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Erschienen in: Journal of Endocrinological Investigation 4/2021

01.04.2021 | Review

Autoimmune polyendocrine syndrome type 1 (APECED) in the Indian population: case report and review of a series of 45 patients

verfasst von: A. Fierabracci, A. Arena, F. Toto, N. Gallo, A. Puel, M. Migaud, M. Kumar, K. G. Chengappa, R. Gulati, V. S. Negi, C. Betterle

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 4/2021

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Abstract

Background

Autoimmune polyendocrinopathy-candidiasis-ectodermal-dystrophy (APECED) or autoimmune polyglandular syndrome type 1 (APS-1) is a rare autosomal recessive genetic disease due to mutations in the AIRE (AutoImmune REgulator) gene. The clinical diagnosis is classically based on the presence of at least two of the three main components: chronic mucocutaneous candidiasis, hypoparathyroidism and primary adrenal insufficiency. Patients often suffer from other endocrine or non-endocrine autoimmune conditions throughout life. APECED etiopathogenesis is mediated by T lymphocytes. Autoantibodies against proteins of the affected organs are found in the serum of APECED patients as well as neutralizing antibodies against cytokines. We report here the clinical and genetic characteristics of 45 Indian APECED patients in comparison to Finnish, Sardinian, Turkish and North/South American cohorts from their published results. We also report a new case of APECED of Indian origin, a 2-year old child suffering from chronic mucocutaneous candidiasis since the age of 8 months, with confirmatory AIRE homozygous mutation c.274C > T (p.R92W).

Conclusion

With the inherent limitations of a retrospective study, analysis of Indian APECED patients suggested that compared to classic criteria, application of Ferre/Lionakis criteria validated in North/South American patients could help in earlier diagnosis in 3 of 8 (37.5%) patients for whom adequate information for evaluation was available.
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Literatur
3.
Zurück zum Zitat Laakso SM, Kekäläinen E, Rossi LH, Laurinolli TT, Mannerström H, Heikkilä N, Lehtoviita A, Perheentupa J, Jarva H, Arstila TP (2011) IL-7 dysregulation and loss of CD8+ T cell homeostasis in the monogenic human disease autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. J Immunol 187:2023–2030. https://doi.org/10.4049/jimmunol.1100212CrossRefPubMed Laakso SM, Kekäläinen E, Rossi LH, Laurinolli TT, Mannerström H, Heikkilä N, Lehtoviita A, Perheentupa J, Jarva H, Arstila TP (2011) IL-7 dysregulation and loss of CD8+ T cell homeostasis in the monogenic human disease autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. J Immunol 187:2023–2030. https://​doi.​org/​10.​4049/​jimmunol.​1100212CrossRefPubMed
8.
Zurück zum Zitat Perri V, Gianchecchi E, Scarpa R, Valenzise M, Rosado MM, Giorda E, Crinò A, Cappa M, Barollo S, Garelli S, Betterle C, Fierabracci A (2017) Altered B cell homeostasis and Toll-like receptor 9-driven response in patients affected by autoimmune polyglandular syndrome Type 1: altered B cell phenotype and dysregulation of the B cell function in APECED patients. Immunobiology 222:372–373. https://doi.org/10.1016/j.imbio.2016.09.001CrossRefPubMed Perri V, Gianchecchi E, Scarpa R, Valenzise M, Rosado MM, Giorda E, Crinò A, Cappa M, Barollo S, Garelli S, Betterle C, Fierabracci A (2017) Altered B cell homeostasis and Toll-like receptor 9-driven response in patients affected by autoimmune polyglandular syndrome Type 1: altered B cell phenotype and dysregulation of the B cell function in APECED patients. Immunobiology 222:372–373. https://​doi.​org/​10.​1016/​j.​imbio.​2016.​09.​001CrossRefPubMed
12.
