Atypical Autoimmune Polyglandular Syndrome Type 3 Overlapped by Chronic HCV Infection Resulting in Carcinogenesis and Fatal Infection

Abstract

The case of a woman with insulin-dependent diabetes mellitus, autoimmune thyroiditis, atrophic gastritis, pernicious anemia, and immunologic thrombocytopenic purpura consisting of autoimmune polyglandular syndrome type 3 associated with a history of gonadal failure is reported. Hepatitis C viral infection added xerophthalmia, lymphocytic sialadenitis, and exacerbation of idiopathic thrombocytopenic purpura. This unique disease constellation was complicated with splenic marginal zone lymphoma and gastric carcinoids. A lung infection, initially treated on an outpatient basis, proved fatal to the patient.

A rare combination of type 3 autoimmune polyendocrine syndrome (APS-3) or multiple autoimmune syndrome (MAS-3)

“…DM-1, alopecia areata, autoimmune neutropenia, Sjögren’s syndrome and chronic cutaneous lupus erythematosus [ 14 ]. Another patient coming from Greece presented Hashimoto’s thyroiditis associated with other three autoimmune diseases: DM-1, atrophic gastritis with pernicious anemia and immunologic thrombocytopenic purpura [ 15 ]. The third patient was described by American colleagues with silent thyroiditis and other three autoimmune diseases, i.e.…”