Recurrent Pregnancy Loss in Women with Hashimoto's Thyroiditis with Concurrent Non-Endocrine Autoimmune Disorders

Cellini, Miriam; Santaguida, Maria Giulia; Stramazzo, Ilaria; Capriello, Silvia; Brusca, Nunzia; Antonelli, Alessandro; Fallahi, Poupak; Gargano, Lucilla; Centanni, Marco; Virili, Camilla

doi:10.1089/thy.2019.0456

Cited by 24 publications

(20 citation statements)

References 46 publications

(60 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Out of 56 studies included in the systematic review, 25 were case‐control studies, 24‐47 17 were cohort studies 48‐64 and 14 were cross‐sectional studies 65‐78 . No clinical trials met the criteria used in the systematic review.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Botello

Herrán

Salcedo

et al. 2020

Clinical Endocrinology

View full text Add to dashboard Cite

Background Thyroid autoimmunity is the most frequent condition involved in polyautoimmunity (PolyA). However, the frequency of latent and overt PolyA in patients with autoimmune thyroid disease (AITD) as the index condition is unknown. Therefore, the purpose of this study was to determine the prevalence of these types of PolyA in patients with AITD as the index condition. Methods This study adhered to the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guideline. Searches through MEDLINE, Embase and LILACS were done to find articles in Spanish and English. Relevant vocabulary terms and key terms related to AITD and other autoimmune diseases were used. Two investigators independently screened the eligible studies, extracted data and assessed the quality and risk of bias. Fixed and random effect models were used accordingly. Cluster analysis was used to determine similarities among diseases in the articles included (based on Jaccard index). Results A total of 56 articles fulfilled the inclusion criteria. Of these, 25 were case‐controls, 17 were cohorts, and 14 were cross‐sectional studies. These studies included a total of 47 509 patients. Female was the predominant gender and included 38 950 patients (81.23%, 95% CI: 80.85‐81.60). Graves’ disease (GD) was the most common type of thyroid autoimmunity (69.16%, 95% CI: 68.23‐70.07). Globally, overt PolyA was found in 13.46% of the patients with AITD. This type of PolyA was represented mainly by type 1 diabetes and autoimmune gastritis. Latent PolyA was presented in 17.45% of the patients, and anti‐proinsulin, anti‐parietal cells and dsDNA antibodies were the most common. HT had the highest frequency of overt PolyA in Europe (15.60%, 95% CI: 14.72‐16.53), whereas latent PolyA was most common in patients with GD in Asia (21.03%, 95% CI: 17.76‐24.71). Overt and latent PolyA were associated with gastrointestinal and endocrinological ADs in most of cases and clustered with rheumatological, dermatological and neurological ADs. Conclusions Latent and overt PolyA are common in patients with AITD. These results provide insightful information for early diagnosis and management of concurrent ADs in patients with AITD. Aggregation of ADs in different clusters may help to define different phenotypes associated with thyroid autoimmunity that are critically relevant in clinical settings.

show abstract

Section: Resultsmentioning

confidence: 99%

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Botello

Herrán

Salcedo

et al. 2020

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

“…Previous research has found that women with thyroid autoimmunity had a higher prevalence of the copresence of non-organ-specific autoantibodies, which could add to the risk of adverse pregnancy outcomes [38,39]. Similarly, a recently published study reported a higher prevalence of RM in women with HT and nonendocrine autoimmune disorders (NEADs), such as atrophic gastritis and connective tissue diseases, than women with isolated HT (p<0.0001) [40]. Therefore, the phenomenon of a higher risk of miscarriage in women with HT and concurrent NEADs is helpful for understanding the pathogenesis of HT-related miscarriage and suggests that patients can simultaneously benefit from effective treatments for NEADs before conceiving.…”

Section: Immune System Disordersmentioning

confidence: 92%

“…Moreover, these authors also demonstrated an increased number of Breg cells with reduced functional parts in patients with HT and concurrent NEADs compared with patients with isolated HT. This insightful discovery and their latest research concerning this topic [40] suggest that more attention should be paid to HT women with NEADs because these women may have more frequent and severe immune system disorders and a higher risk of miscarriage and even RM. However, to date, the literature concerning the functions of Breg cells in immune tolerance in pregnancy is limited to only one study, which revealed a beneficial impact in successful delivery [71].…”

