<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction.</bold> Although type 1 diabetes mellitus is largely associated with autoimmune thyroid disease and this entity has been recently referred to as autoimmune polyglandular syndrome type 3 variant, the autoimmune polyglandular syndrome type 3 variant in patients with rheumatoid arthritis has not been reported so far. We herein describe the first case of rheumatoid arthritis that was associated with autoimmune polyglandular syndrome type 3 variant.<bold>Case report.</bold> A 77-year-old woman with a 15-year history of rheumatoid arthritis (RA) and a 10-year history of type 2 diabetes mellitus (T2D) presented with polyarthralgia and hyperglycaemia. Methotrexate 16 mg/week had been started from the onset and was continued, and adalimumab 40 mg/day was started for RA. Insulin treatment was also started for the diabetes. Laboratory examinations revealed high levels of C-reactive protein (CRP), rheumatoid factor, anti-cyclic citrullinated peptide antibody, and matrix metalloprotease 3. She was admitted multiple times as the symptoms recurred after treatment. Subsequently, based on the clinical course and investigations, she was diagnosed with type 1 diabetes mellitus and Graves’ disease occurring during the course of RA and T2D. Her clinical course improved after reinforcement of insulin therapy and the addition of thiamazole therapy.<bold>Conclusion.</bold> In patients with rheumatoid arthritis, the autoimmune polyglandular syndrome type 3 variant should be considered as the cause of the deterioration.</abstract>

Introduction. Although type 1 diabetes mellitus is largely associated with autoimmune thyroid disease and this entity has been recently referred to as autoimmune polyglandular syndrome type 3 variant, the autoimmune polyglandular syndrome type 3 variant in patients with rheumatoid arthritis has not been reported so far. We herein describe the first case of rheumatoid arthritis that was associated with autoimmune polyglandular syndrome type 3 variant.Case report. A 77-year-old woman with a 15-year history of rheumatoid arthritis (RA) and a 10-year history of type 2 diabetes mellitus (T2D) presented with polyarthralgia and hyperglycaemia. Methotrexate 16 mg/week had been started from the onset and was continued, and adalimumab 40 mg/day was started for RA. Insulin treatment was also started for the diabetes. Laboratory examinations revealed high levels of C-reactive protein (CRP), rheumatoid factor, anti-cyclic citrullinated peptide antibody, and matrix metalloprotease 3. She was admitted multiple times as the symptoms recurred after treatment. Subsequently, based on the clinical course and investigations, she was diagnosed with type 1 diabetes mellitus and Graves’ disease occurring during the course of RA and T2D. Her clinical course improved after reinforcement of insulin therapy and the addition of thiamazole therapy.Conclusion. In patients with rheumatoid arthritis, the autoimmune polyglandular syndrome type 3 variant should be considered as the cause of the deterioration.

Autoimmune polyglandular syndrome type 3 variant in rheumatoid arthritis

Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School

Laboratory of Anatomy, Basic Veterinary Sciences

Romanian Journal of Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

{"article-title":"Autoimmune polyglandular syndrome type 3 variant in rheumatoid arthritis"}

Introduction. Although type 1 diabetes mellitus is largely associated with autoimmune thyroid disease and this entity has been recently referred to as...

Autoimmune polyglandular syndrome type 3 variant in rheumatoid arthritis

Published Online: Mar 03, 2020

Page range: 40 - 43

Received: Mar 11, 2019

DOI: https://doi.org/10.2478/rjim-2019-0024

Keywords
autoimmune thyroid disease (AITD), autoimmune polyglandular syndrome type 3 variant (APS3v), Graves’ disease (GD), rheumatoid arthritis (RA), type 1 diabetes mellitus (T1D), type 2 diabetes mellitus (T2D)

© 2020 Taro Horino et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Autoimmune polyglandular syndrome type 3 variant in rheumatoid arthritis

Published Online: Mar 03, 2020

Page range: 40 - 43

Received: Mar 11, 2019

DOI: https://doi.org/10.2478/rjim-2019-0024

Keywordsautoimmune thyroid disease (AITD), autoimmune polyglandular syndrome type 3 variant (APS3v), Graves’ disease (GD), rheumatoid arthritis (RA), type 1 diabetes mellitus (T1D), type 2 diabetes mellitus (T2D)

© 2020 Taro Horino et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
autoimmune thyroid disease (AITD), autoimmune polyglandular syndrome type 3 variant (APS3v), Graves’ disease (GD), rheumatoid arthritis (RA), type 1 diabetes mellitus (T1D), type 2 diabetes mellitus (T2D)