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Question:

I am a 33 year old male, and have developed a "trigger finger" in my ring and long fingers in both hands over the last six months. During that time I have also developed alopecia of my beard (probably 15-20% of my beard is gone in round patches), and I developed plantar fasciitis in both heels, first the left, later the right. I have six siblings; one brother and one sister have hypothyroidism as does my mother. I have a nephew with celiac disease as well. I do not have diabetes, but I am concerned that I might have some autoimmune poly-disorder that could include diabetes, since, at my initial consultation with him, my hand doctor was surprised to hear that I did not have type 1 diabetes, given my hand condition at my age. Should I be concerned? Is there any blood work I should have done to confirm antibodies, etc? Or should I just relax and not worry about it?

Answer:

Certainly you have a family and personal history that is very suggestive indeed of what is sometimes called the "Autoimmune Polyglandular Syndrome Type II." It isn't of course really polyendocrine or polyglandular, as a wide variety of tissues may be involved. Autoimmune diabetes is a common but not inevitable component of the syndrome.

In your case, I think you might suggest to your doctor that he does do a fasting blood sugar and a test for glucosuria. It would also might help confirm the diagnosis of the syndrome if you had a positive anti-GAD (glutamic acid decarboxylase) test. This is often positive in the fasciitis cases and does not indicate that you might develop diabetes. However if an anti-insulin antibody test and an anti-ICA512 (Islet Cell Antibody) test were also done at the same time and were positive it would be a stronger indication that you might develop a late form of Type 1A diabetes. No treatment for diabetes would be indicated before you had definite signs of glucose intolerance (which you may never develop). In any case relax!

DOB

DTQ-ONCEMDO20000606
Original posting 29 Jun 2000
Posted to Other Illnesses

  
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Last Updated: Tuesday April 06, 2010 15:09:10
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