Patients

Patient A (female) was enrolled in the study at age 25 years. She had DM1 (onset at the first year of life), AAI (onset at age 22), primary hypothyroidism as a result of outcome of AIT (onset at age 22), and diffuse alopecia (onset at age 25). From age 15 years, she suffered from dermatitis, and at age 21, esophageal candidiasis was diagnosed. Both parents and sister denied any autoimmune diseases, did not have any specific complaints related to autoimmune pathology, and refused to undergo in-depth examinations. The patient received 5 mg prednisolone in the morning and 2.5 mg in the evening, 0.2 mg fludrocortisone in the morning, 75 mcg levothyroxine sodium in the morning, and insulin therapy (glargine, lispro).

Patient B (female) was enrolled in the study at age 25 years. From age 11, she noted episodes of loss of consciousness, accompanied by severe hypotension and a craving for salty food. At age 13, convulsive syndrome manifested (but the diagnosis of hypoparathyroidism was verified only 11 years later). At age 14 years, vitamin B₁₂ deficiency was diagnosed. Moreover, at the same age, the patient had alopecia areata (manifested by hair loss from the eyebrows and eyelashes). Alopecia progressed at age 23, when the patient noted hair loss at the scalp. The patient also had primary hypothyroidism as an outcome of AIT (diagnosis was made at age 22) and vulvovaginal candidiasis (diagnosis was made at age 26). Neither parent had autoimmune diseases, according to ERC examinations (specifically, antibodies [Abs] to interferons were investigated, but results were negative). The patient received levothyroxine sodium (112.5 mcg) in the morning and alfacalcidol (1.5 mcg) in the afternoon.