Letters To The Editor
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World J Diabetes. Sep 15, 2010; 1(4): 135-136
Published online Sep 15, 2010. doi: 10.4239/wjd.v1.i4.135
Autoimmune polyglandular syndrome type 3 complicated by mineralocorticoid-responsive hyponatremia of the elderly
Hidekatsu Yanai, Seiko Okamoto, Junwa Kunimatsu
Hidekatsu Yanai, Seiko Okamoto, Junwa Kunimatsu, Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba 272-8516, Japan
Author contributions: Yanai H contributed to the conception, writing and editing of the letter; Okamoto S and Kunimatsu J treated the patient presented in the letter, and contributed to the data collection.
Correspondence to: Hidekatsu Yanai, MD, PhD, FACP, Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba 272-8516, Japan. dyanai@hospk.ncgm.go.jp
Telephone: +81-47-3733501 Fax: +81-47-3721858
Received: July 20, 2010
Revised: August 24, 2010
Accepted: August 31, 2010
Published online: September 15, 2010
Abstract

We experienced the first case with autoimmune polyglandular syndrome type 3 (anti-thyroid peroxidase antibody-positive hypothyroidism and anti-glutamic acid decarboxylase antibody-positive diabetes) complicated by mineralocorticoid-responsive hyponatremia of the elderly. This case is also a rare slowly progressive insulin-dependent diabetes mellitus (SPIDDM) case, for which the patient has been treated for many years with sulfonylurea or glinide. Our observation also demonstrated that glucose metabolism in autoimmune diabetes such as SPIDDM is influenced by appetite, thyroid function and glucocorticoid effect.

Keywords: Anti-glutamic acid decarboxylase antibody; Autoimmune polyglandular syndrome; Mineralocorticoid-responsive hyponatremia of the elderly; Slowly progressive insulin-dependent diabetes mellitus