伴多种并发症的Ⅰ型自身免疫性多内分泌腺病综合征1例及文献复习

A case of typeⅠautoimmune polyendocrinopathy syndrome with multiple complications and review of the literature

该文报道了1例53岁中年女性患者的临床资料。患者因头晕、乏力、恶心、呕吐3 d及腹泻入院。临床检查显示该患者有多种自身免疫性及非免疫性疾病,并伴多种并发症。主要疾病包括口腔念珠菌感染、1型糖尿病、桥本甲状腺炎甲状腺功能减退、中重度非节段型白癜风。同时发现患者患代谢综合征,包括高密度脂蛋白缺乏、高血压病1级(极高危组)及糖尿病性酮症酸中毒、糖尿病性周围神经病变、糖尿病性肾病(G2A1期)、糖尿病性周围血管病变。此外,该患者还患有低蛋白血症、锁骨下动脉斑块、颈总动脉斑块、抑郁状态和骨质疏松等多种并发症,患者被临床诊断为Ⅰ型自身免疫性多内分泌综合征。患者经住院期间综合治疗恢复良好,出院后继续服药。

This paper reports the clinical data of a 53-year-old middle-aged female patient who was admitted to the hospital with dizziness,fatigue,nausea,vomiting for 3 days and diarrhea.The Clinical examination showed that the patient had a variety of autoimmune and non-immune manifestations,accompanied by a variety of complications.The main disease are oral candida infection,typeⅠdiabetes,Hashimoto thyroiditis hypothyroidism,and moderate to severe non-segmental vitiligo.At the same time,it was found that the patient had metabolic syndrome,including high-density lipoprotein deficiency,hypertension grade 1(very high risk group)and diabetic ketoacidosis,diabetic peripheral neuropathy,diabetic nephropathy(stage G2A1),and diabetic peripheral vasculopathy.In addition,the patient had multiple complications such as hypoproteinemia,subclavian artery plaque,common carotid artery plaque,depressive status,and osteoporosis,and was clinically diagnosed as typeⅠautoimmune polyendocrine syndrome.The patient recovered well after comprehensive treatment during hospitalization and continued to take medication after discharge.