Autoimmune polyendocrine syndrome secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There are no established measures for the secondary prevention of [disease name].

OR

Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].

Secondary Prevention

Secondary prevention: Annual measurement of the corticotropin level and the level of cortisol both before and after cosyntropin stimulation (at 8 a.m.) in those with autoantibodies against 21-hydroxylase seems prudent to detect adrenal damage before a hypotensive crisis.

Effective measures for the secondary prevention of autoimmune polyendocrine syndrome (APS) include:

• Patient education: Patient education is an important aspect in early diagnosis and management of APS. In APS the time interval between involvement of one endocrine organ to other endocrine tissue may take years. For example, patients with APS type 1 develops mucocutaneous candidiasis in infancy and it may take upto five years for them to develop hypoparathyroidism. Patients should be informed about symptoms of other disorders for which they are at high risk such as Addison's disease or diabetes mellitus.
• Patients with type 1 and type 2 APS should be screened at an interval of 6 to 12 months for development of other endocrine/non-endocrine disorders.
  • If autoantibodies are present without the associated disease, functional testing is indicated.
  • Patients with antibodies against 21-hydroxylase should be monitored annually for ACTH levels, morning (8 am) cortisol levels, and cosyntropin stimulation testing. The time interval between testing may vary depending upon the signs and symptoms of the disease.