ORIGINAL ARTICLE
Autoimmune thyroiditis associated with autoimmune diseases
 
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1
Department of Internal Medicine, Hedi Chaker University Hospital Sfax-Tunisia, TUNISIA
 
2
Department of Endocrinology, Hedi Chaker University Hospital Sfax-Tunisia, TUNISIA
 
 
Publication date: 2022-08-26
 
 
Electron J Gen Med 2022;19(6):em409
 
KEYWORDS
ABSTRACT
Introduction:
Autoimmune thyroid disorders are frequent. Patients diagnosed with these autoimmune thyroid diseases (AITD) are at high risk of developing other autoimmune diseases (AD), which at times, can be fatal.

Aim:
The aim of this study is to identify epidemiological, clinical, and biological characteristics of the different associations of organ-specific AD and non-organ-specific AD or systemic diseases with AITD and compare our findings with that found in literature.

Patients and methods:
It is a descriptive retrospective single institution study. We collected data from 113 patients diagnosed with a thyroid disorder associated with an autoimmune disease-either organ-specific autoimmune disease or systemic disease- hospitalized over a period of 18 years.

Results:
The sex ratio (F/M) was 3.52. The median age of occurrence of the AITD was 38.22 years’ old. The aetiology of the AITD was mainly Hashimoto’s disease in 69 patients followed by Grave’s disease in 19 patients. Seventeen types of AD were identified in association with the AITD. The most frequent organ-specific AD associated with the thyroid disorder was type 1 diabetes mellitus (41 patients), vitiligo (16 patients) and pernicious anaemia (16 patients). Systemic lupus erythematous (12 cases) and Sjogren’s disease (12 cases) were the most common systemic diseases associated with the AITD.

Conclusion:
AITD are frequent and can be associated with one or more autoimmune diseases. These AD can sometimes be revealing or on the contrary can emerge years later after the diagnosis of the dysthyroidism. A long-term follow-up is warranted in all patients diagnosed with an autoimmune disease.

 
REFERENCES (40)
1.
Antonelli A, Ferrari SM, Corrado A, Di Domenicantonio A, Fallahi P. Autoimmune thyroid disorders. Autoimmun Rev. 2015;14(2):174-80. https://doi.org/10.1016/j.autr... PMid:25461470.
 
2.
Jenkins RC, Weetman AP. Disease associations with autoimmune thyroid disease. Thyroid. 2002;12(11):977-88. https://doi.org/10.1089/105072... PMid:12490075.
 
3.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(Supplement_1):S81-90. https://doi.org/10.2337/dc14-S... PMid:24357215.
 
4.
Meyer O. Lupus et syndrome des anticorps antiphospholipides. Critères de diagnostic et de suivi [Lupus and antiphospholipid antibody syndrome. Diagnosis and follow-up criteria]. Rev Rhum Monogr. 2010;77(2):82-8. https://doi.org/10.1016/j.monr....
 
5.
Varoquier C, Salmon JH, Sibilia J, Gottenberg JÉ. Critères diagnostiques du syndrome de Gougerot-Sjögren [Diagnostic criteria for Gougerot-Sjögren syndrome]. Rev Rhum Monogr. 2013;80(1):20-5. https://doi.org/10.1016/j.monr....
 
6.
Cornec D, Varache S, Morvan J, et al. Comparaison des critères de l’ACR 1987 et l’ACR/EULAR 2010 pour la prédiction du diagnostic à dix ans de polyarthrite rhumatoïde [Comparison of ACR 1987 and ACR/EULAR 2010 criteria for predicting the ten-year diagnosis of rheumatoid arthritis]. Rev Rhum. 2012;79(6):530-4. https://doi.org/10.1016/j.rhum....
 
7.
Calabrese LH, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of hypersensitivity vasculitis. Arthritis Rheum. 1990;33(8):1108-13. https://doi.org/10.1002/art.17... PMid:2202309.
 
8.
Cojocaru M, Cojocaru IM, Silosi I. Multiple autoimmune syndrome. Maedica (Bucur). 2010;5(2):132-4.
 
9.
Haller MJ, Schatz DA, Winter WE. Autoimmune polyendocrine syndromes. Pediatric Endocrinology; 2014. https://doi.org/10.1016/B978-1....
 
