{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:49:16Z","timestamp":1788306556184,"version":"build-2803163510"},"reference-count":7,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Introduction:<\/jats:bold>\n                    Autoimmune polyglandular syndrome (APS) is a condition having multiple endocrine abnormalities. It is divided into three types depending on the involvement of various endocrinopathies. It is also associated with other systemic involvement. The basic pathophysiology of this syndrome revolves around autoimmunity.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case presentation:<\/jats:bold>\n                    We discuss the case of a 50-year-old gentleman who presented to us in emergency with subacute onset progressive weakness of both lower limbs followed by upper limbs. On examination, patient was confused and disoriented. General examination findings include hypotension, pallor, facial puffiness and vitiligo. Neurological examination revealed spasticity and motor weakness in all four limbs with extensor planter response. Sensory examination during hospital course revealed posterior column involvement. Laboratory and radiological investigations confirmed subacute combined degeneration of spinal cord secondary to pernicious anaemia, Addison\u2019s disease and autoimmune thyroid disease. The final diagnosis of autoimmune polyglandular syndrome type II was made after fulfilment of the required criteria.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Autoimmune polyglandular syndrome type II can rarely present to neurologist as subacute combined degeneration of spinal cord. This syndrome and its systemic association should be kept in mind in order to reach the final diagnosis.\n                  <\/jats:p>","DOI":"10.2478\/rjim-2021-0038","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T12:54:14Z","timestamp":1640264054000},"page":"123-126","source":"Crossref","is-referenced-by-count":6,"title":["Autoimmune polyglandular syndrome type II presenting as subacute combined degeneration of spinal cord: a neuroendocrinology crossroad"],"prefix":"10.2478","volume":"60","author":[{"given":"Prateek","family":"Bapat","sequence":"first","affiliation":[{"name":"Department of Neurology , Institute of Human Behaviour and Allied Sciences, Dilshad Garden , Delhi , India ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman","family":"Kushwaha","sequence":"additional","affiliation":[{"name":"Department of Neurology , Institute of Human Behaviour and Allied Sciences, Dilshad Garden , Delhi , India ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Neurology , Institute of Human Behaviour and Allied Sciences, Dilshad Garden , Delhi , India ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Kirangowda","sequence":"additional","affiliation":[{"name":"Department of Neurology , Institute of Human Behaviour and Allied Sciences, Dilshad Garden , Delhi , India ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Seth","sequence":"additional","affiliation":[{"name":"Department of Neurology , Institute of Human Behaviour and Allied Sciences, Dilshad Garden , Delhi , India ,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,6,14]]},"reference":[{"key":"2026042914161284669_j_rjim-2021-0038_ref_001","doi-asserted-by":"crossref","unstructured":"1. HUSEBYE ES, ANDERSON MS, K\u00c4MPE O. Autoimmune Polyendocrine Syndromes. N Engl J Med. 2018 Mar 22; 378(12):1132\u20131141.10.1056\/NEJMra1713301","DOI":"10.1056\/NEJMra1713301"},{"key":"2026042914161284669_j_rjim-2021-0038_ref_002","unstructured":"2. CHEN QY, KUKREJA A, MACLAREN NK. The Autoimmune Polyglandular Syndromes. In: Endocrinology. W.B. Saunders, Philadelphia, 2001:587\u201399."},{"key":"2026042914161284669_j_rjim-2021-0038_ref_003","doi-asserted-by":"crossref","unstructured":"3. SCHATZ DA, WINTER WE. Autoimmune polyglandular syndrome. II: Clinical syndrome and treatment. Endocrinol Metab Clin North Am. 2002 Jun; 31(2):339\u201352.10.1016\/S0889-8529(01)00012-3","DOI":"10.1016\/S0889-8529(01)00012-3"},{"key":"2026042914161284669_j_rjim-2021-0038_ref_004","unstructured":"4. SCHMIDT MB. Eine biglandulare Erkrankung (Nebennieren und Schilddruse) bei Morbus Addisonii. Verh Dtsch Ges Pathol. 1926; 21:212\u2013221."},{"key":"2026042914161284669_j_rjim-2021-0038_ref_005","doi-asserted-by":"crossref","unstructured":"5. ROBLES DT, FAIN PR, GOTTLIEB PA, EISENBARTH GS. The genetics of autoimmune polyendocrine syndrome type II. Endocrinol Metab Clin North Am. 2002 Jun; 31(2):353\u201368, vi-vii.10.1016\/S0889-8529(01)00015-9","DOI":"10.1016\/S0889-8529(01)00015-9"},{"key":"2026042914161284669_j_rjim-2021-0038_ref_006","doi-asserted-by":"crossref","unstructured":"6. BETTERLE C, DAL PRA C, MANTERO F, ZANCHETTA R. Autoimmune adrenal insufficiency and autoimmune polyendocrine syndromes: autoantibodies, autoantigens, and their applicability in diagnosis and disease prediction. Endocr Rev. 2002 Jun;23(3):327\u201364. Erratum in: Endocr Rev. 2002 Aug; 23(4):579.10.1210\/edrv.23.3.046612050123","DOI":"10.1210\/edrv.23.3.0466"},{"key":"2026042914161284669_j_rjim-2021-0038_ref_007","unstructured":"7. PETER A. GOTTLIEB, AARON W. MICHELS. Autoimmune Polyendocrine Syndromes. In: Harrison\u2019s Principles of Internal Medicine, McGraw-Hill Education, New York, 2018:382:2756."}],"container-title":["Romanian Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/rjim-2021-0038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T18:21:09Z","timestamp":1777486869000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/rjim-2021-0038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,1]]},"references-count":7,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,6,14]]},"published-print":{"date-parts":[[2022,6,1]]}},"alternative-id":["10.2478\/rjim-2021-0038"],"URL":"https:\/\/doi.org\/10.2478\/rjim-2021-0038","relation":{},"ISSN":["2501-062X"],"issn-type":[{"value":"2501-062X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,1]]}}}