Autoimmune Thyroiditis and Glomerulopathies

Abstract

Autoimmune thyroiditis (AIT) is generally associated with hypothyroidism. It affects ~2% of the female population and 0.2% of the male population. The evidence of thyroid function- and thyroid autoantibody-unrelated microproteinuria in almost half of patients with AIT and sometimes heavy proteinuria as in the nephrotic syndrome point to a link of AIT with renal disease. The most common renal diseases observed in AIT are membranous nephropathy, membranoproliferative glomerulonephritis, minimal change disease, IgA nephropathy, focal segmental glomerulosclerosis, antineutrophil cytoplasmic autoantibody (ANCA) vasculitis, and amyloidosis. Different hypotheses have been put forward regarding the relationship between AIT and glomerulopathies, and several potential mechanisms for this association have been considered. Glomerular deposition of immunocomplexes of thyroglobulin and autoantibodies as well as the impaired immune tolerance for megalin (a thyrotropin-regulated glycoprotein expressed on thyroid cells) are the most probable mechanisms. Cross-reactivity between antigens in the setting of genetic predisposition has been considered as a potential mechanism that links the described association between ANCA vasculitis and AIT.

Correlation Between Oral Lichen Planus and Thyroid Disease in China: A Case–Control Study

“…This may be partly due to the different methodology (retrospective study versus prospective study). Previous studies have indicated that HT was the most common cause of hypothyroidism ( 45 ), but in our study, the autoantibodies level of patients classified to hypothyroidism group was normal, so the different diagnostic criteria for hypothyroidism, which might explain the different findings ( 16 , 44 ) to some extent.…”

Circulating antithyroid antibodies contribute to the decrease of glomerular filtration rate in lithium-treated patients: a longitudinal study

“…From the clinical point of view, the majority of the cases reported to date were nephrotic syndrome rather than reduced eGFR (for review, see Santoro et al 2017 ). With regard to the relationship between pathological and clinical findings, the most informative contribution has been provided by Koçak et al ( 2012 ) who reviewed retrospectively 28 patients with Hashimoto’s thyroiditis referred to their department because of unexplained haematuria, proteinuria or renal impairment.…”

“…On the other hand, vasculitis or cross-reactivity between antigens are among the mechanisms suggested to explain the cases of glomerulopathies associated with autoimmune thyroiditis (Santoro et al 2017 ).…”

Thyroid Dysfunction in Patients with Antineutrophil Cytoplasmic Antibody–associated Vasculitis: A Monocentric Retrospective Study

“…reported differently according to each autoimmune disease 2 . Given that AAV is one of the systemic autoimmune diseases affecting most major organs 3 , and there is cross-reactivity between thyroid peroxidase and myeloperoxidase (MPO) molecules 4 , the prevalence of thyroid dysfunction, including autoimmune thyroiditis, may be increased in patients with AAV.…”