10.
Cutolo M. Autoimmune polyendocrine syndromes. Autoimmun Rev. 2014;13(2):85-9. https://doi.org/10.1016/j.autr... PMid:24055063.
 
11.
Orgiazzi J. Auto-immunité thyroidienne [Thyroid autoimmunity]. Bull Acad Natle Méd. 2013;197(1):43-63.
 
12.
Boelaert K, Newby PR, Simmonds MJ, et al. Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am J Med. 2010;123(2):183. https://doi.org/10.1016/j.amjm... PMid:20103030.
 
13.
Cooper GS, Stroehla BC. The epidemiology of autoimmune diseases. Autoimmun Rev. 2003;2(3):119-25. https://doi.org/10.1016/S1568-....
 
14.
Humbert P, Dupond JL. The multiple autoimmune syndromes (MAS). Br J Dermatol. 1997;136(3):468-9. https://doi.org/10.1111/j.1365... PMid:9115940.
 
15.
Bouchou K, Andre, M, Cathebras P, et al. Pathologie thyroïdienne et syndromes auto-immuns multiples. Aspects clinique et immunogénétique à propos de 11 observations [Thyroid pathology and multiple autoimmune syndromes. Clinical and immunogenetic aspects apropos of 11 observations]. Rev Méd Interne. 1995;16:283-7. https://doi.org/10.1016/0248-8....
 
16.
Anaya JM, Castiblanco J, Rojas-Villarraga A, et al. The multiple autoimmune syndromes. A clue for the autoimmune tautology. Clin Rev Allergy Immunol. 2012;43(3):256-64. https://doi.org/10.1007/s12016... PMid:22648455.
 
17.
Anthony P, Weetman MD. Non thyroid autoantibodies in autoimmune thyroid disease. Best Pract Res Clin Endocrinol. Metab. 2005;19(1):17-32. https://doi.org/10.1016/j.beem... PMid:15826920.
 
18.
Kordonouri O, Klinghammer A, Lang EB, Grüters-Kieslich A, Grabert M, Holl RW. Thyroid autoimmunity in children and adolescents with type 1 diabetes: A multicenter survey. Diabetes Care. 2002;25(8):1346-50. https://doi.org/10.2337/diacar... PMid:12145233.
 
19.
Karavanaki K, Karayianni C, Vassiliou I, et al. Multiple autoimmunity, type 1 diabetes (T1DM), autoimmune thyroiditis and thyroid cancer: Is there an association? A case report and literature review. J Pediatr Endocrinol Metab. 2014;27(9-10):1011-6. https://doi.org/10.1515/jpem-2....
 
20.
Barker JM. Clinical review: Type 1 diabetes-associated autoimmunity: Natural history, genetic associations, and screening. J Clin Endocrinol Metab. 2006;91(4):1210-7. https://doi.org/10.1210/jc.200... PMid:16403820.
 
21.
Kordonouri O, Hartmann R, Deiss D, Wilms M, Grüters-Kieslich A. Natural course of autoimmune thyroiditis in type 1 diabetes: Association with gender, age, diabetes duration, and puberty. Arch Dis Child. 2005;90(4):411-4. https://doi.org/10.1136/adc.20... PMid:15781936 PMCid:PMC1720371.
 
22.
Peczynska J, Urban M, Glowinska-Olszewska B, Florys B. Prevalence of thyroid diseases in children and adolescents with diabetes type 1. Pediatric Endocrinol. 2006;5(14).
 
23.
Charmandari E, Nicolaides NC, Chrousos GP. Adrenal insufficiency. Lancet. 2014;383(9935):2152-67. https://doi.org/10.1016/S0140-....
 
24.
Erichsen MM, Løvås K, Skinningsrud B, et al. Clinical, immunological, and genetic features of autoimmune primary adrenal insufficiency: Observations from a Norwegian registry. J Clin Endocrinol Metab. 2009;94(12):4882-90. https://doi.org/10.1210/jc.200... PMid:19858318.
 
25.
Meyer G, Badenhoop K, Linder R. Addison’s disease with polyglandular autoimmunity carries a more than 2•5-fold risk for adrenal crises: German health insurance data 2010-2013. Clin Endocrinol. 2016;85(3):347-53. https://doi.org/10.1111/cen.13... PMid:26896640.
 
