AI Article Synopsis

  • - APECED is a rare autoimmune disease often caused by mutations in the autoimmune regulator gene, leading to multiple symptoms.
  • - The disease traditionally includes chronic mucocutaneous candidiasis, hypoparathyroidism, and adrenal insufficiency, but additional symptoms like APECED rash and intestinal dysfunction suggest a broader clinical spectrum.
  • - This report details a case of a 10-month-old girl who exhibited APECED rash and recurrent candidiasis as the initial signs of the disease, highlighting the importance of recognizing early symptoms for timely diagnosis.

Article Abstract

Autoimmune-Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED) is a monogenic autoimmune disease most often resulting from biallelic loss-of-function variants in the autoimmune regulator () gene. Although typically characterized by the classic triad of chronic mucocutaneous candidiasis, hypoparathyroidism, and adrenal insufficiency, we have recently reported that the clinical spectrum of the syndrome is far broader that previously described and that incorporation of an adjunct triad of APECED rash, autoimmune enteritis-associated intestinal dysfunction, and enamel hypoplasia in the classic triad manifestations could lead to earlier diagnosis. Among the adjunct triad manifestations, APECED rash occurs in 66% of American APECED patients by age 3, most often developing in the first year of life. Here, we describe the clinical and histological features of protracted APECED rash manifesting together with recurrent mucocutaneous candidiasis as the first two disease components of APECED in a 10-month-old girl.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976627PMC
http://dx.doi.org/10.1016/j.clicom.2024.03.001DOI Listing

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Article Synopsis
  • - APECED is a rare autoimmune disease often caused by mutations in the autoimmune regulator gene, leading to multiple symptoms.
  • - The disease traditionally includes chronic mucocutaneous candidiasis, hypoparathyroidism, and adrenal insufficiency, but additional symptoms like APECED rash and intestinal dysfunction suggest a broader clinical spectrum.
  • - This report details a case of a 10-month-old girl who exhibited APECED rash and recurrent candidiasis as the initial signs of the disease, highlighting the importance of recognizing early symptoms for timely diagnosis.
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APECED Rash as the First Manifestation of APECED Syndrome.

J Clin Immunol

November 2023

Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy & Infectious Diseases (NIAID), National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 12C103A, Bethesda, MD, 20892, USA.

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Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), also known as autoimmune polyglandular syndrome type 1 (APS-1), is a rare genetic disorder caused most often by biallelic mutations in the gene. Classic clinical findings of the disease are chronic mucocutaneous candidiasis and autoimmunity that primarily targets endocrine tissues, such as hypoparathyroidism and adrenal insufficiency. Recently, however, it has been appreciated that enamel hypoplasia, together with intestinal malabsorption and a characteristic APECED rash, is a prominent early disease manifestation of APECED which can aid in the diagnosis of disease before other potentially life-threatening disease manifestations occur.

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Background: Autoimmune polyglandular syndrome type 2 represents an uncommon endocrine disorder composed by Addison's disease with autoimmune thyroid disease (Schmidt's syndrome) and/or type 1 diabetes mellitus. Scleromyxedema is a rare progressive cutaneous mucinosis usually associated with systemic involvement and paraproteinemia. To the best of our knowledge, there is no case report of Schmidt's syndrome associated with scleromyxedema.

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Objective: Autoimmune polyendocrine syndrome type 1 (APS1) is a rare autosomal recessive disorder characterized by progressive organ-specific autoimmunity. There is scant information on APS1 in ethnic groups other than European Caucasians. We studied clinical aspects and autoimmune regulator () gene mutations in a cohort of Indian APS1 patients.

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