{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T02:25:27Z","timestamp":1787538327787,"version":"build-2736575974"},"reference-count":20,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Latent autoimmune diabetes in adults (LADA) and Graves disease (GD) may coexist due to shared autoimmune mechanisms and genetic susceptibility. We report a 39-year-old woman with class III obesity who presented with palpitations, blurry vision, and hypertension. Evaluation revealed new-onset diabetes (hemoglobin A1c 8.3% [SI: 67\u2005mmol\/mol]; reference range, 4.6-6.4% [SI: 27-46\u2005mmol\/mol]) and hyperthyroidism with suppressed thyroid stimulating hormone and elevated free thyroxine (free T4), along with positive thyroid peroxidase and thyrotropin receptor antibodies, confirming GD. Further testing demonstrated markedly elevated glutamic acid decarboxylase-65, zinc transporter 8, and insulinoma-associated antigen-2 antibodies. C-peptide was 2.34\u2005ng\/mL (SI: 0.78\u2005nmol\/L) (reference range, 0.80-3.85\u2005ng\/mL [SI: 0.26-1.27\u2005nmol\/L]) with a glucose of 92\u2005mg\/dL (SI: 5.1\u2005mmol\/L) (reference range, 70-99\u2005mg\/dL [SI: 3.9-5.5\u2005mmol\/L]), consistent with early LADA. She was treated with methimazole and metformin as she was quite averse to insulin therapy and was able to achieve good glycemic control. At 23 months, worsening hyperglycemia with declining C-peptide level, necessitated multiple daily insulin injections and continuous glucose monitoring. This case highlights the biphasic course of LADA and the importance of screening for additional autoimmune diseases, consistent with autoimmune polyglandular syndrome type 3.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag219","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T11:30:55Z","timestamp":1785065455000},"source":"Crossref","is-referenced-by-count":0,"title":["Double autoimmune endocrinopathies: concurrent presentation of latent autoimmune diabetes in adults and Graves disease"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0644-3894","authenticated-orcid":false,"given":"Zar","family":"Tun","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, University of Missouri-Kansas City , Kansas City, MO 64108 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1028-9882","authenticated-orcid":false,"given":"Macy","family":"Baugh","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Missouri-Kansas City , Kansas City, MO 64108 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2266-8853","authenticated-orcid":false,"given":"Emmeline Monique","family":"Ngo","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, University of Missouri-Kansas City , Kansas City, MO 64108 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"2026082322025735200_luag219-B1","doi-asserted-by":"crossref","DOI":"10.3389\/fphys.2019.00320","article-title":"Etiology and pathogenesis of latent autoimmune diabetes in adults (LADA) compared to type 2 diabetes","volume":"10","author":"Carlsson","year":"2019","journal-title":"Front Physiol"},{"issue":"10","key":"2026082322025735200_luag219-B2","doi-asserted-by":"crossref","first-page":"3759","DOI":"10.1210\/jc.2012-2037","article-title":"GADA titer-related risk for organ-specific autoimmunity in LADA subjects subdivided according to gender (NIRAD study 6)","volume":"97","author":"Zampetti","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2026082322025735200_luag219-B3","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1111\/j.1365-2265.2011.03976.x","article-title":"High titre of antiglutamic acid decarboxylase autoantibody is a strong predictor of the development of thyroid autoimmunity in patients with type 1 diabetes and latent autoimmune diabetes in adults","volume":"74","author":"Jin","year":"2011","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2026082322025735200_luag219-B4","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1007\/s12020-019-01852-w","article-title":"Prevalence of diabetes and presence of autoantibodies against zinc transporter 8 and glutamic decarboxylase at diagnosis and at follow up of Graves\u2019 disease","volume":"64","author":"Jonsdottir","year":"2019","journal-title":"Endocrine"},{"issue":"3","key":"2026082322025735200_luag219-B5","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.autrev.2018.10.001","article-title":"The association of other autoimmune diseases in patients with Graves\u2019 disease (with or without ophthalmopathy): review of the literature and report of a large series","volume":"18","author":"Ferrari","year":"2019","journal-title":"Autoimmun Rev"},{"issue":"4","key":"2026082322025735200_luag219-B6","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/cen.14304","article-title":"Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: a systematic review and meta-analysis","volume":"93","author":"Botello","year":"2020","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"9","key":"2026082322025735200_luag219-B7","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1089\/thy.2021.0170","article-title":"Screening