26.
Cruchaud A, Juditz E. An analysis of gastric parietal cell antibodies and thyroid cell antibodies in patients with pernicious anaemia and thyroid disorders. Clin Exp Immunol. 1968;3(8):771-81.
 
27.
Virili C, Bassotti G, Santaguida MG, et al. Atypical celiac disease as cause of increased need for thyroxine: A systematic study. J Clin Endocrinol Metab. 2012;97(3):E419-22. https://doi.org/10.1210/jc.201... PMid:22238404.
 
28.
Lahner E, Capasso M, Carabotti M, Annibale B. Incidence of cancer (other than gastric cancer) in pernicious anaemia: A systematic review with meta-analysis. Dig Liver Dis. 2018;50(8):780-6. https://doi.org/10.1016/j.dld.... PMid:29887343.
 
29.
Meyer O. Lupus érythémateux systémique [Systemic lupus erythematosus]. EMC-Rhumatologie Orthopédie. 2005;2(1):1-32. https://doi.org/10.1016/j.emcr....
 
30.
Klionsky Y, Antonelli M. Thyroid disease in lupus: An updated review. ACR Open Rheumatol. 2020;2(2):74-8. https://doi.org/10.1002/acr2.1... PMid:32043833 PMCid:PMC7011406.
 
31.
Biró E, Szekanecz Z, Czirják L, et al. Association of systemic and thyroid autoimmune diseases. Clin Rheumatol. 2006;25(2):240-5. https://doi.org/10.1007/s10067... PMid:16247581.
 
32.
Appenzeller S, Pallone AT, Natalin RA, Costallat LT. Prevalence of thyroid dysfunction in systemic lupus erythematosus. J Clin Rheumatol. 2009;15(3):117-9. https://doi.org/10.1097/RHU.0b... PMid:19300286.
 
33.
Westhoff G, Zink A. Epidemiologie des primären Sjögren-syndroms [Epidemiology of primary Sjörgren’s syndrome]. Z Rheumatol. 2010;69(1):41-9. https://doi.org/10.1007/s00393... PMid:20012976.
 
34.
Punzi L, Betterle C. Thyroïdite chronique auto-immune et manifestations rhumatologiques [Chronic autoimmune thyroiditis and rheumatological manifestations]. Revue du Rhumatisme. 2004;71:555-64. https://doi.org/10.1016/j.rhum....
 
35.
Lazúrová I, Benhatchi K. Autoimmune thyroid diseases and nonorgan specific autoimmunity. Pol Arch Med Wewn. 2012;122 Suppl 1:55-9. https://doi.org/10.20452/pamw.... PMid:23222800.
 
36.
Dieppe P. Epidemiology of the rheumatic diseases. Int J Epidemiol. 2002;31(5):1079-80. https://doi.org/10.1093/ije/31....
 
37.
Chen Y-L, Lin J-Z, Mo Y-Q, et al. Joint damage is amplified in rheumatoid arthritis patients with positive thyroid autoantibodies. Peer J. 2018. https://doi.org/10.7717/peerj.... PMid:29312834 PMCid:PMC5756613.
 
38.
Raterman HG, Voskuyl AE, Simsek S, et al. Increased progression of carotid intima media thickness in thyroid peroxidase antibodies-positive rheumatoid arthritis patients. Eur J Endocrinol. 2013;169:751-7. https://doi.org/10.1530/EJE-13... PMid:24005313.
 
39.
Fallahi P, Ferrari SM, Ruffilli I, et al. The association of other autoimmune diseases in patients with autoimmune thyroiditis: Review of the literature and report of a large series of patients. Autoimm Rev. 2016;15(12):1125-8. https://doi.org/10.1016/j.autr... PMid:27639841.
 
40.
Anaya JM, Rojas-Villarraga A, García-Carrasco M. The autoimmune tautology: From polyautoimmunity and familial autoimmunity to the autoimmune genes. Autoimmune Dis. 2012;1-2. https://doi.org/10.1155/2012/2... PMid:22666553 PMCid:PMC3362807.
 
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