A Rare Case of Hypothyroidism, Type 1 Diabetes Mellitus, and Systemic Lupus Erythematosus with Immunosuppressive Consequences

Introduction

Autoimmune diseases often present in complex and overlapping patterns, making diagnosis and management a challenge. This case study highlights a rare coexistence of Systemic Lupus Erythematosus (SLE), Type 1 Diabetes Mellitus (T1DM), and Hypothyroidism, with immunosuppressive therapy leading to opportunistic infections. The interplay of these conditions presents significant clinical implications.

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Case Overview

A young female patient with a history of hypothyroidism was diagnosed with T1DM after experiencing loss of consciousness. Further evaluation revealed SLE, confirmed by anti-DNA and anti-nuclear antibody tests. She was placed on hydroxychloroquine, corticosteroids, and Mycophenolate Mofetil (MMF).

Six months into immunosuppressive therapy, she developed pulmonary tuberculosis, confirmed by positive acid-fast bacillus sputum test. Her treatment plan was modified to include anti-TB therapy while adjusting immunosuppressive drugs.

Key Clinical Findings

• Autoimmune Overlap: SLE and T1DM are both characterized by autoantibody production, affecting multiple organs.
• Immunosuppressive Consequences: Immunosuppression heightened infection risk, reinforcing the need for careful monitoring.
• Genetic and Environmental Triggers: The interplay between genetics, environmental factors, and immune dysregulation played a role in disease progression.

Medical Insights & Broader Implications

According to the American College of Rheumatology (ACR), managing autoimmune conditions with overlapping syndromes requires a multidisciplinary approach. Immunosuppressive therapy should be closely monitored, especially during the first six months, when the risk of opportunistic infections is highest.

Full Study of the article.

Read the full study at https://doi.org/10.29328/journal.jcn.1001138

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