Successful Management of Insulin Allergy and Autoimmune Polyendocrine Syndrome Type 4 with Desensitization Therapy and Glucocorticoid Treatment: A Case Report and Review of the Literature

Table 2

Classification of autoimmune polyglandular syndromes (APS).

Category	Subtypes	Criteria
APS-1	—	Two or more from the following; (i) Addison’s disease; (ii) Chronic candidiasis; (iii) Hypoparathyroidism; Associated conditions; (i) Alopecia; (ii) Autoimmune gastritis/pernicious anemia; (iii) Type 1 diabetes; (iv) Vitiligo; (v) Autoimmune thyroid disease; (vi) Chronic hepatitis; (vii) Autoimmune-related gonadal failure
APS-2	—	Addison’s disease plus any of the following; (i) Type 1 diabetes; (ii) Autoimmune thyroid disease
APS-3	APS-3A; APS-3B; APS-3C; APS-3D	Autoimmune thyroid disease plus: type 1 diabetes with/without any other endocrine organ involvement; Autoimmune thyroid disease plus: autoimmune gastrohepatic disease (inflammatory bowel syndrome, pernicious anemia, autoimmune gastritis, and primary biliary cirrhosis); Autoimmune thyroid disease plus: skin autoimmune disease (vitiligo with/without alopecia areata) with/without nervous system autoimmune disease (miastenia gravis, multiple sclerosis); Autoimmune thyroid disease plus: rheumatological autoimmune disease (systemic and discoid lupus, rheumatoid arthritis, Sjögren syndrome, systemic sclerosis, vasculitis, and antiphospholipid syndrome) with/without hematological disease
APS-4	—	Any other combination of specific organ and nonorgan specific autoimmune diseases