |vauthors=Lun Y, Wu X, Xia Q, Han Y, Zhang X, Liu Z, Wang F, Duan Z, Xin S, Zhang J |title=Hashimoto's thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis |journal=Otolaryngol Head Neck Surg |volume=148 |issue=3 |pages=396–402 |year=2013 |pmid=23300224 |doi=10.1177/0194599812472426 |url=}}</ref><ref name="pmid22498583">{{cite journal |vauthors=Ahmed R, Al-Shaikh S, Akhtar M |title=Hashimoto thyroiditis: a century later |journal=Adv Anat Pathol |volume=19 |issue=3 |pages=181–6 |year=2012 |pmid=22498583 |doi=10.1097/PAP.0b013e3182534868 |url=}}</ref><ref name="pmid27797845">{{cite journal |vauthors=Chiang B, Cheng S, Seow CJ |title=Commonly forgotten complication of Hashimoto's thyroiditis |journal=BMJ Case Rep |volume=2016 |issue= |pages= |year=2016 |pmid=27797845 |doi=10.1136/bcr-2016-217568 |url=}}</ref>
'''APS type 3'''
*Common complications of APS type 3 include those arising from [[autoimmune thyroiditis]] such as:<ref name="pmid24434360">{{cite journal |vauthors=Caturegli P, De Remigis A, Rose NR |title=Hashimoto thyroiditis: clinical and diagnostic criteria |journal=Autoimmun Rev |volume=13 |issue=4-5 |pages=391–7 |year=2014 |pmid=24434360 |doi=10.1016/j.autrev.2014.01.007 |url=}}</ref><ref name="pmid25027262">{{cite journal |vauthors=Kirshner HS |title=Hashimoto's encephalopathy: a brief review |journal=Curr Neurol Neurosci Rep |volume=14 |issue=9 |pages=476 |year=2014 |pmid=25027262 |doi=10.1007/s11910-014-0476-2 |url=}}</ref><ref name="pmid23300224">{{cite journal |vauthors=Lun Y, Wu X, Xia Q, Han Y, Zhang X, Liu Z, Wang F, Duan Z, Xin S, Zhang J |title=Hashimoto's thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis |journal=Otolaryngol Head Neck Surg |volume=148 |issue=3 |pages=396–402 |year=2013 |pmid=23300224 |doi=10.1177/0194599812472426 |url=}}</ref><ref name="pmid22498583">{{cite journal |vauthors=Ahmed R, Al-Shaikh S, Akhtar M |title=Hashimoto thyroiditis: a century later |journal=Adv Anat Pathol |volume=19 |issue=3 |pages=181–6 |year=2012 |pmid=22498583 |doi=10.1097/PAP.0b013e3182534868 |url=}}</ref><ref name="pmid27797845">{{cite journal |vauthors=Chiang B, Cheng S, Seow CJ |title=Commonly forgotten complication of Hashimoto's thyroiditis |journal=BMJ Case Rep |volume=2016 |issue= |pages= |year=2016 |pmid=27797845 |doi=10.1136/bcr-2016-217568 |url=}}</ref>
**[[Hypothyroidism]]
**[[Hypothyroidism]]
**[[Hyperthyroidism]]
**[[Hyperthyroidism]]
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**[[Myxedema coma|Myxedema Coma]]
**[[Myxedema coma|Myxedema Coma]]
**[[Tracheal compression|Tracheal and/or esophageal compression]]
**[[Tracheal compression|Tracheal and/or esophageal compression]]
**[[Hashimoto's encephalopathy]]
**[[Papillary thyroid cancer|Papillary thyroid carcinoma]] (PTC)
**[[Papillary thyroid cancer|Papillary thyroid carcinoma]] (PTC)
**Thyroid [[lymphoma]]
**[[Thyroid]] [[lymphoma]]
 
*Other common complications of the APS type 3 include [[pernicious anemia]]
===Prognosis===
'''Type I:''' The prognosis of autoimmune polyendocrine syndrome type I is variable, depending on how organs are affected and the severity of the disease.
 
'''Type II:''' Prognosis of autoimmune polyendocrine syndrome type II depends on whether endocrine end-organ failures occur or not.
 
'''Type III:''' Prognosis of autoimmune polyendocrine syndrome type III depends on whether glandular failures occur or not.


