Polyglandular autoimmune syndrome?

[match2011]

A 15y girl had recurrent candidal infections of the skin and nucous membranes since childhood, 2 years Hx of type 1 DM and 1y Hx of autoimmune thyroiditis.

Which of the following is the most likelymechanism of her recurrent candidal infections?
A. Autoimmune destruction of the thymus
B. Blunting of the inflammatory response from complement deficiency
C. deficiency in anticandidal Ab
D. Impaired cell-mediated immunity
E. inability of macrophage to present candidal antigen

I thought this girl has Polyglandular autoimmune syndrome type I. But she did not have hypoparathyroidism or autoimmune adrenal insufficiency.

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[Valadi]

I think cell mediated immunity. DM & some cases of non-infectious causes of thyroiditis are T-cell mediated processes. Moreover, you get candida if you have defunct T-cells.

Autoimmune polyglandular syndrome gets.. well, glands. It doesn't -primarily- affect immunity.

 

[SlaveOfTCMC]

as the above poster mentioned, this may be Chronic Mucocutaneous Candidasis


But regardless, APS syndromes comprise of a large variety of possible presentations. The "classic triad or tetrad" is never set in stone. Each component has a certain % chance of presentation attached to it

Because this is the USMLE and it goes with "most commons," then I would say going with CMC is most logical