Zurück zum Zitat Scarpa R, Alaggio R, Norberto L, Furmaniak J, Chen S, Smith BR, Masiero S, Morlin L, Plebani M, De Luca F, Salerno MC, Giordano R, Radetti G, Ghizzoni L, Tonini G, Farinati F, Betterle C (2013) Tryptophan hydroxylase autoantibodies as markers of a distinct autoimmune gastrointestinal component of autoimmune polyendocrine syndrome type 1. J Clin Endocrinol Metab 98:704–712. https://doi.org/10.1210/jc.2012-2734CrossRefPubMed Scarpa R, Alaggio R, Norberto L, Furmaniak J, Chen S, Smith BR, Masiero S, Morlin L, Plebani M, De Luca F, Salerno MC, Giordano R, Radetti G, Ghizzoni L, Tonini G, Farinati F, Betterle C (2013) Tryptophan hydroxylase autoantibodies as markers of a distinct autoimmune gastrointestinal component of autoimmune polyendocrine syndrome type 1. J Clin Endocrinol Metab 98:704–712. https://​doi.​org/​10.​1210/​jc.​2012-2734CrossRefPubMed
13.
Zurück zum Zitat Alimohammadi M, Björklund P, Hallgren A, Pöntynen N, Szinnai G, Shikama N, Keller MP, Ekwall O, Kinkel SA, Husebye ES, Gustafsson J, Rorsman F, Peltonen L, Betterle C, Perheentupa J, Akerström G, Westin G, Scott HS, Holländer GA, Kämpe O (2008) Autoimmune polyendocrine syndrome type 1 and NALP5, a parathyroid autoantigen. N Engl J Med 358:1018–1028. https://doi.org/10.1056/NEJMoa0706487CrossRefPubMed Alimohammadi M, Björklund P, Hallgren A, Pöntynen N, Szinnai G, Shikama N, Keller MP, Ekwall O, Kinkel SA, Husebye ES, Gustafsson J, Rorsman F, Peltonen L, Betterle C, Perheentupa J, Akerström G, Westin G, Scott HS, Holländer GA, Kämpe O (2008) Autoimmune polyendocrine syndrome type 1 and NALP5, a parathyroid autoantigen. N Engl J Med 358:1018–1028. https://​doi.​org/​10.​1056/​NEJMoa0706487CrossRefPubMed
14.
Zurück zum Zitat Meloni A, Furcas M, Cetani F, Marcocci C, Falorni A, Perniola R, Pura M, Bøe Wolff AS, Husebye ES, Lilic D, Ryan KR, Gennery AR, Cant AJ, Abinun M, Spickett GP, Arkwright PD, Denning D, Costigan C, Dominguez M, McConnell V, Willcox N, Meager A (2008) Autoantibodies against type I interferons as an additional diagnostic criterion for autoimmune polyendocrine syndrome type I. J Clin Endocrinol Metab 93:4389–4397. https://doi.org/10.1210/jc.2008-0935CrossRefPubMed Meloni A, Furcas M, Cetani F, Marcocci C, Falorni A, Perniola R, Pura M, Bøe Wolff AS, Husebye ES, Lilic D, Ryan KR, Gennery AR, Cant AJ, Abinun M, Spickett GP, Arkwright PD, Denning D, Costigan C, Dominguez M, McConnell V, Willcox N, Meager A (2008) Autoantibodies against type I interferons as an additional diagnostic criterion for autoimmune polyendocrine syndrome type I. J Clin Endocrinol Metab 93:4389–4397. https://​doi.​org/​10.​1210/​jc.​2008-0935CrossRefPubMed
15.
