Expanding the Clinical Spectrum of Multiple Autoimmune Syndrome Type 3: A Case Series of Overlapping Endocrine and Systemic Autoimmune Diseases in Young Adults
https://doi.org/10.15605/jafes.041.S1
- Author:
Yanne Pradwi Efendi
1
;
Alexander Kam
2
;
Dinda Aprilia
3
;
Eva Decroli
3
;
Syafril Syahbuddin
3
;
Athari Fadhila
2
Author Information
1. Internal Medicine Department, Medical Faculty, Universitas Andalas, Indonesia
2. Internal Medicine Department, Medical Faculty, Universitas Andalas, Indonesia; Metabolic Endocrinology and Diabetes Division, Internal Medicine Department, Medical Faculty, Universitas Andalas/ M. Djamil General Hospital, Indonesia
3. Metabolic Endocrinology and Diabetes Division, Internal Medicine Department, Medical Faculty, Universitas Andalas/ M. Djamil General Hospital, Indonesia
- Publication Type:Journal Article
- MeSH:
Young Adult;
Humans;
Autoimmune Diseases
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):53-54
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Multiple autoimmune syndrome (MAS) type 3 is characterized by the coexistence of autoimmune thyroid disease
with other organ-specific or systemic autoimmune
disorders, excluding adrenal insufficiency. MAS represents
a form of polyautoimmunity, in which shared immunological mechanisms contribute to clustering of multiple
autoimmune diseases within a single individual. Recent
studies suggest the clinical spectrum of MAS continues
to expand, with increasing recognition of diverse autoimmune combinations across different organ systems.
However, detailed clinical characterization of MAS type
3 involving overlapping endocrine and neuromuscular
autoimmune diseases in young adults remains limited.
Cases:We report four young adults (aged 21–37 years) with
heterogeneous manifestations of MAS type 3 involving
endocrine and systemic autoimmune diseases. Autoimmune
thyroid disease was identified in three patients, all
diagnosed with Graves’ disease with suppressed thyroidstimulating hormone, elevated free thyroxine, and positive
thyrotropin receptor antibodies. Autoimmune diabetes was
present in three patients, including latent autoimmune
diabetes in adults (LADA) and type 1 diabetes mellitus,
with variable glycemic control (hemoglobin A1c range
6.7–13.9%) and C-peptide levels ranging from preserved
to markedly reduced. Myasthenia gravis was observed
in three patients. Additional autoimmune conditions
included systemic lupus erythematosus, systemic sclerosis,
rheumatoid arthritis, and ulcerative colitis. Notably, rare
combinations such as Graves’ disease with LADA and
myasthenia gravis, as well as coexistence with systemic
autoimmune diseases, were identified. All patients
received individualized multidisciplinary management.
Clinical and biochemical improvement was observed in
all cases, with stabilization of both endocrine and systemic
autoimmune manifestations.
Conclusion:This case series highlights the heterogeneous and
expanding clinical spectrum of MAS type 3, including
rare combinations of autoimmune endocrine and systemic
diseases in young adults. Early recognition of autoimmune clustering and comprehensive screening are
essential to optimize management and improve outcomes.
These findings provide insights into autoimmune disease
clustering and support the need for proactive multidisciplinary management strategies.
- Full text:202607301608149992EP_A063.pdf
