AB0776 MULTIPLE AUTOIMMUNE SYNDROME

Background:Multiple autoimmune syndrome (MAS) is a rare entity, defined by the association of three autoimmune diseases in the same patient. MAS can be classified into three groups.Objectives:The objective of this work was to describe the autoimmune diseases profile in MAS in An Internal Medicine Department.Methods:We report a retrospective analysis including 14 cases of MAS seen in The Internal Medicine Department at Taher Sfar Hospital, Mahdia, TUNISIA over a period of 10 years.Results:We followed 14 patients with MAS. They were 14 women. The mean age of patients was 52 years. SAM was type 3 in 12 patients (85%), type 2 in one patient (7.1%) and one patient satisfied both type 2 and type 3 MAS criteria (7.1%). No cases of MAS type 1 had been reported. We found 13 patients with 3 associated autoimmune diseases and one patient with 4 associated autoimmune diseases. The autoimmune diseases were: Sjögren’s syndrome in 14 patients (100%), Hashimoto’s thyroiditis in 11 cases (78%), systemic lupus erythematosus in 7 cases (50%), Addison’s disease in 4 cases (28, 5%), scleroderma, thymoma, vitiligo, Biermer and primary biliary cholangitis each in one case (7.1%).Conclusion:Multiple autoimmune syndrome remains a rare but probably under-diagnosed entity. Thus, in patients with autoimmune disease, initial investigation and follow-up of clinical signs and biological stigmas of other autoimmune diseases should be cautious.Disclosure of Interests:None declared

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P0479 IMPACT OF THE ANTI-TNF α AGENTS TREATMENT IN PATIENTS WITH PSORIATIC ARTHRITIS (PA)- EXPERIENCE OF AN AUTOIMMUNE DISEASES CONSULTATION OF AN INTERNAL MEDICINE DEPARTMENT

European Journal of Internal Medicine ◽

10.1016/s0953-6205(09)60499-4 ◽

2009 ◽

Vol 20 ◽

pp. S159

Author(s):

Margarida Rocha ◽

Pedro Cunha ◽

Jorge Cotter

Keyword(s):

Internal Medicine ◽

Psoriatic Arthritis ◽

Autoimmune Diseases ◽

Medicine Department ◽

Internal Medicine Department ◽

Tnf Α

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Autoimmune diseases go well together — Multiple autoimmune syndrome type 3

European Journal of Internal Medicine ◽

10.1016/j.ejim.2013.08.637 ◽

2013 ◽

Vol 24 ◽

pp. e248

Author(s):

S.C. Verdasca ◽

S. Fernandes ◽

A. Mansinho ◽

M. Cortes ◽

R. Fernandes ◽

...

Keyword(s):

Autoimmune Diseases ◽

Syndrome Type ◽

Autoimmune Syndrome ◽

Multiple Autoimmune Syndrome ◽

Type 3

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Socio-demographic characteristics and treatment outcome of patients with malignancy and type 2 diabetes

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v28i2.33355 ◽

2018 ◽

Vol 28 (2) ◽

pp. 70-74

Author(s):

Md Raziur Rahman ◽

Samira Rahat Afroze ◽

Rene Suzan Claude Sarker ◽

Muhammad Abdur Rahim ◽

Khwaja Nazim Uddin

Keyword(s):

Internal Medicine ◽

Type 2 Diabetes ◽

General Hospital ◽

Response To Treatment ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Medicine Department ◽

