Autoimmune polyendocrine syndrome CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

A CT scan may be helpful in the diagnosis of autoimmune polyendocrine syndrome (APS) associated hypoparathyroidism and Addison’s disease. Hypoparathyroidism on CT may present with increased volumetric bone mineral density (vBMD) of both cortical and trabecular bones. Addison’s disease on CT scan may present with small adrenal remnants bilaterally (suggestive of autoimmune adrenalitis) or as atrophied adrenal glands.

CT scan findings in autoimmune polyendocrine syndrome (APS) depends upon the subtype of APS and the organ involved. In APS type 1, parathyroids and adrenal glands are often involved and may present with:

• CT scan of the abdomen may be helpful in the diagnosis of autoimmune polyendocrine syndrome (APS) type 1. Findings on CT scan suggestive of adrenal insufficiency as seen in APS include:
  • Small adrenal remnants bilaterally suggestive of autoimmune adrenalitis.
  • Chronic cases of APS may have dense calcification in one or both adrenal beds.
  • Atrophic adrenal glands – in idiopathic autoimmune Addison’s disease.

• Peripheral quantitative computed tomography (pQCT) may be helpful in the diagnosis of hypoparathyroidism.^[1][2]
• Findings on pQCT scan suggestive of hypoparathyroidism include:
  • Increase in volumetric bone mineral density (vBMD) of both cortical and trabecular bones.
  • Increase in bone mineral density (BMD) of both cortical and trabecular bones.

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