===Prognosis===
===Prognosis===
The prognosis of autoimmune polyendocrine syndrome type is variable, depending on how organs are affected and the severity of the disease. Prognosis also depends on whether endocrine end-organ failures occur or not.
*The [[prognosis]] of [[autoimmune]] polyendocrine syndrome is variable and depends upon the duration and severity of [[endocrine]]/non-[[endocrine]] organ involved.
*Patients of APS with [[endocrine]] involvement generally require lifelong [[hormone]](s) replacement [[therapy]].
*Patients with family history of APS who are [[Screening (medicine)|screened]] and diagnosed early have a good [[prognosis]]. In other patients, the [[prognosis]] depends upon the component diseases.


==References==
==References==

Latest revision as of 21:23, 27 October 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

If left untreated, patients with autoimmune polyendocrine syndrome (APS) may progress to involve other endocrine and non-endocrine organs. APS can be a life-threatening condition if vital hormone producing organs of the body are involved such as adrenal glands, thyroid, parathyroid glands. The complications of APS depend upon the subtype and organ system involved. Common complications of APS include those arising from hypoparathyroidism, Addison's disease and autoimmune thyroiditis. The prognosis of APS is variable and depends upon the duration and severity of endocrine/non-endocrine organ involved. Patients of APS with endocrine involvement generally require lifelong hormone replacement therapy.

Natural History, Complications, and Prognosis

Natural History

Complications

The complications of autoimmune polyendocrine syndrome (APS) depends upon the subtype and endocrine/non-endocrine organ involved.

APS type 1

APS type 2

APS type 3

Prognosis

References

  1. ↑ Mitchell DM, Regan S, Cooley MR, Lauter KB, Vrla MC, Becker CB, Burnett-Bowie SA, Mannstadt M (2012). "Long-term follow-up of patients with hypoparathyroidism". J. Clin. Endocrinol. Metab. 97 (12): 4507–14. doi:10.1210/jc.2012-1808. PMC 3513540. PMID 23043192.
  2. ↑ Brandi ML, Bilezikian JP, Shoback D, Bouillon R, Clarke BL, Thakker RV, Khan AA, Potts JT (2016). "Management of Hypoparathyroidism: Summary Statement and Guidelines". J. Clin. Endocrinol. Metab. 101 (6): 2273–83. doi:10.1210/jc.2015-3907. PMID 26943719.
  3. ↑ Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L (2014). "Postsurgical hypoparathyroidism--risk of fractures, psychiatric diseases, cancer, cataract, and infections". J. Bone Miner. Res. 29 (11): 2504–10. doi:10.1002/jbmr.2273. PMID 24806578.
  4. ↑ Abate EG, Clarke BL (2016). "Review of Hypoparathyroidism". Front Endocrinol (Lausanne). 7: 172. doi:10.3389/fendo.2016.00172. PMC 5237638. PMID 28138323.
  5. ↑ Goswami R, Sharma R, Sreenivas V, Gupta N, Ganapathy A, Das S (2012). "Prevalence and progression of basal ganglia calcification and its pathogenic mechanism in patients with idiopathic hypoparathyroidism". Clin. Endocrinol. (Oxf). 77 (2): 200–6. doi:10.1111/j.1365-2265.2012.04353.x. PMID 22288727.
  6. ↑ Quinkler M (2012). "[Addison's disease]". Med Klin Intensivmed Notfmed (in German). 107 (6): 454–9. doi:10.1007/s00063-012-0112-3. PMID 22907517.
  7. ↑ Caturegli P, De Remigis A, Rose NR (2014). "Hashimoto thyroiditis: clinical and diagnostic criteria". Autoimmun Rev. 13 (4–5): 391–7. doi:10.1016/j.autrev.2014.01.007. PMID 24434360.
  8. ↑ Kirshner HS (2014). "Hashimoto's encephalopathy: a brief review". Curr Neurol Neurosci Rep. 14 (9): 476. doi:10.1007/s11910-014-0476-2. PMID 25027262.
  9. ↑ Lun Y, Wu X, Xia Q, Han Y, Zhang X, Liu Z, Wang F, Duan Z, Xin S, Zhang J (2013). "Hashimoto's thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis". Otolaryngol Head Neck Surg. 148 (3): 396–402. doi:10.1177/0194599812472426. PMID 23300224.
  10. ↑ Ahmed R, Al-Shaikh S, Akhtar M (2012). "Hashimoto thyroiditis: a century later". Adv Anat Pathol. 19 (3): 181–6. doi:10.1097/PAP.0b013e3182534868. PMID 22498583.
  11. ↑ Chiang B, Cheng S, Seow CJ (2016). "Commonly forgotten complication of Hashimoto's thyroiditis". BMJ Case Rep. 2016. doi:10.1136/bcr-2016-217568. PMID 27797845.

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