Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis—A case report of autoimmune polyglandular syndrome type III C + D and literature review
ObjectiveThis study aims to summarize the clinical characteristics of one teenager with autoimmune polyglandular syndrome (APS) type III C + D to improve the understanding of APS III C + D and its effect of thyroid function.MethodsThis article reported the clinical manifestations, laboratory examina...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-03-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1062505/full |
| _version_ | 1797857882000064512 |
|---|---|
| author | Yongmei Sun Xuan Kan Rongxiu Zheng Liping Hao Zongtao Mao Ying Jia |
| author_facet | Yongmei Sun Xuan Kan Rongxiu Zheng Liping Hao Zongtao Mao Ying Jia |
| author_sort | Yongmei Sun |
| collection | DOAJ |
| description | ObjectiveThis study aims to summarize the clinical characteristics of one teenager with autoimmune polyglandular syndrome (APS) type III C + D to improve the understanding of APS III C + D and its effect of thyroid function.MethodsThis article reported the clinical manifestations, laboratory examinations, treatment methods, and outcomes of an adolescent with anemia admitted to the Pediatrics Department of Tianjin Medical University General Hospital in July 2020 and reviewed the literature.ResultsA girl, aged 13 years and 1 month, was admitted to the hospital due to anemia for more than 4 years and episodic abdominal pain for 1 week. Four years ago, the girl went to a local hospital for “vitiligo”, and a routine blood test revealed anemia. The lowest hemoglobin (HGB) was 61 g/L, and the blood test revealed iron deficiency anemia. She had no menstrual cramps for 2 months. Urine routine showed protein 3+∼4+ and 258 red blood cells (RBCs)/high-power field. Urine protein was 3,380 mg/24 h. Free thyroxine was low, thyroid-stimulating hormone was >100 uIU/ml, thyroid peroxidase antibody was >1,000 IU/ml, and thyroglobulin antibody and thyrotropin receptor antibody were negative. Pituitary magnetic resonance imaging showed a mass in the sellar region with a uniform signal and a maximum height of about 15.8 mm. The result of the antinuclear antibody was 1:80 homogeneous type, and anti-dsDNA and anticardiolipin antibodies IgA and IgM were slightly higher. Thyroxine and iron were given for 1 month, menstruation resumed, and urine protein and RBC count decreased. After 5 months of treatment, free thyroid function, HGB, RBCs in urine, and pituitary returned to normal. Later, a renal biopsy showed changes in focal proliferative glomerulonephritis, and the girl was diagnosed with lupus glomerulonephritis type III. After 3 days of shock therapy with methylprednisolone, prednisone, mycophenolate mofetil, and other treatments were administrated for 1 year. At the time of writing, urine protein was 280 mg/24 h.ConclusionCo-occurrence of Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis is rare. It is very important to pay attention to the screening of thyroid function. |
| first_indexed | 2024-04-09T21:04:01Z |
| format | Article |
| id | doaj.art-5c3b4e658d57445bac5408d08320181a |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-09T21:04:01Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-5c3b4e658d57445bac5408d08320181a2023-03-29T04:49:53ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-03-011110.3389/fped.2023.10625051062505Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis—A case report of autoimmune polyglandular syndrome type III C + D and literature reviewYongmei Sun0Xuan Kan1Rongxiu Zheng2Liping Hao3Zongtao Mao4Ying Jia5Department of Pediatrics, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Pediatrics, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Pediatrics, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Pediatrics, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Plastic and Reconstructive Surgery, The First Hospital of Jilin University, Changchun, ChinaDepartment of Pediatrics, Tianjin Medical University General Hospital, Tianjin, ChinaObjectiveThis study aims to summarize the clinical characteristics of one teenager with autoimmune polyglandular syndrome (APS) type III C + D to improve the understanding of APS III C + D and its effect of thyroid function.MethodsThis article reported the clinical manifestations, laboratory examinations, treatment methods, and outcomes of an adolescent with anemia admitted to the Pediatrics Department of Tianjin Medical University General Hospital in July 