1Gozde Akademi Hospital, Clinic of Endocrinology and Metabolism, Malatya, Turkey
2Inonu University, Faculty of Medicine, Department of Neurology, Malatya, Turkey
3Inonu University, Faculty of Medicine, Department of Ophthalmology, Malatya, Turkey
Autoimmune polyglandular syndrome type III (APS III) is characterised by autoimmune destruction of various endocrine and non-endocrine tissues. It differs from APS I and APS II in terms of without adrenal involvement. Although APS III includes a series of autoimmune disorders, it is rarely associated with multiple sclerosis (MS). A 41-year-old female patient had diplopia, visual blurring, dizziness, and giddiness for 2 weeks. In her medical history, she had a diagnosis of MS and using Teriflunomide. It was detected positivity of antinuclear antibody (ANA), anti-thyroid peroxidase (Anti-TPO) and anti-thyroglobulin (Anti-TG) antibodies. Based on these results, the patient with MS who has chronic autoimmune thyroiditis and primary ovarian failure was diagnosed with APS III. The coexistence of APS-III and MS is a rare clinical entity. Moreover, hypothyroidism has been detected during teriflunomide therapy in the patient. Hypothyroidism was most likely a component of APS-III in our case, but it may also have been triggered by teriflunomide.
Keywords: Autoimmune polyglandular syndrome (APS) type III; multiple sclerosis; teriflunomide