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目的探讨自身免疫多内分泌腺病综合征-3型(autoimmune polyendocrine syndrome,APS-3)的临床特点。方法总结1例APS-3型女性患者的临床经过,并进行文献复习。结果患者先后出现慢性淋巴细胞性甲状腺炎、1型糖尿病反复出现低血糖,通过糖皮质激素替代治疗,血糖控制稳定,入院查24h UFC、血ACTH、血F在正常范围,但兴奋实验不被兴奋。其它免疫指标:抗SSA抗体(+),抗SSB抗体(-),ANA(+)。最终诊断APS-3。结论 APS-3临床表现各异,该患者主要表现血糖波动大,皮质醇储备功能差,同时还存在生长激素的缺乏,血糖的波动,除需考虑胰岛素用量问题、原发肾上腺皮质功能减退等因素外还要注意有无继发肾上腺皮质功能减退的可能。
Objective To investigate the clinical features of autoimmune polyendocrine syndrome (APS-3). Methods A total of 1 APS-3 female patients were reviewed and reviewed. Results Patients had chronic lymphocytic thyroiditis, type 1 diabetes recurrent hypoglycemia, glucocorticoid replacement therapy, stable blood glucose control admission 24h UFC, blood ACTH, blood F in the normal range, but the excitement experiment was not excited . Other immune indicators: anti-SSA antibody (+), anti-SSB antibody (-), ANA (+). The final diagnosis of APS-3. Conclusions The clinical manifestations of APS-3 are different. The main manifestations of APS-3 are as follows: fluctuating blood glucose, poor cortisol reserve, lack of growth hormone and fluctuation of blood glucose. In addition to factors such as insulin dosage and primary adrenal insufficiency Should also pay attention to whether there is the possibility of secondary adrenocortical dysfunction.