endocrine and metabolic disorders
Polyglandular Deficiency Syndromes
Treatment of Polyglandular Deficiency Syndromes
Hormone replacement Treatment of the various individual glandular deficiencies is discussed elsewhere in THE MANUAL; the treatment of multiple deficiencies can be more complex than treatment of an isolated endocrine deficiency. For example, treatment of hypothyroidism with thyroid hormone replacement can precipitate an adrenal crisis in patients with undiagnosed adrenal insufficiency. Chronic mucocutaneous candidiasis associated with type 1 polyglandular deficiency usually requires lifelong Treatment (eg, oral , and umbilical cord blood transplantation. However, the impact of these measures in preventing other autoimmune endocrine deficiencies in patients with type 1 diabetes remains unknown ( Treatment references ). 1.Cai J, Wu Z, Xu X, et al: Umbilical cord mesenchymal stromal cell with autologous bone marrow cell transplantation in established type 1 diabetes: A pilot randomized controlled open-label clinical study to assess safety and impact oninsulinsecretion.Diabetes Care39:149–157, 2016. 2.Haller MJ, Gitelman SE, Gottlieb PA, et al:Anti-thymocyte globulin/G-CSFtreatment preserves β cell function in patients with established type 1 diabetes.J Clin Invest125(1):448–455, 2015. 3.Kroger CJ, Clark M, Ke Q, and Tisch RM: Therapies to suppress β cell autoimmunity in type 1 diabetes.Front Immunol9:1891, 2018. doi: 10.3389/fimmu.2018.01891 4.Nourelden AZ, Elshanbary AA, El-Sherif L, et al: Safety and efficacy ofteplizumabfor treatment of type one diabetes mellitus: a systemic review and meta-analysis.Endocr Metab Immune Disord Drug Targets21(10):1895-1904, 2021. 