Type 3 autoimmune polyendocrine syndrome (APS) diagnosed in an 87-year-old patient with a concomitant chronic autoimmune urticaria

Introduction
Autoimmune polyendocrine syndromes constitute a group of diseases with a diverse clinical picture, and a common aetiology associated with autoreactive mechanisms. Four basic types of the disease have been specified. Type 3 autoimmune polyendocrine syndrome includes co-existence of autoimmune thyroid disease with at least one of the following: type 1 diabetes, leucoderma, alopecia areata, chronic atrophic gastritis, or myasthenia.

Objective
To describe type 3 autoimmune polyendocrine syndrome diagnosed in a patient admitted to the hospital due to chronic urticaria.

Case report
An 87-year-old female patient was admitted to Dermatology and Venereology Clinic to determine the cause and modify the treatment for chronic urticaria. Physical examination revealed disseminated urticarial nodules, depigmentation lesions covering about 98% of the body surface, and alopecia areata of the scalp. Furthermore, hypothyroidism and malignant anaemia were confirmed. The patient was diagnosed with type 3 autoimmune polyendocrine syndrome.

Conclusions
Not only does the ability to diagnose the described disease unit have a cognitive value, but it also enables diagnosing and treating concomitant autoimmune diseases.