Zurück zum Zitat Puel A, Döffinger R, Natividad A, Chrabieh M, Barcenas-Morales G, Picard C, Cobat A, Ouachée-Chardin M, Toulon A, Bustamante J, Al-Muhsen S, Al-Owain M, Arkwright PD, Costigan C, McConnell V, Cant AJ, Abinun M, Polak M, Bougnères PF, Kumararatne D, Marodi L, Nahum A, Roifman C, Blanche S, Fischer A, Bodemer C, Abel L, Lilic D, Casanova JL (2010) Autoantibodies against IL-17A, IL-17F, and IL-22 in patients with chronic mucocutaneous candidiasis and autoimmune polyendocrine syndrome type I. J Exp Med 207:291–297. https://doi.org/10.1084/jem.20091983CrossRefPubMedPubMedCentral Puel A, Döffinger R, Natividad A, Chrabieh M, Barcenas-Morales G, Picard C, Cobat A, Ouachée-Chardin M, Toulon A, Bustamante J, Al-Muhsen S, Al-Owain M, Arkwright PD, Costigan C, McConnell V, Cant AJ, Abinun M, Polak M, Bougnères PF, Kumararatne D, Marodi L, Nahum A, Roifman C, Blanche S, Fischer A, Bodemer C, Abel L, Lilic D, Casanova JL (2010) Autoantibodies against IL-17A, IL-17F, and IL-22 in patients with chronic mucocutaneous candidiasis and autoimmune polyendocrine syndrome type I. J Exp Med 207:291–297. https://​doi.​org/​10.​1084/​jem.​20091983CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Ferre EM, Rose SR, Rosenzweig SD, Burbelo PD, Romito KR, Niemela JE, Rosen LB, Break TJ, Gu W, Hunsberger S, Browne SK, Hsu AP, Rampertaap S, Swamydas M, Collar AL, Kong HH, Lee CR, Chascsa D, Simcox T, Pham A, Bondici A, Natarajan M, Monsale J, Kleiner DE, Quezado M, Alevizos I, Moutsopoulos NM, Yockey L, Frein C, Soldatos A, Calvo KR, Adjemian J, Similuk MN, Lang DM, Stone KD, Uzel G, Kopp JB, Bishop RJ, Holland SM, Olivier KN, Fleisher TA, Heller T, Winer KK, Lionakis MS (2016) Redefined clinical features and diagnostic criteria in autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. JCI Insight 1:e88782. https://doi.org/10.1172/jci.insight.88782CrossRefPubMedPubMedCentral Ferre EM, Rose SR, Rosenzweig SD, Burbelo PD, Romito KR, Niemela JE, Rosen LB, Break TJ, Gu W, Hunsberger S, Browne SK, Hsu AP, Rampertaap S, Swamydas M, Collar AL, Kong HH, Lee CR, Chascsa D, Simcox T, Pham A, Bondici A, Natarajan M, Monsale J, Kleiner DE, Quezado M, Alevizos I, Moutsopoulos NM, Yockey L, Frein C, Soldatos A, Calvo KR, Adjemian J, Similuk MN, Lang DM, Stone KD, Uzel G, Kopp JB, Bishop RJ, Holland SM, Olivier KN, Fleisher TA, Heller T, Winer KK, Lionakis MS (2016) Redefined clinical features and diagnostic criteria in autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. JCI Insight 1:e88782. https://​doi.​org/​10.​1172/​jci.​insight.​88782CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Perheentupa J, Miettinen A (1999) Autoimmune polyendocrine syndrome type I (APECED). In: Eisenbarth GS (ed) Endocrine and organ specific autoimmunity. RG Landes Company, Austin, pp 19–40 Perheentupa J, Miettinen A (1999) Autoimmune polyendocrine syndrome type I (APECED). In: Eisenbarth GS (ed) Endocrine and organ specific autoimmunity. RG Landes Company, Austin, pp 19–40
30.
Zurück zum Zitat Cihakova D, Trebusak K, Heino M, Fadeyev V, Tiulpakov A, Battelino T, Tar A, Halász Z, Blümel P, Tawfik S, Krohn K, Lebl J, Peterson P (2001) Novel AIRE mutations and P450 cytochrome autoantibodies in Central and Eastern European patients with APECED. Hum Mutat 18:225–232. https://doi.org/10.1002/humu.1178CrossRefPubMed Cihakova D, Trebusak K, Heino M, Fadeyev V, Tiulpakov A, Battelino T, Tar A, Halász Z, Blümel P, Tawfik S, Krohn K, Lebl J, Peterson P (2001) Novel AIRE mutations and P450 cytochrome autoantibodies in Central and Eastern European patients with APECED. Hum Mutat 18:225–232. https://​doi.​org/​10.​1002/​humu.​1178CrossRefPubMed
33.
Zurück zum Zitat Ekwall O, Hedstrand H, Grimelius L, Haavik J, Perheentupa J, Gustafsson J, Husebye E, Kämpe O, Rorsman F (1998) Identification of tryptophan hydroxylase as an intestinal autoantigen. Lancet 352:279–283CrossRef Ekwall O, Hedstrand H, Grimelius L, Haavik J, Perheentupa J, Gustafsson J, Husebye E, Kämpe O, Rorsman F (1998) Identification of tryptophan hydroxylase as an intestinal autoantigen. Lancet 352:279–283CrossRef
34.
