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Case Report
A multidisciplinary approach to management of autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED)
  1. Mohammed Ramzy Gouda1,
  2. Azzam Al-Amin2,
  3. Heike Grabsch3,
  4. Clare Donnellan4
  1. 1Department of Colorectal Surgery, St. James's University Hospital, Leeds, UK
  2. 2Department of Colorectal Surgery, Leeds Teaching Hospitals, Leeds, UK
  3. 3Department of Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
  4. 4Department of Gastroenterology and Nutrition, St. James's University Hospital, Leeds, UK
  1. Correspondence to Mohammed Ramzy Gouda, mg_ramzy{at}yahoo.com

Summary

We present a case of an 18-year-old Caucasian man with a rare autosomal recessive disorder called autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED). This patient had manifestations of all clinical components of this multisystemic disease which included intestinal failure secondary to autoimmune enteropathy. We present a unique multidisciplinary management for this genetic condition. Although patients with APECED do not always have all the disease components (a total of eight exist), the majority have at least 3–5 components. This excludes the psychosexual implications which are often ignored. This case highlights the importance of (1) management of APECED in a multidisciplinary nature that includes a gastroenterologist, immunologist, endocrinologist, dietitians, etc and the (2) management of intestinal failure component of APECED is best suited in a specialist intestinal failure unit where expertise is available for complex malabsorption disorders.

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