of organ-specific autoantibodies in a large cohort of patients with autoimmune thyroid diseases","volume":"31","author":"Pilli","year":"2021","journal-title":"Thyroid"},{"issue":"9","key":"2026082322025735200_luag219-B8","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1055\/s-0035-1555764","article-title":"The impact of thyroid autoimmunity on the clinical and diabetes parameters of patients with latent autoimmune diabetes in adults","volume":"123","author":"Reghina","year":"2015","journal-title":"Exp Clin Endocrinol Diabetes"},{"issue":"10","key":"2026082322025735200_luag219-B9","doi-asserted-by":"crossref","first-page":"4769","DOI":"10.1210\/jc.2019-00602","article-title":"Autoimmune polyendocrinopathy","volume":"104","author":"Frommer","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"2026082322025735200_luag219-B10","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2021.734685","article-title":"Case report: a rare case of coexisting of autoimmune polyglandular syndrome type 3 and isolated gonadotropin-releasing hormone deficiency","volume":"12","author":"Jiang","year":"2021","journal-title":"Front Immunol"},{"issue":"4","key":"2026082322025735200_luag219-B11","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s40618-022-01994-1","article-title":"Type 3 autoimmune polyglandular syndrome (APS-3) or type 3 multiple autoimmune syndrome (MAS-3): an expanding galaxy","volume":"46","author":"Betterle","year":"2023","journal-title":"J Endocrinol Invest"},{"issue":"6","key":"2026082322025735200_luag219-B12","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1210\/er.2008-0015","article-title":"Joint genetic susceptibility to type 1 diabetes and autoimmune thyroiditis: from epidemiology to mechanisms","volume":"29","author":"Huber","year":"2008","journal-title":"Endocr Rev"},{"issue":"8","key":"2026082322025735200_luag219-B13","doi-asserted-by":"crossref","first-page":"4904","DOI":"10.1210\/jc.2004-2236","article-title":"Genetic analysis of families with autoimmune diabetes and thyroiditis: evidence for common and unique genes","volume":"90","author":"Golden","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026082322025735200_luag219-B14","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1210\/jc.2008-2193","article-title":"Autoimmune thyroiditis and diabetes: dissecting the joint genetic susceptibility in a large cohort of multiplex families","volume":"94","author":"Villano","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026082322025735200_luag219-B15","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/j.1749-6632.2002.tb02951.x","article-title":"Autoantibody profile and epitope mapping in latent autoimmune diabetes in adults","volume":"958","author":"Falorni","year":"2002","journal-title":"Ann N Y Acad Sci"},{"issue":"10","key":"2026082322025735200_luag219-B16","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.2337\/dbi20-0017","article-title":"Management of latent autoimmune diabetes in adults: a consensus statement from an international expert panel","volume":"69","author":"Buzzetti","year":"2020","journal-title":"Diabetes"},{"issue":"9","key":"2026082322025735200_luag219-B17","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.2337\/dci18-0023","article-title":"Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association","volume":"41","author":"Chiang","year":"2018","journal-title":"Diabetes Care"},{"issue":"24","key":"2026082322025735200_luag219-B18","first-page":"12051","article-title":"The expression of GADA, ZnT8A and IA-2A in patients with type 1 diabetes mellitus with thyroid disease and their correlation with thyroid autoantibodies","volume":"27","author":"Chen","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"12","key":"2026082322025735200_luag219-B19","doi-asserted-by":"crossref","first-page":"4635","DOI":"10.1210\/jc.2009-1120","article-title":"Latent autoimmune diabetes in adults","volume":"94","author":"Naik","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2026082322025735200_luag219-B20","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.2337\/dc20-2834","article-title":"Latent autoimmune diabetes of adults (LADA) is likely to represent a mixed population of autoimmune (type 1) and nonautoimmune (type 2) diabetes","volume":"44","author":"Jones","year":"2021","journal-title":"Diabetes Care"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/9\/luag219\/70766469\/luag219.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/9\/luag219\/70766469\/luag219.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T02:03:06Z","timestamp":1787536986000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luag219\/8768962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,7,27]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luag219","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,7,27]]},"article-number":"luag219"}}