Autoimmune polyglandular syndrome type 3B: a key to diagnosing autoimmune gastritis and asymptomatic primary biliary cholangitis

Background: Autoimmune polyglandular syndrome type 3 (APS-3) encompasses autoimmune thyroid disease and other autoimmune disorders. APS-3 is further categorized into four subtypes, with APS-3B involving gastrointestinal autoimmune diseases. In this case, we diagnosed autoimmune gastritis, a conditio...

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Main Authors: Sayaka Mabuchi, Hiroya Mabuchi, Takashi Watari
Format: Article
Language:English
Published: SMC MEDIA SRL 2025-05-01
Series:European Journal of Case Reports in Internal Medicine
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Online Access:https://www.ejcrim.com/index.php/EJCRIM/article/view/5376
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author Sayaka Mabuchi
Hiroya Mabuchi
Takashi Watari
author_facet Sayaka Mabuchi
Hiroya Mabuchi
Takashi Watari
author_sort Sayaka Mabuchi
collection DOAJ
description Background: Autoimmune polyglandular syndrome type 3 (APS-3) encompasses autoimmune thyroid disease and other autoimmune disorders. APS-3 is further categorized into four subtypes, with APS-3B involving gastrointestinal autoimmune diseases. In this case, we diagnosed autoimmune gastritis, a condition challenging to identify based on endoscopic findings alone, and asymptomatic primary biliary cholangitis (PBC) through the recognition of APS-3B. Case report: An 84-year-old female patient presented with forgetfulness and a history of Hashimoto’s disease. Although endoscopy revealed pan-atrophic gastritis, autoimmune gastritis was suspected rather than Helicobacter pylori infection due to consideration of the APS-3 framework. Specific observations, including adherent mucus and remnants of oxyntic mucosa, guided tests for anti-endogenous antibodies, confirming autoimmune gastritis. Recognizing APS-3B prompted further evaluation for PBC, including measurement of anti-mitochondrial M2 antibody, which led to the diagnosis of asymptomatic PBC. Conclusion: Recognition of APS-3 offers a valuable framework for the differential diagnosis of autoimmune diseases.
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spelling doaj-art-fb83623fdb1c448e98c923804aa19df12025-08-20T03:07:37ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942025-05-0110.12890/2025_0053764911Autoimmune polyglandular syndrome type 3B: a key to diagnosing autoimmune gastritis and asymptomatic primary biliary cholangitisSayaka Mabuchi0Hiroya Mabuchi1Takashi Watari2Department of General Medicine, Iinan Hospital, Shimane, JapanDepartment of General Medicine, Iinan Hospital, Shimane, JapanIntegrated Clinical Education Center, Kyoto University Hospital, Kyoto, Japan; General Medicine Center, Shimane University Hospital, Shimane, JapanBackground: Autoimmune polyglandular syndrome type 3 (APS-3) encompasses autoimmune thyroid disease and other autoimmune disorders. APS-3 is further categorized into four subtypes, with APS-3B involving gastrointestinal autoimmune diseases. In this case, we diagnosed autoimmune gastritis, a condition challenging to identify based on endoscopic findings alone, and asymptomatic primary biliary cholangitis (PBC) through the recognition of APS-3B. Case report: An 84-year-old female patient presented with forgetfulness and a history of Hashimoto’s disease. Although endoscopy revealed pan-atrophic gastritis, autoimmune gastritis was suspected rather than Helicobacter pylori infection due to consideration of the APS-3 framework. Specific observations, including adherent mucus and remnants of oxyntic mucosa, guided tests for anti-endogenous antibodies, confirming autoimmune gastritis. Recognizing APS-3B prompted further evaluation for PBC, including measurement of anti-mitochondrial M2 antibody, which led to the diagnosis of asymptomatic PBC. Conclusion: Recognition of APS-3 offers a valuable framework for the differential diagnosis of autoimmune diseases.https://www.ejcrim.com/index.php/EJCRIM/article/view/5376autoimmune polyglandular syndrome type 3diagnosisautoimmune gastritisprimary biliary cholangitis
spellingShingle Sayaka Mabuchi
Hiroya Mabuchi
Takashi Watari
Autoimmune polyglandular syndrome type 3B: a key to diagnosing autoimmune gastritis and asymptomatic primary biliary cholangitis
European Journal of Case Reports in Internal Medicine
autoimmune polyglandular syndrome type 3
diagnosis
autoimmune gastritis
primary biliary cholangitis
title Autoimmune polyglandular syndrome type 3B: a key to diagnosing autoimmune gastritis and asymptomatic primary biliary cholangitis
title_full Autoimmune polyglandular syndrome type 3B: a key to diagnosing autoimmune gastritis and asymptomatic primary biliary cholangitis
title_fullStr Autoimmune polyglandular syndrome type 3B: a key to diagnosing autoimmune gastritis and asymptomatic primary biliary cholangitis
title_full_unstemmed Autoimmune polyglandular syndrome type 3B: a key to diagnosing autoimmune gastritis and asymptomatic primary biliary cholangitis
title_short Autoimmune polyglandular syndrome type 3B: a key to diagnosing autoimmune gastritis and asymptomatic primary biliary cholangitis
title_sort autoimmune polyglandular syndrome type 3b a key to diagnosing autoimmune gastritis and asymptomatic primary biliary cholangitis
topic autoimmune polyglandular syndrome type 3
diagnosis
autoimmune gastritis
primary biliary cholangitis
url https://www.ejcrim.com/index.php/EJCRIM/article/view/5376
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AT hiroyamabuchi autoimmunepolyglandularsyndrometype3bakeytodiagnosingautoimmunegastritisandasymptomaticprimarybiliarycholangitis
AT takashiwatari autoimmunepolyglandularsyndrometype3bakeytodiagnosingautoimmunegastritisandasymptomaticprimarybiliarycholangitis