Autoimmune Diabetes: watch our for the tell-tale signs of associated multi-organ failure

Pancreatic islet

Autoimmunity is a condition where the body’s defenses turn on it’s own selves. The process where the body learns to recognize self from non-self is called as clonal selection, that takes place in the thymus (an organ situated in the anterior part of the chest wall) in children. The thymus disappears in adults. But sometimes the thymus due to an infective, idiopathic or genetic cause, produces hyperactive lymphocytes or the white blood cells which start attacking specific cells in our body resulting in various autoimmune conditions. It can attack the endocrine system and destroy the cells of the various organ systems involved, like the adrenal glands, the thyroid, the parathyroids, the melanocytes, the parietal cells of the stomach, intestinal cells, suprarenal glands and the pancreas and resulting in a multi organ failure syndrome.

The syndrome of multiple endocrine organ involvement (and other organs that don't have hormones, like the skin) is called by several names, including:

• autoimmune endocrine failure syndrome,
• autoimmune polyendocrine syndrome,
• autoimmune polyglandular syndrome, and
• immunoendocrinopathy syndrome.

This syndrome might include any or most of the following disorders:

• Type 1 or autoimmune Diabetes (attacks the islet cells of the pancreas)
• Vitiligo (white patches on the skin that lack pigmentation)
• Premature menopause
• Addison's disease (adrenal gland failure)
• Pernicious Anemia
• Hypothyroidism (underactive thyroid gland), hyperthyroidism (overactive thyroid gland function), and thyroiditis (inflammation of the thyroid gland).
• Alopecia Totalis (loss of body hair)
• Parathyroid gland failure
• Pituitary gland failure
• Candidia infections of the skin and mucus membranes

Types….

Two varieties of the syndrome have been described:

Pathology…

If someone has several of these conditions, or if one member of a family has one of these conditions, and another family member has another, it's very likely that they may have antibodies against other endocrine tissues. (And, if a biopsy of affected tissue were obtained, it will show lymphocytic infiltration).

Therapy…

If a family member, has several of these conditions, there's no specific therapy that's different than if he or she had only one of them. Every associated condition will be treated individually.

Current management of diabetes involves daily blood sugar testing, insulin injections, and careful meal planning. The only way to cure diabetes is to replace the destroyed beta cells or replace their function.

Whole-pancreas transplants have been successful in restoring insulin production in people with advanced diabetes, but because of significant risks the procedure has been limited to those who are also undergoing kidney transplantation.1,2

There are, however, several points to be made:

1. You and your physician should watch for the possibility of developing another of the disorders.
2. You and your family should be aware of the possibility of developing any of the disorders in any family member.
3. Antibody levels could be measured for several of the disorders: thyroid antibodies are the most commonly available.