Autoimmune polyendocrine syndrome type 2 complicated with hyperthyroidism crisis and diabetic acute complications： a case report and literature review

Abstract

Objective To enhance clinicians’ diagnosis and treatment capability for autoimmune polyendocrine syndrome type 2 （APS-2），and reduce missed diagnosis and misdiagnosis. Methods A 46-year-old female APS-2 patient with polyendocrine crisis was reported. Using the key words of “autoimmune polyendocrine syndrome” “diabetic acute complications” and “hyperthyroidism crisis” ，relevant literatures were searched from PubMed，SinoMed，CNKI，Wanfang Data and China Science and Technology Journal Database. Data of APS patients complicated with diabetic acute complications and hyperthyroidism crisis were collected and analyzed. Results The main manifestations of this patient were repeated polyuria and polydipsia for 18 years. She was admitted due to nausea and vomiting for half a day. Relevant examinations suggested the signs of diabetic ketoacidosis complicated with lactic acidosis and hyperthyroidism crisis，and the diagnosis of APS-2 was confirmed. Only 2 cases of APS-3 combined with acute diabetic complications and hyperthyroidism crisis were found in the literature，no APS-2 or other APS types patient complicated with diabetic acute complications and hyperthyroidism crisis was searched. Conclusions APS-2 patients complicated with diabetic acute complications and hyperthyroidism crisis are rare，which is likely to miss diagnosis and delay the diagnosis and treatment. Clinicians should improve relevant diagnosis and treatment capability. Prompt treatment contributes to favorable prognosis.

Keywords

• autoimmune polyendocrine syndrome type 2|diabetic acute complication|hyperthyroidism crisis