Autoimmune polyglandular syndrome type 3A diagnosed by repeated hypokalemia

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  • 繰り返す低カリウム血症から診断された多腺性自己免疫症候群3A型の1例

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Abstract

A man in his 30s was brought to the emergency room because of recurrent limb weakness and myalgia. On arrival at the hospital, he was found to have severe hypokalemia, which was corrected by intravenous potassium supplementation. After admission, blood tests showed hyperthyroidism, and endocrinological examination revealed Graves’ disease, Hashimoto’s disease, and slowly progressive type 1 diabetes mellitus. Therefore, autoimmune polyglandular syndrome (APS) type 3A was diagnosed. APS is an autoimmune disease that causes dysfunction in multiple tissues, including endocrine glands. APS type 3A is an autoimmune thyroid disease complicated by type 1 diabetes mellitus without Addison’s disease. Although APS type 3A is sometimes diagnosed based on the presence of complications associated with type 1 diabetes mellitus, such as diabetic ketoacidosis, no reports have described the diagnosis of APS type 3A based on hypokalemia, as in this case. It is important to determine the causative disease in patients with repeated electrolyte abnormalities. In addition, if diabetes mellitus is found in patients with thyroid dysfunction, further investigation should be performed to check for APS.

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