Clinical and genetic characteristics of patients with autoimmune thyroid disease with anti-islet autoimmunity

Moriguchi, Masanori; Noso, Sinsuke; Kawabata, Yumiko; Yamauchi, Takaaki; Harada, Takeshi; Komaki, Katsumori; Babaya, Naru; Hiromine, Yoshihisa; Ito, Hiroyuki; Yamagata, S; Murata, Keiji; Higashimoto, Takahiro; Park, Choongyong; Yamamoto, Akinobu; Ohno, Yasuhiro; Ikegami, Hiroshi

doi:10.1016/j.metabol.2010.07.025

Cited by 42 publications

(57 citation statements)

References 30 publications

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“…These results are comparable with studies previously reported (17)(18)(19). A Turkish study reported a prevalence of 5.1% GAD-positivity in 215 patients with Hashimoto's thyroiditis, which is a similar percentage as our finding of 6.6% (17).…”

Section: Graves'supporting

confidence: 92%

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Clustering of additional autoimmunity behaves differently in Hashimoto's patients compared with Graves' patients

Wiebolt

Achterbergh

Boer

et al. 2011

European Journal of Endocrinology

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Section: Graves'supporting

confidence: 92%

“…A Turkish study reported a prevalence of 5.1% GAD-positivity in 215 patients with Hashimoto's thyroiditis, which is a similar percentage as our finding of 6.6% (17). In Japanese studies, around 4% of Graves' patients and around 3-6% of Hashimoto's patients were positive for GAD-antibodies (18,19).…”

Section: Graves'supporting

confidence: 88%

Clustering of additional autoimmunity behaves differently in Hashimoto's patients compared with Graves' patients

Wiebolt

Achterbergh

Boer

et al. 2011

European Journal of Endocrinology

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“…On the other hand, the HLA type DQB1 * 0601 is disease-resistant to type 1A diabetes, although in a previous case of APS III associated with SPIDDM, the patient was reported to have HLA-DR and DQ alleles that were both disease-resistant to type 1A diabetes, including DQB1 * 0601 (13). Furthermore, in one Japanese study (14), the frequencies of the DRB1 * 0803 allele and DRB1 * 0803-DQB1 * 0601 haplotypes were reported to be significantly higher in patients with autoimmune thyroid disease who Hematology:were negative for anti-GAD antibodies than in those who were positive for anti-GAD antibodies or in the control group volunteers. The authors also noted that when anti-GAD antibody-positive patients with and without diabetes were compared, the frequency of the DRB1 * 0803-DQB1 * 0601 haplotype was significantly higher in the nondiabetic patients than in the diabetic patients (30.4% vs. 0.0%).…”

Section: Discussionmentioning

confidence: 96%

Autoimmune Polyglandular Syndrome III in a Patient with Idiopathic Portal Hypertension

et al. 2013

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A 42-year-old woman with a history of idiopathic portal hypertension (IPH) developed type 1A diabetes and was found to have chronic thyroiditis. The concurrence of IPH and type 1A diabetes has been previously reported in only one case. This is the second known case, and our patient was classified as having autoimmune polyglandular syndrome (APS) III. The patient's HLA DR and DQ alleles were determined to be susceptible to autoimmune thyroid diseases but resistant to type 1A diabetes. Case ReportThe patient initially consulted her local physician at 37 years of age due to abdominal pain, at which time she presented with pancytopenia, splenomegaly and esophageal varices. She was referred to our department of gastroenterology where she underwent detailed examinations, including a liver biopsy. She was diagnosed with idiopathic portal hypertension (IPH) and treated as an outpatient. She required periodic treatment for esophageal varices. She first developed thirst and polyuria in February 2011, and her body weight decreased by 5 kg over two months. In April 2011, she had a casual serum glucose level of 254 mg/dL and an HbA1c level of 11.6% with positive glycosuria and ketonuria. On April 13, 2011, she was admitted to our hospital for further evaluation and treatment.Table shows the patient's admitting laboratory data. The blood work showed pancytopenia and hypoalbuminemia in addition to mildly elevated hepatic enzymes and ammonia levels; however, these results did not differ markedly from the patient's previous results. The acetoacetate and hydroxybutyrate levels were elevated, and ketosis was present, although no acidosis was observed on an arterial blood gas analysis. The anti-GAD antibody titer was very high, and anti-insulin antibodies were positive. A C-peptide response (CPR) test showed serum C-peptide concentrations of 0.5 ng/mL after an overnight fast and 3.3 ng/mL two hours after a meal (Table), thus indicating a reduced capacity of endogenous insulin secretion. Based on these results, the patient was diagnosed with type 1A diabetes and treated with intensified insulin therapy after admission, leading to a relatively rapid normalization of the blood glucose level. The total insulin dose at discharge was only 9 units.Thyroid function tests revealed an elevated TSH level with depressed FT3 and FT4 and positive anti-TPO and antithyroglobulin antibodies (Table). There was no enlargement of the thyroid gland on thyroid echography; however, mild attenuation and heterogeneity of the internal echo were observed, which were consistent with chronic thyroiditis. Therefore, a diagnosis of hypothyroidism due to chronic thyroiditis was made, and treatment with levothyroxine sodium hydrate was initiated with a maintenance dose of 100 μg/day.As type 1A diabetes and chronic thyroiditis were observed in addition to IPH, the patient was diagnosed with autoimmune polyglandular syndrome (APS) III. The ACTH level and the cortisol level at rest were normal, and Addi-

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“…Therefore, it is difficult to comment on the absence or presence of variances in incidence rates of AITD between different geographical locations. Coexistence of T1D and AITD is common, with 15 to 30% of T1D subjects having AITD [44][45][46], whereas the prevalence of glutamic acid decarboxylase antibodies (GADAb) in AITD patients is around 5% [47,48]. There is a need to distinguish T1D with AITD (T1D+AITD, APS-3A) from T1D without AITD (T1D-AITD).…”

Section: Nomenclaturementioning

confidence: 99%

The Relationship Between Human Leukocyte Antigen Class II Genes and Type 1 Diabetes, Autoimmune Thyroid Diseases, and Autoimmune Polyendocrine Syndrome Type 3

Katahira¹

2014

HLA and Associated Important Diseases

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Clinical and genetic characteristics of patients with autoimmune thyroid disease with anti-islet autoimmunity

Cited by 42 publications

References 30 publications

Clustering of additional autoimmunity behaves differently in Hashimoto's patients compared with Graves' patients

Clustering of additional autoimmunity behaves differently in Hashimoto's patients compared with Graves' patients

Autoimmune Polyglandular Syndrome III in a Patient with Idiopathic Portal Hypertension

The Relationship Between Human Leukocyte Antigen Class II Genes and Type 1 Diabetes, Autoimmune Thyroid Diseases, and Autoimmune Polyendocrine Syndrome Type 3

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