Autoimmune polyendocrine syndrome screening
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Differentiating Autoimmune polyendocrine syndrome from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
There is insufficient evidence to recommend routine screening for [disease/malignancy].
OR
According to the [guideline name], screening for [disease name] is not recommended.
OR
According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
Screening
Screening is an important aspect in early diagnosis and management of autoimmune polyendocrine syndrome (APS). In patients of APS, high clinical suspicion should be maintained for presence of other autoimmune disorders.
- In APS type 1, the time interval between onset of mucocutaneous candidiasis and hypoparathyroidism may take upto five years and further involvement of adrenal glands may take upto ten years. Thus, a high degree of clinical suspicion is necessary in patients with a single autoimmune endocrine disorder.
- Once a patient has been diagnosed with a single autoimmune disorder. Screening should be done for presence of other auto-antibodies such as 21- hydroxylase, 17-hydroxylase, thyroid peroxidase, parietal cell, anti-intrinsic factor and islet cell antibodies.
- Recent research have shown that in APS, autoantibodies can develop at any age and there is insufficient evidence to suggest optimum interval between testing. For example patients of celiac disease are often asymptomatic and are detected only after screening for transglutaminase autoantibodies. Thus, individuals with single autoimmune disorder should be rescreened for autoantibodies for other autoimmune conditiosn at appropriate intervals even if their initial autoantibody tests are negative.