Multiple Autoimmune Syndrome (Graves’ Disease, Autoimmune Hepatitis, SLE) in Young Male with ASD Secundum: A Rare Case

Authors

  • Dinar Dewi Miftah Tyas Arum Resident of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret Author
  • Herlina Kusuma Dewi Faculty of Medicine, Universitas Sebelas Maret Author
  • Eva Niamuzisilawati Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine, Dr. Moewardi Hospital/ Universitas Sebelas Maret Author
  • Aritantri Darmayani Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Dr. Moewardi Hospital/ Universitas Sebelas Maret Author
  • Agus Joko Susanto Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine, Dr. Moewardi Hospital/ Universitas Sebelas Maret Author
  • Astri Kurniati Martiana Division of Cardiovascular Diseases, Department of Internal Medicine, Faculty of Medicine, Dr. Moewardi Hospital/ Universitas Sebelas Maret Author
  • Brian Wasita Department of Pathology Anatomy, Faculty of Medicine, Dr. Moewardi Hospital/ Universitas Sebelas Maret Author

DOI:

https://doi.org/10.66266/inajemd.v2i1.45

Keywords:

Multiple autoimmune syndromes, Graves’ disease, autoimmune hepatitis, SLE, rial septal defect secundum

Abstract

Multiple autoimmune syndrome (MAS) is characterized by the presence of at least three autoimmune diseases, presenting complex clinical challenges due to overlapping conditions and varied manifestations. Multiple autoimmune syndrome is rarely reported in men, particularly with the combination of Graves’ disease, systemic lupus erythematosus (SLE), and autoimmune hepatitis (AIH). We report a case of a 22-year-old male who presented with symptoms of jaundice, significant weight loss, and classic signs of hyperthyroidism, including palpitations and tremors. Physical examination revealed jaundice, exophthalmos, and an enlarged thyroid gland, and he was diagnosed with Graves' disease, SLE, and AIH. Additional findings included stasis dermatitis and an atrial septal defect (ASD) with a moderate risk of pulmonary hypertension. The patient received thiamazole, propranolol, and corticosteroids, leading to clinical stabilization and symptom resolution. This rare MAS case with concurrent Graves’ disease, SLE, and AIH highlights the need for accurate diagnosis and individualized management. The immunological interplay among these diseases contributes to diverse clinical manifestations, requiring a multidisciplinary approach. Our patient’s management strategy effectively controlled hyperthyroidism, mitigated hepatic inflammation, and stabilized cardiac function, illustrating the effectiveness of comprehensive therapy. In young patients presenting with multiple autoimmune symptoms, MAS should be considered, especially with unusual combinations. Early detection and tailored treatment approaches, along with interdisciplinary collaboration, are essential to manage MAS and its associated complications.

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Published

01-07-2025

How to Cite

1.
Dinar Dewi Miftah Tyas Arum, Herlina Kusuma Dewi, Eva Niamuzisilawati, Aritantri Darmayani, Agus Joko Susanto, Astri Kurniati Martiana, et al. Multiple Autoimmune Syndrome (Graves’ Disease, Autoimmune Hepatitis, SLE) in Young Male with ASD Secundum: A Rare Case. InaJEMD [Internet]. 2025 Jul. 1 [cited 2026 May 15];2(1):74-86. Available from: https://inajemd.pbperkeni.or.id/index.php/journal/article/view/Vol2No1-11

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