PMID- 16946565
OWN - NLM
STAT- MEDLINE
DCOM- 20070402
LR  - 20190907
IS  - 0918-8959 (Print)
IS  - 0918-8959 (Linking)
VI  - 53
IP  - 5
DP  - 2006 Oct
TI  - A case of polyglandular autoimmune syndrome type III complicated with autoimmune 
      hepatitis.
PG  - 705-9
AB  - A 58-year-old woman complaining of finger tremor was referred to our hospital. 
      The diagnosis of Graves' disease was made based on increased free 
      triiodothyronine (18.88 pg/ml) and free thyroxine (7.47 ng/dl), low TSH (<0.005 
      microIU/ml) and increased TSH receptor binding antibody activity (70.9%). Serum 
      level of AST (62 U/l) and ALT (93 U/l) were increased and liver biopsy revealed 
      linkage of adjacent portal areas by lymphoplasmacytic infiltrates and fibrosis 
      with piecemeal necrosis. Although antinuclear antibody was negative, these 
      findings indicated that she had autoimmune hepatitis (AIH) according to the 
      criteria of the International Autoimmune Hepatitis Scoring System. Slowly 
      progressive type 1 diabetes mellitus (DM) was confirmed by a diabetic response 
      pattern due to 75 g-oral glucose tolerance test, and seropositivity towards 
      anti-glutamic acid decarboxylase (725 U/ml) and islet cell (80 JDF Units) 
      antibodies. This case exhibited an extremely rare combination of three different 
      autoimmune diseases, including Graves' disease, slowly progressive type 1 DM and 
      AIH, and had no known sensitive human leukocyte antigen (HLA) typing or haplotype 
      for these disorders. Although it is common for patients with Graves' disease to 
      exhibit abnormal liver function, it is important to make an accurate diagnosis of 
      AIH because of this life-threatening disorder.
FAU - Oki, Kenji
AU  - Oki K
AD  - Department of Molecular and Internal Medicine, Graduate School Biomedical 
      Sciences, Hiroshima University, Kasumi, Hiroshima, Japan.
FAU - Yamane, Kiminori
AU  - Yamane K
FAU - Koide, Junko
AU  - Koide J
FAU - Mandai, Koichi
AU  - Mandai K
FAU - Nakanishi, Shuhei
AU  - Nakanishi S
FAU - Fujikawa, Rumi
AU  - Fujikawa R
FAU - Kohno, Nobuoki
AU  - Kohno N
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20060901
PL  - Japan
TA  - Endocr J
JT  - Endocrine journal
JID - 9313485
RN  - 9002-60-2 (Adrenocorticotropic Hormone)
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Adrenocorticotropic Hormone/blood
MH  - Diabetes Mellitus, Type 1/blood/complications
MH  - Female
MH  - Glucose Tolerance Test
MH  - Graves Disease/blood/complications/diagnosis
MH  - Hepatitis, Autoimmune/blood/*complications/pathology
MH  - Humans
MH  - Hydrocortisone/blood
MH  - Liver/pathology
MH  - Middle Aged
MH  - Polyendocrinopathies, Autoimmune/blood/*complications/diagnosis
MH  - Serologic Tests
MH  - Syndrome
EDAT- 2006/09/02 09:00
MHDA- 2007/04/03 09:00
CRDT- 2006/09/02 09:00
PHST- 2006/09/02 09:00 [pubmed]
PHST- 2007/04/03 09:00 [medline]
PHST- 2006/09/02 09:00 [entrez]
AID - JST.JSTAGE/endocrj/K05-166 [pii]
AID - 10.1507/endocrj.k05-166 [doi]
PST - ppublish
SO  - Endocr J. 2006 Oct;53(5):705-9. doi: 10.1507/endocrj.k05-166. Epub 2006 Sep 1.