Achalasia and thyroid disease

Raisi, Mostafa; Amini, J; Daghaghzadeh, Hamed

doi:10.3748/wjg.v13.i4.594

Cited by 14 publications

(20 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, in their series, Emami and cols. (17) did not find a direct correlation between the gravity of thyroid disease and the degree of achalasia symptoms. This finding was similar in our case, where the patient had more significant esophageal symptoms than those related to the thyroid disease.…”

Section: Discussionmentioning

confidence: 82%

“…(17), examining a group of 30 patients (20 women and 10 men) with achalasia, whose ages varied from 30 to 70 years, found that this esophageal anomaly was associated with AITDs in 23% of the cases (17). In this group, hypothyroidism due to Hashimoto thyroiditis was the most common occurrence.…”

Section: Discussionmentioning

confidence: 99%

“…A cluster consisting of varied autoimmune diseases has been linked to achalasia: myasthenia gravis, polymyositis, autoimmune thyroid disease, among others, contributing to the argument that autoimmunity may be a cause for some idiopathic achalasia (17)(18)(19). A further achalasia candidate gene selected based on its involvement in autoimmunity is the protein of tyrosine phosphatase N22 gene (PTPN22) on chromosome 1p13 (20).…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, clinical investigations usually ignore the existence of achalasia as the cause of dysphagia, despite the fact there is sufficient literature citations linking it mainly to Hashimoto thyroiditis and, to a lesser degree, to hyperthyroidism (17).…”

Section: Sumáriomentioning

confidence: 99%

See 3 more Smart Citations

Achalasia and thyroid disease: possible autoimmune connection?

Quidute

Freitas²,

Lima³

et al. 2012

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

SUMMARYMany cases have been published showing a co-existence of autoimmune thyroid diseases (AITDs) and other autoimmune diseases. About a quarter of patients with achalasia have a concurrent thyroid disease, most commonly associated with hypothyroidism. Although relatively rare, the association of achalasia and hyperthyroidism requires attention. The physiopathology of Grave's Disease (GD) involves B-and T-mediator lymphocytes, which have an affinity for known thyroid antigens: thyroglobulin, thyroid-peroxidase, and thyrotrophin receptor. Currently, however, the real physiopathogenesis of achalasia continues to be unknown. Some important findings are suggestive of an autoimmune mechanism: significant infiltration of the myoenteric plexus by monocytes, presence of the class II-Human Histocompatibility Complex DQwl antigen and antibodies to myoenteric neurons. The present case reports a patient who, despite testing negative for Chagas' disease, had achalasia, progressed to developing significant wasting and worsening of his quality of life, was later diagnosed with hyperthyroidism. After endoscopic esophageal dilatation and radioiodine ablation of the thyroid gland, there was great improvement in the patient clinical condition. Arq Bras Endocrinol Metab. 2012;56(9):677-82 SUMáRioMuitos casos têm sido publicados mostrando uma coexistência entre as doenças autoimunes da tireoide (DAIT) e outras doenças autoimunes. Cerca de um quarto dos pacientes com acalasia têm doenças da tireoide concomitantemente, sendo a mais comum a associação com hipotireoidismo. Apesar de ser relativamente rara, a associação da acalasia e hipertireoidismo requer atenção. A fisiopatologia da doença de Graves (DG) envolve os linfócitos B e T-mediados, os quais têm afinidade pelos antígenos da tireoide: tireoglobulina, tireoperoxidase e receptor de tireotrofina. Atualmente, a real fisiopatogenia da acalasia continua desconhecida. No entanto, alguns importantes achados em análise são sugestivos de mecanismo autoimune: infiltração significativa do plexo mioentérico pelos monócitos, presença do antígeno-DQwl do Complexo Humano de Histocompatibilidade classe II e presença de anticorpos contra neurô-nios mioentéricos. Este presente caso aborda um paciente que, apesar de testes negativos para doença de Chagas, tem acalasia que progrediu para o desenvolvimento de significativa perda ponderal e piora da sua qualidade de vida, posteriormente, diagnosticado com hipertireoidismo. Após dilatação endoscópica esofágica e ablação da glândula tireoide com radioiodo, houve grande melhora na condição clínica do paciente. Arq Bras Endocrinol Metab. 2012;56(9):677-82

show abstract

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Sumáriomentioning

confidence: 99%

See 2 more Smart Citations

Achalasia and thyroid disease: possible autoimmune connection?

