{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T01:03:13Z","timestamp":1785805393663,"version":"3.56.0"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Genes"],"abstract":"<jats:p>Background: Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED) is a rare monogenetic autosomal recessive disorder caused by a mutation in the autoimmune regulator (AIRE) gene characterized by complex phenotypic characteristics discovered over years of follow-up. Methods: 7 patients were recruited in this case series in a period of the last 37 years from Southern Croatia. All patients were screened for AIRE R257X mutations. Results: This study group had a mean current age of 25.3 years (age range from 5.4 to 40.2 years), while the mean age at the onset of the disease was 6.5 years (age range from 0.7 to 9.2 years) and with a mean follow-up period of 17.8 years. The overall prevalence of APECED syndrome is estimated to be 1 in 75,000. The most common initial manifestation of the disease was onychodystrophy, while the first major component of APECED syndrome was chronic mucocutaneous candidiasis. Conclusions: APECED is a \u2018\u2018multi-faced\u2019\u2019 disease based on the very unpredictable and inconsistent onset of major components. Furthermore, based on our results, we suggest that onychodystrophy could be included as a warning sign of APECED syndrome.<\/jats:p>","DOI":"10.3390\/genes13040558","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T14:55:35Z","timestamp":1647960935000},"page":"558","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical Characteristics in the Longitudinal Follow-Up of APECED Syndrome in Southern Croatia\u2014Case Series"],"prefix":"10.3390","volume":"13","author":[{"given":"Veselin","family":"Skrabic","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia"},{"name":"Department of Pediatrics, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivna","family":"Skrabic","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roko","family":"Skrabic","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanka","family":"Roje","sequence":"additional","affiliation":[{"name":"Laboratory for Cancer Research, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5720-0893","authenticated-orcid":false,"given":"Marko","family":"Simunovic","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia"},{"name":"Department of Pediatrics, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1056\/NEJM199006283222601","article-title":"Clinical Variation of Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED) in a Series of 68 Patients","volume":"322","author":"Ahonen","year":"1990","journal-title":"N. 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