Internal Medicine Department ◽

Radiology Reports

Background: In Bangladesh prevalence of malignancy in diabetic patients seems to be increasing as case detection of both diseases are far more than before. No statistical data of diabetic patients with malignancy is currently available in Bangladesh. Treatment of both diabetes and malignancy in the same patient is challenging for the physician and requires multidisciplinary support. For such cases BIRDEM General Hospital offers supportive facilities including intensive care, chemotherapy, surgical intervention and oncology day care.Methods : This is a cross-sectional observational study carried out from January 2011 to June 2016 which included adult diabetic patients with malignancy admitted in Internal Medicine Department of BIRDEM General Hospital. With prior informed consent of the patients, data were collected and statistical analysis was done using professional SPSS version 17.0 windows based program.Results : Total number of type 2 diabetic patients with malignancy was 80. Among them 49 (61.3%) were male and 31 (37.7%) were female patients. Almost two-third of the patients was between 41-60 years (63.8%). More than half of the patients belonged to urban settings (42, 52.5%) followed by sub-urban area (27, 33.7%). Smoking was the commonest (23.8%) among the risk factors. Family history for malignancy and exposure to occupational hazards were present in 11.3% and 7.5% cases respectively. Among co-morbid conditions, hypertension and ischemic heart disease were predominant. Twenty categories of malignancies were confirmed by histopathological evidence, radiology reports and cancer markers. The commonest malignancy in male and female was lymphoma and carcinoma breast respectively. Most patients were treated with chemotherapy (48.8%) and combined approach was required in 36.3% cases. Good response to treatment was observed in 46.3% cases, 15% patients deteriorated and death occurred in 6.3% cases.Conclusion : Type 2 diabetes and malignancy individually have their own consequences. When co-existing, patients require a holistic approach. Complications can arise from either spectrum of the diseases. If managed promptly and adequately, outcome of such cases is encouraging. Management outcome of these cases so far in Internal Medicine Department, BIRDEM General Hospital shows a promising future.Bangladesh J Medicine Jul 2017; 28(2) : 70-74

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Multiple Autoimmune Syndrome: An Unusual Combination of Autoimmune Disorders

Reviews on Recent Clinical Trials ◽

10.2174/1574887115666200621184110 ◽

2020 ◽

Vol 15 (3) ◽

pp. 240-243 ◽

Cited By ~ 1

Author(s):

Sabahat Sarfaraz ◽

Sabiha Anis

Keyword(s):

Celiac Disease ◽

Case Report ◽

Autoimmune Disease ◽

Autoimmune Diseases ◽

Autoimmune Hepatitis ◽

Primary Biliary Cholangitis ◽

Team Approach ◽

Crest Syndrome ◽

Autoimmune Syndrome ◽

Multiple Autoimmune Syndrome

Background: Autoimmune diseases are multifactorial with environmental and heritable factors. Autoimmunity reflects an altered immune status, therefore the presence of more than one disorder is not uncommon. The coexistence of three or more autoimmune diseases in a patient constitutes multiple autoimmune syndrome (MAS). This is an interesting case of a middle-aged female who had celiac disease, primary biliary cholangitis, autoimmune hepatitis and evolving CREST (Calcinosis, Rhaynaud’s phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasia) syndrome. Case Report: Fifty years old female patient presented with generalized fatigue, fever, weight loss, vertigo and constipation. She was a diagnosed case of celiac disease, and responded well to glutenfree diet. Family history was unremarkable for any autoimmune disorder. Laboratory workup showed normal complete blood counts, markedly elevated transaminases and alkaline phosphates. Her antinuclear antibodies (ANA) test was strongly positive (>1:320) and showed an anti-centromere pattern. Anti-extractable nuclear antibody(ENA) assay showed anti-mitochondrial and anti- CENP B antibodies. Liver biopsy revealed overlap syndrome (primary biliary cholangitis and autoimmune hepatitis). : This patient had celiac disease, primary biliary cholangitis and autoimmune hepatitis. Extensive immunological workup unexpectedly revealed the presence of anti-centromere protein B (anti-CENP B) antibodies which are strongly associated with CREST syndrome. Clinical re-evaluation of the patient gave clues of the evolving CREST syndrome. This case report highlights the importance of adequate immunological investigations in conjunction with clinical information for adequate patient management to achieve favorable consequences in the future. Conclusion: Patients suffering from an autoimmune disease need special attention as multiple immune- mediated disorders may be present simultaneously or sequentially during the course of the disease process. MAS patients are at a higher risk of acquiring infections and tumor development due to prolonged use of immunosuppressants. These patients need close surveillance for the development of another autoimmune disease, so as to control the current disease and to prevent future complications. This case report emphasizes the importance of a multidisciplinary team approach including an immunologist who may facilitate a better understanding of disorders related to the breakdown of immune tolerance.

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