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Alopecia totalis, Hypotonie und erektile Dysfunktion bei einem 34-jährigen Mann

Schwierige Klärung einer gemeinsamen Ursache

Alopecia totalis, hypotension and erectile dysfunction in a 34 year old patient

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Zusammenfassung

Das Auftreten mehrerer Autoimmunendokrinopathien in Verbindung mit nichtendokrinen Autoimmunerkrankungen wird als polyglanduläres Autoimmunsyndrom (PAS) bezeichnet. Bei einem 34-jährigen Mann mit Schwäche, Gewichtsverlust und erektiler Dysfunktion fanden sich ein Hypokortisolismus durch Autoimmunadrenalitis und ein Hypogonadismus durch Hypophysitis mit einer Störung der Gonadotropinsekretion. Als weitere Zeichen einer breiten Autoimmunendokrinopathie zeigten sich Autoantikörper gegen Schilddrüsenmikrosomen und gegen Inselzellen, jedoch ohne Nachweis eines Hormonmangels. In den nächsten 11 Jahren wurden insgesamt 3 Endokrinopathien (Nebennierenrindeninsuffizienz, hypogonadotroper Hypogonadismus infolge Hypophysitis, Diabetes mellitus Typ 1) klinisch manifest. Parallel dazu manifestierten sich mehrere nichtendokrine Autoimmunerkrankungen: Alopecia totalis, Vitiligo, Retrobulbärneuritis und Keratokonjunktivitis.

Abstract

The occurence of both autoimmune endocrinopathies and endocrinopathies caused by other reasons is called polyglandular autoimmune syndrome (PAS-syndrome). In a 34 years old man with weakness, weight loss and erectile dysfunction we found low cortisol caused by an autoimmune adrenalitis and low testosteron caused by a hypophysitis with impaired gonadotropin secretion. Thyroid autoantibodies and islet cell autoantibodies without any hormone deficiencies were further signs of a broad endocrine autoimmune syndrome. In the following 11 years the patient developed three autoimmune disorders: paradrenal glandular insufficiency, hypogonadism caused by hypophysitis, Diabetes mellitus type 1. In the same time several non endocrine autoimmune diseases became manifest: alopecia totalis, vitiligo, retrobulbar neuritis and keratoconjunctivitis.

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  1. Funktionsbereich Endokrinologie und Stoffwechselerkrankungen, Klinik für Innere Medizin III, Universitätsklinikum Jena

    W. Hunger-Dathe, A. Braun & U. A. Müller

  2. Klinik für Innere Medizin III, Friedrich-Schiller-Universität, 07740, Jena

    W. Hunger-Dathe

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  1. W. Hunger-Dathe
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  2. A. Braun
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  3. U. A. Müller
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Correspondence to W. Hunger-Dathe.

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Hunger-Dathe, W., Braun, A. & Müller, U.A. Alopecia totalis, Hypotonie und erektile Dysfunktion bei einem 34-jährigen Mann. Internist 46, 690–694 (2005). https://doi.org/10.1007/s00108-005-1380-2

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