Autoimmune polyendocrine syndrome secondary prevention: Difference between revisions
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Effective measures for the [[secondary prevention]] of autoimmune polyendocrine syndrome (APS) include: | Effective measures for the [[secondary prevention]] of autoimmune polyendocrine syndrome (APS) include: | ||
*[[Patient education]]: [[Patient education]] is an important aspect in early [[diagnosis]] and management of APS. In APS the time interval between involvement of one [[endocrine organ]] to other [[endocrine]]/nonendocrine [[Organ (anatomy)|organ]] may take years. For example, patients with APS type 1 develops mucocutaneous [[candidiasis]] in [[infancy]] and it may take upto five years for them to develop [[hypoparathyroidism]]. [[Patient|Patients]] should also be informed about [[symptoms]] of other [[disorders]] for which they are at high risk such as [[Addison's disease]] or [[diabetes mellitus]]. | *[[Patient education]]: [[Patient education]] is an important aspect in early [[diagnosis]] and management of APS. In APS the time interval between involvement of one [[endocrine organ]] to other [[endocrine]]/nonendocrine [[Organ (anatomy)|organ]] may take years. For example, patients with APS type 1 develops mucocutaneous [[candidiasis]] in [[infancy]] and it may take upto five years for them to develop [[hypoparathyroidism]]. [[Patient|Patients]] should also be informed about [[symptoms]] of other [[disorders]] for which they are at high risk such as [[Addison's disease]] or [[diabetes mellitus]]. | ||
*[[Patients]] with type 1 and type 2 APS should be screened at an interval of 6 to 12 months for development of other [[endocrine]]/non-endocrine disorders | *[[Patients]] with type 1 and type 2 APS should be screened at an interval of 6 to 12 months for development of other [[endocrine]]/non-endocrine disorders: | ||
**If [[autoantibodies]] are present without the associated disease, functional testing is indicated. | **If [[autoantibodies]] are present without the associated disease, functional testing is indicated. | ||
**[[Patients]] with [[antibodies]] against [[21-Hydroxylase|21-hydroxylase]] should be monitored annually for [[Adrenocorticotropic hormone|ACTH]] levels, morning (8 am) [[Cortisol level|cortisol levels]], and [[cosyntropin]] stimulation testing. The time interval between testing may vary depending upon the [[Signs and Symptoms|signs and symptoms]] of the [[disease]]. | **[[Patients]] with [[antibodies]] against [[21-Hydroxylase|21-hydroxylase]] should be monitored annually for [[Adrenocorticotropic hormone|ACTH]] levels, morning (8 am) [[Cortisol level|cortisol levels]], and [[cosyntropin]] stimulation testing. The time interval between testing may vary depending upon the [[Signs and Symptoms|signs and symptoms]] of the [[disease]]. | ||
Revision as of 19:02, 28 September 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
Effective measures for the secondary prevention of autoimmune polyendocrine syndrome (APS) include patient education and periodic screening. In APS the time interval between involvement of one endocrine organ to other endocrine/nonendocrine organ may take years. Thus, patient should be informed about signs and symptoms of commonly associated conditions/disorders with APS. In addition, periodic screening at an interval of 6-12 months should be done to detect the presence of any autoantibody such as antibodies against 21-hydroxylase or islet cells.
Secondary Prevention
Effective measures for the secondary prevention of autoimmune polyendocrine syndrome (APS) include:
- Patient education: Patient education is an important aspect in early diagnosis and management of APS. In APS the time interval between involvement of one endocrine organ to other endocrine/nonendocrine organ may take years. For example, patients with APS type 1 develops mucocutaneous candidiasis in infancy and it may take upto five years for them to develop hypoparathyroidism. Patients should also be informed about symptoms of other disorders for which they are at high risk such as Addison's disease or diabetes mellitus.
- Patients with type 1 and type 2 APS should be screened at an interval of 6 to 12 months for development of other endocrine/non-endocrine disorders:
- If autoantibodies are present without the associated disease, functional testing is indicated.
- Patients with antibodies against 21-hydroxylase should be monitored annually for ACTH levels, morning (8 am) cortisol levels, and cosyntropin stimulation testing. The time interval between testing may vary depending upon the signs and symptoms of the disease.
- Patients with antibodies against islet cell who are asymptomatic should be tested for serum glucose level. This can help in early detection of diabetes before overt clinical symptoms sets in. Educating these patients about the importance of diet and glucose home monitoring can help prevent progression and complications of the disease.