Section: B Regulatory Cellsmentioning

confidence: 98%

“…Therefore, the phenomenon of a higher risk of miscarriage in women with HT and concurrent NEADs is helpful for understanding the pathogenesis of HT-related miscarriage and suggests that patients can simultaneously benefit from effective treatments for NEADs before conceiving. Regarding HT, although the circulating TPOAb or TgAb level has repeatedly been reported to be an independent risk factor determining miscarriage, the association between different titers of these antibodies and the risk ratio of miscarriage is still debatable 40 - 43 . Indeed, importantly, immune system disorders, including the upregulation of proinflammatory cells and downregulation of anti-inflammatory cells, are observed in the peripheral blood (PB) of patients with HT ( Table 1 ).…”

Section: Immune System Disordersmentioning

confidence: 99%

See 1 more Smart Citation

The exploration of Hashimoto's Thyroiditis related miscarriage for better treatment modalities

Min¹,

Wang²,

Chen³

et al. 2020

Int. J. Med. Sci.

View full text Add to dashboard Cite

Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disease (ATD) worldwide and is strongly associated with miscarriage and even recurrent miscarriage (RM). Moreover, with a deepening understanding, emerging evidence has shown that immune dysfunctions caused by HT conditions, including imbalanced subsets of CD4+ T-helper cells, B regulatory (Breg) cells, high expression levels of CD56dim natural killer (NK) cells, and cytokines, possibly play an important role in impairing maternal tolerance to the fetus. In recent years, unprecedented progress has been made in recognizing the specific changes in immune cells and molecules in patients with HT, which will be helpful in exploring the mechanism of HT-related miscarriage. Based on these findings, research investigating some potentially more effective treatments, such as selenium (Se), vitamin D3, and intravenous immunoglobulin (IVIG), has been well developed over the past few years. In this review, we highlight some of the latest advances in the possible immunological pathogenesis of HT-related miscarriage and focus on the efficacies of treatments that have been widely introduced to clinical trials or practice described in the most recent literature.

show abstract

“…There is a well-established tendency for distinct autoimmune (AI) conditions to co-exist in patients who have previously been diagnosed with an AI condition, such as autoimmune thyroiditis (i.e. polyautoimmunity) (9)(10)(11). Although polyautoimmunity has been shown to affect AI disease severity (12)(13)(14)(15), its association with TED severity has never been investigated.…”

Section: Introductionmentioning

confidence: 99%

Association of Other Autoimmune Diseases With Thyroid Eye Disease

et al. 2021

View full text Add to dashboard Cite

BackgroundThyroid eye disease (TED) is a potentially disfiguring and sight-threatening autoimmune (AI) orbitopathy, affecting up to 400,000 people in the UK. There are no accurate early predictors of TED severity. Although polyautoimmunity has been shown to affect AI disease severity, its influence on TED severity has never been investigated. The prevalence of polyautoimmunity among TED patients is also unclear, with discordant results reported in the literature. This study evaluates the prevalence of non-thyroid/“other” AI (OAI) conditions in an ethnically diverse TED cohort and assesses how polyautoimmunity affects TED severity and activity.MethodsA retrospective study of patients presenting to multidisciplinary TED clinics across three North-West London hospitals between 2011 and 2019. Data collected included: 1) demographics; 2) OAI conditions and management; 3) endocrine management of thyroid dysfunction; 4) details of TED and clinical activity score at presentation.ResultsTwo hundred and sixty-seven patients with a median age of 46 (35–54) years were included, 79.4% were female and 55% were Black, Asian and minority ethnic (BAME). Thirty-seven patients (13.9%) had OAI conditions, with rheumatoid arthritis (3.7%), vitiligo (3.0%) and psoriasis (3.0%) among the most prevalent. Of patients with OAI conditions, 43.2% (16/37) required immunosuppression prior to TED onset. Non-immunosuppressed patients with OAI conditions had a significantly higher clinical activity score at presentation than TED-only and previously immunosuppressed patients (p=0.02). No significant differences were observed in thyroid receptor antibody titers between these groups.ConclusionsThis study finds a 13.9% prevalence of OAI conditions among TED patients. Patients with OAI conditions overall have a tendency for more severe and significantly more clinically active TED than those without OAI conditions. Larger, prospective studies are warranted to further evaluate polyautoimmunity as an early predictor of TED severity.

show abstract

Recurrent Pregnancy Loss in Women with Hashimoto's Thyroiditis with Concurrent Non-Endocrine Autoimmune Disorders

Cited by 24 publications

References 46 publications

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

The exploration of Hashimoto's Thyroiditis related miscarriage for better treatment modalities

Association of Other Autoimmune Diseases With Thyroid Eye Disease

Contact Info

Product

Resources

About