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

Wiebolt, Janneke; Achterbergh, Roos; Boer, Ad den; Leij, S.; Marsch, Elke; Suelmann, Britt B. M.; Vries, R. de; Haeften, Timon W. van

doi:10.1530/eje-10-1172

Cited by 50 publications

(45 citation statements)

References 24 publications

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“…By contrast, CD prevalence in British patients with GD showed a 20-fold increase compared to the general UK population (0.9 vs. 0.047%) [22]. In Dutch patients with AIT, the prevalence of CD appears to be fairly low, both for Hashimoto's disease and GD, with Hashimoto's thyroiditis being associated with T1DM significantly more often [23]. The rate of other nonthyroid autoantibodies, i.e.…”

Section: Discussionmentioning

confidence: 99%

Hyperthyroidism in 276 Children and Adolescents with Type 1 Diabetes from Germany and Austria

Dost

Rohrer²,

Fröhlich‐Reiterer³

et al. 2015

Horm Res Paediatr

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Background/Aims: Little is known about the incidence and clinical consequences of hyperthyroidism in pediatric patients with type 1 diabetes mellitus (T1DM). Methods: We analyzed the DPV database (Diabetes Prospective Follow-Up Registry)to investigate the rate of hyperthyroidism in pediatric T1DM patients, its impact on metabolic control, and potential associations with organ-specific autoantibodies. Results: Hyperthyroidism was found in 276/60,456 patients (0.46%) and was associated with younger age, shorter diabetes duration, female sex, and reduced body mass index. Diabetic ketoacidosis (DKA) and hypoglycemia were more frequent in T1DM with comorbid hyperthyroidism, while long-term metabolic control (HbA1c) was similar in both groups. Absolute blood pressure and arterial hypertension rate were elevated in the hyperthyroid patients. Rates of microalbuminuria and diabetic retinopathy were not different. Thyroid-specific antibodies (thyroid peroxidase, thyroglobulin, thyroid receptor) were associated with hyperthyroidism. Thyroid volume and rates of cysts and nodules were higher, and echogenicity was decreased. Conclusion: Prevalence of hyperthyroidism is low in diabetic children with T1DM but increased compared to children <18 years without diabetes. Hyperthyroidism is primarily associated with acute diabetes complications (DKA and hypoglycemia) and affects blood pressure regulation. Long-term metabolic control or insulin requirement were not different.

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Section: Discussionmentioning

confidence: 99%

Hyperthyroidism in 276 Children and Adolescents with Type 1 Diabetes from Germany and Austria

Dost

Rohrer²,

Fröhlich‐Reiterer³

et al. 2015

Horm Res Paediatr

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“…Both these disorders have been associated with type 2 polyglandular autoimmune syndrome also known as Schmidt's syndrome, although the association is somewhat stronger for Hashimoto's thyroiditis 1. This report describes a patient with autoimmune thyroid disease on a background of Schmidt's syndrome.…”

Section: Introductionmentioning

confidence: 87%

Hot and cold: coexistent Graves’ disease and Hashimoto's thyroiditis in a patient with Schmidt's syndrome

et al. 2014

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A 37-year-old housewife presented with generalised fatigue, palpitations and weight loss over the past 3 months. Physical examination revealed signs of hyperthyroidism. Thyroid function tests confirmed the presence of thyrotoxicosis. Pertechnetate radionuclide imaging of the thyroid showed diffusely increased radiotracer uptake consistent with Graves’ disease and a cold nodule in the right lobe. Needle aspiration from the nodule yielded evidence of Hashimoto's thyroiditis. The patient also tested strongly positive for antithyroid peroxidase antibodies. Simultaneous laboratory evaluation revealed primary adrenal failure and probable pernicious anaemia, thus producing a diagnosis of Schmidt's syndrome. The patient was initiated on appropriate medical therapy for endocrinopathy. Graves’ disease was treated with radioablation.

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“…It must be acknowledged that the majority of genetic studies have focussed on Graves disease rather than Hashimoto thyroiditis, and in some studies these two disorders are bundled together as ‘autoimmune thyroid disease’, which has dubious nosological credibility. As just one example, disease associations with these two disorders, which are very likely to have a genetic basis, are rather distinct [23]. …”

Section: Genetic Factorsmentioning

confidence: 99%

The Immunopathogenesis of Chronic Autoimmune Thyroiditis One Century after Hashimoto

Weetman¹

2012

Eur Thyroid J

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Hakaru Hashimoto described 4 patients with a hitherto unknown cause for goitre, struma lymphomatosa, a century ago. He was careful to distinguish this from Riedel thyroiditis but it has become clear that fibrosis and atrophy of the thyroid are indeed components of Hashimoto thyroiditis, and in rare cases IgG4-related sclerosing disease may be an outcome. Although the cause of the lymphocytic infiltration was unknown to Hashimoto, we now know through the pioneering studies of N.R. Rose and E. Witebsky [J Immunol 1956;76:417–427] that this condition is the archetype for autoimmune destruction as a disease mechanism. In the last two decades in particular, there has been huge interest in unravelling the genetic basis for this and related autoimmune disorders. The list of polymorphisms associated with autoimmune thyroid disease grows each year, and in the case of vitiligo, which is frequently found in association with thyroid autoimmunity, we know that 27 separate susceptibility loci account for less than 20% of the heritability of this condition. Environmental and existential factors may turn out to be just as complex in number and in interactions. We can thus imagine a ‘Swiss cheese’ model for the causation of autoimmune thyroid disease, in which the effects of cumulative weaknesses line up – like the holes in slices of cheese – to allow the catastrophic event of autoimmune destruction to occur.

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

Cited by 50 publications

References 24 publications

Hyperthyroidism in 276 Children and Adolescents with Type 1 Diabetes from Germany and Austria

Hyperthyroidism in 276 Children and Adolescents with Type 1 Diabetes from Germany and Austria

Hot and cold: coexistent Graves’ disease and Hashimoto's thyroiditis in a patient with Schmidt's syndrome

The Immunopathogenesis of Chronic Autoimmune Thyroiditis One Century after Hashimoto

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