Cascade auto-immune a propos d’une observation

الملخص FRE

Autoimmunity can be separated into two major subtypes: organ specific and systemic.

The endocrine system appears to be particularly vulnerable to this affection and the more susceptible organs are thyroid, pancreatic islets and adrenal cortex.

These forms of endocrine autoimmunity can especially occur simultaneously in patient as a part of an autoimmune polyglandular syndrome (APS) .which can be associated with other specific or non specific autoimmune organs diseases during the evolution.

In this article, we report a case of 34 years old woman who developed in 9 years an APS type 2 associating: Addison disease, auto-immune primary ovarian failure ?primary hypothyroidism, Gougerot-Sjögren syndrome and glomerular nephropathy.

Her history began at the age of 25 years with an Addison disease which was revealed by an acute adrenal insufficiency.

Two years after, our patient developed a premature menopause.

Then the autoimmune process affected the thyroid gland with screening for an infra clinical primary hypothyroidism without goiter 3 years later.

In addition, we deduced a positivity of the anti nuclear antibodies (anti- SSA and anti SSB) wchich permitted us to make the diagnosis of Gougerot-Sjögren syndrome.

Finally, 9 years after the initial autoimmune affection, our patient developed at the age of 34 years a nephrotic syndrome.

The biopsy showed an extra membranous glomerulonephritis.