Autoimmune polyendocrine syndrome secondary prevention

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

Overview

There are no established measures for the secondary prevention of [disease name].

OR

Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].

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 tissue to other endocrine tissue 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