Autoimmune polyglandular syndrome type 2

2025-08-04T20:57:08-05:00

Introduction: Autoimmune polyglandular syndrome type 2 (APS-II) is a rare disorder characterized by the coexistence of primary adrenal insufficiency with autoimmune thyroid disease and/or type 1 diabetes mellitus. It may also be associated with other endocrine and non-endocrine autoimmune conditions.

Objective: To report a clinical case of autoimmune polyglandular syndrome type 2 and highlight the importance of its timely recognition in clinical practice.

Case presentation: A 33-year-old woman with a history of autoimmune hypothyroidism and vitiligo presented with constitutional symptoms and cutaneous manifestations. Evaluation revealed adrenal crisis, hypergonadotropic hypogonadism, the presence of positive antithyroid antibodies, and thyroid dysfunction, findings consistent with APS-II. Treatment with glucocorticoids, mineralocorticoids, and hormone replacement therapy was initiated, with progressive clinical improvement.

Discussion: Autoimmune polyglandular syndrome type 2 is a challenging diagnosis due to its heterogeneous and progressive presentation. A high index of suspicion is required, especially in patients with multiple autoimmune conditions. The combination of clinical manifestations and hormonal studies allows for diagnosis and guides appropriate treatment. Although less common, hypergonadotropic hypogonadism may occur as part of the clinical spectrum.

Conclusion: This case underscores the importance of considering autoimmune polyglandular syndrome type 2 in patients with multiple autoimmune diseases. Early diagnosis enables appropriate treatment and helps prevent serious complications. Additionally, it contributes to raising awareness of this condition in Colombia, where reports remain scarce.

“Diabetic hand”: Hand complications in people with diabetes

2025-05-05T12:36:30-05:00

Context: Distal and symmetrical diabetic peripheral neuropathy affects the feet first, and later, the hands. Its natural history may conclude in diabetic foot syndrome. It is one of the most frequent diabetes complications. This raises the question of which are the most common hand complications in people with diabetes and whether hand and foot complications share similar physio pathological mechanisms.

Objective: To analyze the most frequent hand problems in people with diabetes and their similarities and differences compared with those of diabetic foot syndrome.

Methodology: A search of indexed scientific literature was conducted.

Results: Hand problems are more frequent in people with diabetes than in the general population. They are associated with microvascular complications, especially retinopathy, longer disease duration, and poor glycemic control. Diabetes is neither a cause nor a risk factor for hand deformities; however, frequent causes include trauma and compression neuropathies. The most common extra-articular hand problems in people with diabetes are: 1) diabetic cheiroarthropathy (hand rigidity or limitation of articular mobility); 2) the compression or entrapment neuropathies, of which the most common is carpal tunnel syndrome; and 3) fibroproliferative disorders (trigger finger and Dupuytren’s contracture). Management focuses on improving glycemic control, alleviating pain, and preserving or improving function.

Conclusions: Hand problems in people with diabetes are musculoskeletal disorders and have a different etiology from that of diabetic microvascular complications.

Revista Colombiana de Endocrinología, Diabetes & Metabolismo

Autoimmune polyglandular syndrome type 2

“Diabetic hand”: Hand complications in people with diabetes