AUTOIMMUNE POLYGLANDULAR FAILURE ASSOCIATED WITH MALABSORPTION AND GASTRIC CARCINOID-TUMOR

A 21-year-old female with autoimmune polyglandular failure (APG) manif ested by insulin-dependent diabetes mellitus (IDDM), hypothyroidism an d pernicious anaemia developed severe malabsorption due to exocrine pa ncreatic insufficiency. Supplemental pancreatic enzymes resulted in ma rked improvement of steatorrhea. There was also an incidental finding of gastric carcinoid tumour. We identified only 13 other patients in o ur institution with either type 2 or 3 APG, one of which had significa nt steatorrhoea. Another patient with IDDM, hypothyroidism and pernici ous anaemia had an asymptomatic gastric carcinoid tumour. The possible mechanisms for malabsorption in APG are discussed.