Chapter 12 Autoimmune Polyendocrine Syndromes (APS) or Multiple Autoimmune Syndromes (MAS)
Section snippets
Historical considerations in autoimmune disorders of the endocrine glands
The origin of endocrine autoimmunity goes back to 1956, when it was found that patients with chronic thyroiditis had autoantibodies against thyroglobulin (Roitt et al., 1956), those with Graves’ disease had a factor stimulating the thyroid gland (Adams and Purves, 1956) and chronic thyroiditis could be produced in animals by immunization with homogenates of autologous tissue (Rose and Witebsky, 1956). It was first shown in 1957 that patients with “idiopathic” Addison's disease (AD) had
Autoimmune polyendocrine syndromes or multiple autoimmune syndromes
In 1980, Neufeld proposed a classification of autoimmune polyendocrine syndrome (APS) based on clinical criteria and identifying four types of APS (Table 2) (Neufeld and Blizzard, 1980). Following the publication of Neufeld's criteria, a large body of new data has been acquired in the field of autoimmune diseases, and for this reason we believe that the proposed classification needs some modifications.
The term APS is used historically but is not fully appropriate because it indicates not only
Conclusions
In recent years, the study of MAS has received great interest thanks to the growing number of the diseases recognized as autoimmune and the knowledge of their natural history. Clinically overt disorders are considered only the tip of the autoimmune iceberg, since latent forms are much more frequent (Fig. 1). Autoantibody determination in patients with a single disease undoubtedly facilitates the recognition of those with the autoimmune form, but in patients with one autoimmune disease the
Acknowledgments
This work was partially supported by FP6 EURAPS project: autoimmune polyendocrine syndrome type I—a rare disorder of childhood as a model for autoimmunity. Contract no. LSHM-CT-2005-005223.
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