Zurück zum Zitat Sköldberg F, Portela-Gomes GM, Grimelius L, Nilsson G, Perheentupa J, Betterle C, Husebye ES, Gustafsson J, Rönnblom A, Rorsman F, Kämpe O (2003) Histidine decarboxylase, a pyridoxal phosphate-dependent enzyme, is an autoantigen of gastric enterochromaffin-like cells. J Clin Endocrinol Metab 88:1445–1452CrossRef Sköldberg F, Portela-Gomes GM, Grimelius L, Nilsson G, Perheentupa J, Betterle C, Husebye ES, Gustafsson J, Rönnblom A, Rorsman F, Kämpe O (2003) Histidine decarboxylase, a pyridoxal phosphate-dependent enzyme, is an autoantigen of gastric enterochromaffin-like cells. J Clin Endocrinol Metab 88:1445–1452CrossRef
36.
Zurück zum Zitat Cervato S, Mariniello B, Lazzarotto F, Morlin L, Zanchetta R, Radetti G, De Luca F, Valenzise M, Giordano R, Rizzo D, Giordano C, Betterle C (2009) Evaluation of the autoimmune regulator (AIRE) gene mutations in a cohort of Italian patients with autoimmune-polyendocrinopathy-candidiasis-ectodermal-dystrophy (APECED) and in their relatives. Clin Endocrinol 70:421–428. https://doi.org/10.1111/j.1365-2265.2008.03318.xCrossRef Cervato S, Mariniello B, Lazzarotto F, Morlin L, Zanchetta R, Radetti G, De Luca F, Valenzise M, Giordano R, Rizzo D, Giordano C, Betterle C (2009) Evaluation of the autoimmune regulator (AIRE) gene mutations in a cohort of Italian patients with autoimmune-polyendocrinopathy-candidiasis-ectodermal-dystrophy (APECED) and in their relatives. Clin Endocrinol 70:421–428. https://​doi.​org/​10.​1111/​j.​1365-2265.​2008.​03318.​xCrossRef
38.
Zurück zum Zitat Valenzise M, Fierabracci A, Cappa M, Porcelli P, Barcellona R, De Luca F, Barollo S, Garelli S, Betterle C (2014) Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy: report of seven additional sicilian patients and overview of theoverall series from Sicily. Horm Res Paediatr 82:127–132. https://doi.org/10.1159/000363537CrossRefPubMed Valenzise M, Fierabracci A, Cappa M, Porcelli P, Barcellona R, De Luca F, Barollo S, Garelli S, Betterle C (2014) Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy: report of seven additional sicilian patients and overview of theoverall series from Sicily. Horm Res Paediatr 82:127–132. https://​doi.​org/​10.​1159/​000363537CrossRefPubMed
39.
Zurück zum Zitat Palma A, Crinó A, Palombi M, Cappa M, Fierabracci A (2013) Peculiar genotypes of the autoimmune regulator gene in Italian patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome. Clin Lab 59:675–680CrossRef Palma A, Crinó A, Palombi M, Cappa M, Fierabracci A (2013) Peculiar genotypes of the autoimmune regulator gene in Italian patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome. Clin Lab 59:675–680CrossRef
40.
Zurück zum Zitat Capalbo D, Mazza C, Giordano R, Improda N, Arvat E, Cervato S, Morlin L, Pignata C, Betterle C, Salerno M (2012) Molecular background and genotype-phenotype correlation in autoimmune-polyendocrinopathy-candidiasis-ectodermal-distrophy patients from Campania and in their relatives. J Endocrinol Invest 32:169–173. https://doi.org/10.3275/7677CrossRef Capalbo D, Mazza C, Giordano R, Improda N, Arvat E, Cervato S, Morlin L, Pignata C, Betterle C, Salerno M (2012) Molecular background and genotype-phenotype correlation in autoimmune-polyendocrinopathy-candidiasis-ectodermal-distrophy patients from Campania and in their relatives. J Endocrinol Invest 32:169–173. https://​doi.​org/​10.​3275/​7677CrossRef
41.