2020 and reviewed the literature.ResultsA girl, aged 13 years and 1 month, was admitted to the hospital due to anemia for more than 4 years and episodic abdominal pain for 1 week. Four years ago, the girl went to a local hospital for “vitiligo”, and a routine blood test revealed anemia. The lowest hemoglobin (HGB) was 61 g/L, and the blood test revealed iron deficiency anemia. She had no menstrual cramps for 2 months. Urine routine showed protein 3+∼4+ and 258 red blood cells (RBCs)/high-power field. Urine protein was 3,380 mg/24 h. Free thyroxine was low, thyroid-stimulating hormone was >100 uIU/ml, thyroid peroxidase antibody was >1,000 IU/ml, and thyroglobulin antibody and thyrotropin receptor antibody were negative. Pituitary magnetic resonance imaging showed a mass in the sellar region with a uniform signal and a maximum height of about 15.8 mm. The result of the antinuclear antibody was 1:80 homogeneous type, and anti-dsDNA and anticardiolipin antibodies IgA and IgM were slightly higher. Thyroxine and iron were given for 1 month, menstruation resumed, and urine protein and RBC count decreased. After 5 months of treatment, free thyroid function, HGB, RBCs in urine, and pituitary returned to normal. Later, a renal biopsy showed changes in focal proliferative glomerulonephritis, and the girl was diagnosed with lupus glomerulonephritis type III. After 3 days of shock therapy with methylprednisolone, prednisone, mycophenolate mofetil, and other treatments were administrated for 1 year. At the time of writing, urine protein was 280 mg/24 h.ConclusionCo-occurrence of Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis is rare. It is very important to pay attention to the screening of thyroid function.https://www.frontiersin.org/articles/10.3389/fped.2023.1062505/fullautoimmune polyglandular syndrome (APS) type IIIHashimoto's thyroiditis (HT)vitiligoanemialupus nephritis (LN)pituitary hyperplasia |
| spellingShingle | Yongmei Sun Xuan Kan Rongxiu Zheng Liping Hao Zongtao Mao Ying Jia Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis—A case report of autoimmune polyglandular syndrome type III C + D and literature review Frontiers in Pediatrics autoimmune polyglandular syndrome (APS) type III Hashimoto's thyroiditis (HT) vitiligo anemia lupus nephritis (LN) pituitary hyperplasia |
| title | Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis—A case report of autoimmune polyglandular syndrome type III C + D and literature review |
| title_full | Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis—A case report of autoimmune polyglandular syndrome type III C + D and literature review |
| title_fullStr | Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis—A case report of autoimmune polyglandular syndrome type III C + D and literature review |
| title_full_unstemmed | Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis—A case report of autoimmune polyglandular syndrome type III C + D and literature review |
| title_short | Hashimoto's thyroiditis, vitiligo, anemia, pituitary hyperplasia, and lupus nephritis—A case report of autoimmune polyglandular syndrome type III C + D and literature review |
| title_sort | hashimoto s thyroiditis vitiligo anemia pituitary hyperplasia and lupus nephritis a case report of autoimmune polyglandular syndrome type iii c d and literature review |
| topic | autoimmune polyglandular syndrome (APS) type III Hashimoto's thyroiditis (HT) vitiligo anemia lupus nephritis (LN) pituitary hyperplasia |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1062505/full |
| work_keys_str_mv | AT yongmeisun hashimotosthyroiditisvitiligoanemiapituitaryhyperplasiaandlupusnephritisacasereportofautoimmunepolyglandularsyndrometypeiiicdandliteraturereview AT xuankan hashimotosthyroiditisvitiligoanemiapituitaryhyperplasiaandlupusnephritisacasereportofautoimmunepolyglandularsyndrometypeiiicdandliteraturereview AT rongxiuzheng hashimotosthyroiditisvitiligoanemiapituitaryhyperplasiaandlupusnephritisacasereportofautoimmunepolyglandularsyndrometypeiiicdandliteraturereview AT lipinghao hashimotosthyroiditisvitiligoanemiapituitaryhyperplasiaandlupusnephritisacasereportofautoimmunepolyglandularsyndrometypeiiicdandliteraturereview AT zongtaomao hashimotosthyroiditisvitiligoanemiapituitaryhyperplasiaandlupusnephritisacasereportofautoimmunepolyglandularsyndrometypeiiicdandliteraturereview AT yingjia hashimotosthyroiditisvitiligoanemiapituitaryhyperplasiaandlupusnephritisacasereportofautoimmunepolyglandularsyndrometypeiiicdandliteraturereview |