Clinical manifestations and management of patients with autoimmune polyendocrine syndrome type i

Husebye ES, Perheentupa J, Rautemaa R, Kämpe O (Institute of Medicine, University of Bergen; Haukeland University Hospital; Bergen, Norway, Helsinki University Hospital; University of Helsinki; Helsinki, Finland, and Uppsala University Hospital, Uppsala, Sweden). Clinical manifestations and management of patients with autoimmune polyendocrine syndrome type I (Review). J Intern Med 2009; 265:514-529. Autoimmune polyendocrine syndrome type I (APS-I) is a monogenic model disease of autoimmunity. Its hallmarks are chronic mucocutaneous candidosis, hypoparathyroidism and adrenal insufficiency, but many other autoimmune disease components occur less frequently. The first components usually appear in childhood, but may be delayed to adolescence or early adult life. There is enormous variation in presentation and phenotype, which makes the diagnosis difficult. Antibodies against interferon-ω and -α have recently been shown to be sensitive and relatively specific markers for APS-I, and mutational analysis of the autoimmune regulator gene gives the diagnosis in >95% of cases. The treatment and follow-up of patients is demanding and requires the collaboration of specialists of several fields. However, the literature is especially sparse regarding information on treatment and follow-up; hence, we present here a comprehensive overview on clinical characteristics, treatment and follow-up based on personal experience and published studies. © 2009 Blackwell Publishing Ltd.