Zurück zum Zitat Cetani F, Barbesino G, Borsari S, Pardi E, Cianferotti L, Pinchera A, Marcocci C (2001) A novel mutation of the autoimmune regulator gene in an italian kindred with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy, acting in a dominant fashion and strongly cosegregating with hypothyroid autoimmune thyroiditis. J Clin Endocrinol Metab 86:4747–4752. https://doi.org/10.1210/jcem.86.10.7884CrossRefPubMed Cetani F, Barbesino G, Borsari S, Pardi E, Cianferotti L, Pinchera A, Marcocci C (2001) A novel mutation of the autoimmune regulator gene in an italian kindred with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy, acting in a dominant fashion and strongly cosegregating with hypothyroid autoimmune thyroiditis. J Clin Endocrinol Metab 86:4747–4752. https://​doi.​org/​10.​1210/​jcem.​86.​10.​7884CrossRefPubMed
42.
Zurück zum Zitat Oftedal BE, Hellesen A, Erichsen MM, Bratland E, Vardi A, Perheentupa J, Kemp EH, Fiskerstrand T, Viken MK, Weetman AP, Fleishman SJ, Banka S, Newman WG, Sewell WA, Sozaeva LS, Zayats T, Haugarvoll K, Orlova EM, Haavik J, Johansson S, Knappskog PM, Løvås K, Wolff AS, Abramson J, Husebye ES (2015) Dominant mutations in the autoimmune regulator AIRE are associated with common organ-specific autoimmune diseases. Immunity 42:1185–1196. https://doi.org/10.1016/j.immuni.2015.04.021CrossRefPubMed Oftedal BE, Hellesen A, Erichsen MM, Bratland E, Vardi A, Perheentupa J, Kemp EH, Fiskerstrand T, Viken MK, Weetman AP, Fleishman SJ, Banka S, Newman WG, Sewell WA, Sozaeva LS, Zayats T, Haugarvoll K, Orlova EM, Haavik J, Johansson S, Knappskog PM, Løvås K, Wolff AS, Abramson J, Husebye ES (2015) Dominant mutations in the autoimmune regulator AIRE are associated with common organ-specific autoimmune diseases. Immunity 42:1185–1196. https://​doi.​org/​10.​1016/​j.​immuni.​2015.​04.​021CrossRefPubMed
43.
Zurück zum Zitat Magitta NF, Pura M, Bøe Wolff AS, Vanuga P, Meager A, Knappskog MP, Husebye ES (2008) Autoimmune polyendocrine syndrome type I in Slovakia: relevance of screening patients with autoimmune Addison’s disease. Eur J Endocrinol 158:705–709. https://doi.org/10.1530/EJE-07-0843CrossRef Magitta NF, Pura M, Bøe Wolff AS, Vanuga P, Meager A, Knappskog MP, Husebye ES (2008) Autoimmune polyendocrine syndrome type I in Slovakia: relevance of screening patients with autoimmune Addison’s disease. Eur J Endocrinol 158:705–709. https://​doi.​org/​10.​1530/​EJE-07-0843CrossRef
44.
Zurück zum Zitat Halonen M, Eskelin P, Myhre AG, Perheentupa J, Husebye ES, Kämpe O, Rorsman F, Peltonen L, Ulmanen I, Partanen J (2002) AIRE mutations and human leukocyte antigen genotypes as determinants of the autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy phenotype. J Clin Endocrinol Metab 87:2568–2574. https://doi.org/10.1210/jcem.87.6.8564CrossRefPubMed Halonen M, Eskelin P, Myhre AG, Perheentupa J, Husebye ES, Kämpe O, Rorsman F, Peltonen L, Ulmanen I, Partanen J (2002) AIRE mutations and human leukocyte antigen genotypes as determinants of the autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy phenotype. J Clin Endocrinol Metab 87:2568–2574. https://​doi.​org/​10.​1210/​jcem.​87.​6.​8564CrossRefPubMed
50.
Zurück zum Zitat Pal N, Raj HJ, Das A, Maiti PK (2015) A rare case of autoimmuno polyglandular syndrome type I in two siblings: first case from Eastern India. Int J Curr Microbiol Appl Sci 4:50–54 Pal N, Raj HJ, Das A, Maiti PK (2015) A rare case of autoimmuno polyglandular syndrome type I in two siblings: first case from Eastern India. Int J Curr Microbiol Appl Sci 4:50–54
51.
Zurück zum Zitat Khan GQ, Hassan G, Qureshi W, Kak M, Kadri M, Akhter D, Bakshi J (2005) Polyglandular Autoimmune Syndrome Type-I. JIACM 6:155–157 Khan GQ, Hassan G, Qureshi W, Kak M, Kadri M, Akhter D, Bakshi J (2005) Polyglandular Autoimmune Syndrome Type-I. JIACM 6:155–157
53.
