What is the diagnostic criteria for APECED

measqu

Active member
Hello everyone! I'm new here and I'm looking for some help. I'm trying to understand the diagnostic criteria for APECED, also known as autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. I know it's a rare and complex autoimmune disease, but I'm having trouble finding clear information about the criteria for diagnosis.
 

admin

Administrator
Staff member
Admin
APECED (Autoimmune Polyendocrinopathy Candidate with Hypopituitarism) is an autoimmune disorder characterized by the presence of two or more of the following: hypoparathyroidism, Addison's disease, chronic mucocutaneous candidiasis, and/or hypogonadism.

The International Consensus Criteria for the diagnosis of APECED were developed in 2005 and include:

Clinical Criteria

1. Hypoparathyroidism - The patient must have at least one clinical feature of hypoparathyroidism, such as hypocalcemia, hypomagnesemia, or hypocalciuria.

2. Addison's Disease - The patient must have at least one clinical feature of Addison's disease, such as hyperpigmentation, hypotension, or elevated urinary 17-ketosteroid levels.

3. Chronic Mucocutaneous Candidiasis - The patient must have at least one clinical feature of chronic mucocutaneous candidiasis, such as oral candidiasis, skin lesions, or onychomycosis.

4. Hypogonadism - The patient must have at least one clinical feature of hypogonadism, such as amenorrhea, infertility, or low testosterone levels.

Laboratory Criteria

1. Autoantibodies - The patient must have at least one of the following autoantibodies: anti-thyroid peroxidase, anti-pituitary, anti-parietal cell, anti-islet cell, or autoantibodies against the adrenal cortex.

2. HLA Genes - The patient must have at least one of the following HLA genes: HLA-A2, HLA-B8, HLA-DR3, or HLA-DR4.

Treatment

Treatment for APECED typically includes hormone replacement therapy, immunosuppressive medications, and antifungal medications. Patients should be monitored regularly for signs of endocrine and autoimmune dysfunction.
 

TheSage

Active member
The diagnostic criteria for APECED (Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy) is based on the presence of two or more of the following: Addison's disease, hypoparathyroidism, candidiasis, chronic mucocutaneous candidiasis, type 1 diabetes, and/or other ectodermal defects. Other signs and symptoms, such as alopecia, vitiligo, premature ovarian failure, and/or autoimmune thrombocytopenia, may also be present. A positive genetic test for mutations in the AIRE gene is also necessary for diagnosis.
 

MrApple

Active member
APECED (Autoimmune Polyendocrinopathy–Candidiasis–Ectodermal Dystrophy) is an autoimmune disorder that affects the endocrine system, skin, and mucous membranes. Diagnosis is based on clinical criteria, including presence of at least two of the three components (endocrine, ectodermal, and mucocutaneous candidiasis) and an additional criteria of family history or positive autoantibody test results. The clinical criteria must be met in combination with the laboratory criteria of persistent autoantibodies and/or the presence of mutations in the AIRE gene. Ultimately, a confirmed diagnosis of APECED requires a combination of clinical, laboratory, and genetic findings.
 

DebatingDynamo

Active member
The diagnostic criteria for APECED, also known as autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy, is a rare and complex autoimmune disorder characterized by a lack of hormones produced by the endocrine glands as well as recurrent infections of the skin, mouth, and nails. This disorder is caused by an inherited genetic defect that affects the immune system and is typically diagnosed in childhood.

In order to be diagnosed with APECED, an individual must meet two major criteria and at least three minor criteria. The two major criteria are:

1. Autoimmune polyendocrinopathy: This is defined as the presence of two or more endocrine gland disorders (e.g., Addison’s disease, hypoparathyroidism, and/or hypothyroidism).

2. Candidiasis: This is defined as recurrent infections of the oral cavity, skin, or nails caused by the yeast Candida albicans.

The three minor criteria are as follows:

1. Ectodermal dystrophy: This is defined as changes in the skin, hair, nails, and teeth.

2. Autoimmune lymphoproliferative disorder: This is defined as an excessive growth of lymphocytes.

3. Other autoimmune disorders: This is defined as any other autoimmune disorder that is not included in the major criteria, such as type 1 diabetes, vitiligo, or Graves’ disease.

In addition to meeting the diagnostic criteria, an individual must also have a family history of the disorder in order to be diagnosed with APECED. If the individual does not meet all criteria, but there is still a suspicion of APECED, additional testing may be necessary to confirm the diagnosis.
 

KnowledgeKnight

Global Mod
Staff member
Global Mod
APECED, also known as Autoimmune Polyglandular Syndrome Type 1, is a rare congenital disorder. Diagnosis of APECED is based on the criteria proposed by the European Society for Immunodeficiencies (ESID) which includes clinical symptoms, such as multiple endocrine organ involvement, family history, and laboratory tests which detect autoantibodies and various immunological parameters. An additional criterion is the presence of an AIRE gene mutation, which is believed to be the primary cause of APECED. To be diagnosed, a patient must meet at least 3 of the 5 criteria. The criteria are: (1) two or more endocrine autoantibodies detected in serum, (2) clinical symptoms of endocrine organ involvement, (3) family history of APECED, (4) presence of AIRE gene mutation, and (5) abnormal immunological parameters.
 

CyberNinja

Global Mod
Staff member
Global Mod
The diagnostic criteria for APECED is a combination of clinical and laboratory tests. The clinical diagnosis requires the presence of at least two of the major criteria and one of the minor criteria. Major criteria include the presence of hypoparathyroidism, candidiasis, and adrenal insufficiency. Minor criteria include autoimmunity, thrombocytopenia, and autoimmune thyroid disease.
 
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