Quidute

Freitas²,

Lima³

et al. 2012

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…4 The primary lesion could also be a severe myopathy of the smooth muscle cells. 4,5 Familial occurrence and association with class II HLA antigens also suggest genetic predisposition. 6,7 A secondary form of achalasia is Chagas disease, an infectious disease cause by the parasite Trypanasoma Cruzi.…”

Section: Introductionmentioning

confidence: 99%

Achalasia: What is the best treatment?

Ahmed

2008

Ann Afr Med

View full text Add to dashboard Cite

Background: Achalasia is an infrequent primary motility disorder of the esophagus. Because of uncertain etiology, treatment is only palliative and is directed at decreasing lower esophageal sphincter pressure, improving esophageal emptying and relieving the symptoms of achalasia. Current treatment options include pharmacological, endoscopic and surgical. We undertook a systematic literature review of the management strategies currently available for achalasia. Method: A Medline, PubMed and Cochrane database search was conducted using reference manager 11. Original articles and reviews published in the English literature on the management of achalasia were reviewed. Emphasis was placed on articles published in the last ten years on randomized controlled trials comparing the various forms of treatment. Results: Esophageal manometry is the standard diagnostic evaluation for achalasia. Accurate diagnosis can also be made based on clinical findings and barium esophagogram. Medical treatment with nitrates or calcium channel blockers has variable results in alleviating the symptoms of achalasia but long-term results are disappointing because of tolerance and side effects. Intrasphincteric injection of botulinum toxin, pneumatic dilatation and surgical myotomy are variably effective at controlling the symptoms of achalasia but each modality has specific strength and weaknesses which make their choice suitable in a particular group of patients. While pneumatic dilatation is superior to botulinum toxin injection surgical myotomy provides the best long-term control of symptoms in patients with achalasia. Conclusion: Laparoscopic myotomy should be the initial treatment for most patients with achalasia. Pneumatic dilatation is the most cost-effective alternative but its long-term efficacy is less than that of surgical myotomy. Endoscopic botulinum toxin injection can be considered when other forms of treatment are contraindicated. Key words: Achalasia, Heller's esophagomyotomy, pneumatic dilatationRésumé Contexte: L'achalasie est une rare anomalie motrice de l'oesophage. En raison de son étiologie incertaine, le traitement est seulement palliatif et vise la réduire la pression sphinctérienne du bas oesophage, l'amélioration de la vidange et le soulagement des symptômes de l'achalasie. Les options thérapeutiques courantes font appel aux moyens pharmacologiques, endoscopiques et chirurgicaux. Nous avons effectué une revue systématique de la littérature relative aux stratégies thérapeutiques actuellement disponibles pour l'achalasie. Méthode: Une recherche sur Medline, Pubmed et Cochrane a été faite a l'aide du logiciel Reference Manager 11. Les articles originaux et les rapports portant sur la prise en charge de l'achalasie et publiés en anglaise ont été passés en revue. L'accent a été mis sur les articles publiés au cours des dix dernières années et sur les essais contrôlés comparant les diverses formes de traitement. Résultats: La manométrie oesophagienne est la méthode de diagnostic standard pour l'achalasie. Le dia...

show abstract

Achalasia: will genetic studies provide insights?

et al. 2010

View full text Add to dashboard Cite

Despite increasing understanding of the pathophysiology of achalasia, the etiology of this esophageal motility disorder remains largely unknown. However, the occurrence of familial achalasia and its association with well-defined genetic syndromes suggest the involvement of genetic factors. Mutant mouse models display gastrointestinal disturbances that are similar to those observed in achalasia patients. The candidate gene approach has revealed some promising results; however, it has not established conclusive links to specific genes so far. The aim of this review was to summarize current knowledge of the genetics of achalasia. We also discuss the extent to which our understanding of achalasia is likely to be enhanced through future molecular genetic research.

show abstract

Achalasia and thyroid disease

Abstract: AIM:To investigate some possible etiologies of achalasia by screening patients with achalasia for some autoimmune diseases such as thyroid disease.

Cited by 14 publications

References 43 publications

Achalasia and thyroid disease: possible autoimmune connection?

Achalasia and thyroid disease: possible autoimmune connection?

Achalasia: What is the best treatment?

Achalasia: will genetic studies provide insights?

Contact Info

Product

Resources

About