56.
Zurück zum Zitat Zaidi G, Bhatia V, Sahoo SK, Sarangi AN, Bharti N, Zhang L, Yu L, Eriksson D, Bensing S, Kämpe O, Bharani N, Yachha SK, Bhansali A, Sachan A, Jain V, Shah N, Aggarwal R, Aggarwal A, Srinivasan M, Agarwal S, Bhatia E (2017) Autoimmune polyendocrine syndrome type 1 in an Indian cohort: a longitudinal study. Endocr Connect 6:289–296. https://doi.org/10.1530/EC-17-0022CrossRefPubMedPubMedCentral Zaidi G, Bhatia V, Sahoo SK, Sarangi AN, Bharti N, Zhang L, Yu L, Eriksson D, Bensing S, Kämpe O, Bharani N, Yachha SK, Bhansali A, Sachan A, Jain V, Shah N, Aggarwal R, Aggarwal A, Srinivasan M, Agarwal S, Bhatia E (2017) Autoimmune polyendocrine syndrome type 1 in an Indian cohort: a longitudinal study. Endocr Connect 6:289–296. https://​doi.​org/​10.​1530/​EC-17-0022CrossRefPubMedPubMedCentral
60.
Zurück zum Zitat Sahoo SK, Zaidi G, Srivastava R, Sarangi AN, Bharti N, Eriksson D, Bensing S, Kämpe O, Aggarwal A, Aggarwal R, Bhatia E (2016) Identification of autoimmune polyendocrine syndrome type 1 in patients with isolated hypoparathyroidism. Clin Endocrinol 85:544–550. https://doi.org/10.1111/cen.13111CrossRef Sahoo SK, Zaidi G, Srivastava R, Sarangi AN, Bharti N, Eriksson D, Bensing S, Kämpe O, Aggarwal A, Aggarwal R, Bhatia E (2016) Identification of autoimmune polyendocrine syndrome type 1 in patients with isolated hypoparathyroidism. Clin Endocrinol 85:544–550. https://​doi.​org/​10.​1111/​cen.​13111CrossRef
61.
Zurück zum Zitat Makharia G, Tandon N, Stephen N, Gupta S, Tandon R (2007) Primary intestinal lymphangiectasia as a component of autoimmune polyglandular syndrome type I: a report of 2 cases. Indian J Gastroenterol 26:293–295PubMed Makharia G, Tandon N, Stephen N, Gupta S, Tandon R (2007) Primary intestinal lymphangiectasia as a component of autoimmune polyglandular syndrome type I: a report of 2 cases. Indian J Gastroenterol 26:293–295PubMed
62.
Zurück zum Zitat Patel ML, Sachan R, Patil MR, Mishra A (2012) Autoimmune polyglandular syndrome type-1. J Assoc Physicians India 60:61PubMed Patel ML, Sachan R, Patil MR, Mishra A (2012) Autoimmune polyglandular syndrome type-1. J Assoc Physicians India 60:61PubMed
63.
Zurück zum Zitat Joshi RR, Rao S, Prabhu SS (2006) Polyglandular autoimmune syndrome type 1. Indian Pediatr 43:1085–1087PubMed Joshi RR, Rao S, Prabhu SS (2006) Polyglandular autoimmune syndrome type 1. Indian Pediatr 43:1085–1087PubMed
64.
Zurück zum Zitat Trivedi SV, Joshi C, Amichandwala K, Porwal V, Arora P (2004) Polyglandular autoimmune syndrome type-1. Assoc Physicians India 52:681–682 Trivedi SV, Joshi C, Amichandwala K, Porwal V, Arora P (2004) Polyglandular autoimmune syndrome type-1. Assoc Physicians India 52:681–682
Metadaten
Titel
Autoimmune polyendocrine syndrome type 1 (APECED) in the Indian population: case report and review of a series of 45 patients
verfasst von
A. Fierabracci
A. Arena
F. Toto
N. Gallo
A. Puel
M. Migaud
M. Kumar
K. G. Chengappa
R. Gulati
V. S. Negi
C. Betterle
Publikationsdatum
01.04.2021
Verlag
Springer International Publishing
Erschienen in
Journal of Endocrinological Investigation / Ausgabe 4/2021
Elektronische ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-020-01376-5

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