Abstract
There is coincidence of systemic, organ-specific and organ-localised autoimmune diseases which can form autoimmune polyglandular syndrome. The most frequent autoimmune endocrinopathies include autoimmune thyropathy and diabetes mellitus type 1.
Patients with other autoimmune diseases and individuals from genetically predisposed families with higher incidence of autoimmune diseases should always be examined for possible juvenile lymphocytic thyroiditis. In patients suffering from multiple autoimmune diseases, it is advisable to follow the development of organ specific antibodies to reveal the pre-clinical stage of life-threatening endocrinopathy, such as autoimmune adrenalitis. 21-hydroxylase antibodies which determine the development of autoimmune adrenalitis have high specifity and sensitivity.
The development of autoimmune polyglandular syndrome type 2 can start in childhood. In this syndrome, endocrinopathies mostly occur in the following order: diabetes mellitus type 1, autoimmune thyroiditis and Addison's disease.
Autoimmune non-endocrine diseases, such a vitiligo, can prevent endocrinopathies in this syndrome. Screening of 21-hydroxylase antibodies is not usually performed in patients with diabetes mellitus type 1.