S, B, and autoantibodies to thyroid

[Guest guest]

I'm cutting and pasting a study that was just released re: autoimmune

thyroiditis and the association with arthritis -- as well as other autoimmune

conditions.

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" April 2010 Volume 3 Issue 4

CLINICAL THYROIDOLOGY FOR PATIENTS

A publication of the American Thyroid Associaton

Summaries for Patients from Clinical Thyroidology (February & March 2010)

AUTOIMMUNE THYROID DISEASE

Patients with autoimmune thyroid

disease have an increased risk for other autoimmune diseases

ABBREVIATIONS & DEFINITIONS

Graves’ disease — the

most common cause of hyperthyroidism in the United States. It is caused

by antibodies that attack the thyroid and turn it on.

Hashimoto’s thyroiditis — the most common cause of hypothyroidism in the

United States. It is caused

by antibodies that attack the thyroid and destroy the gland.

Antibodies — proteins

that are produced by the body’s immune cells that attack and destroy

bacteria and viruses that cause infections. Occasionally the antibodies

get confused and attack the body’s own tissues, causing autoimmune

disease.

Autoimmune disorders — A

diverse group of disorders that are caused by antibodies that get

confused and attack the body’s own tissues. The disorder depends on what

tissue the antibodies attack. Graves’ disease and Hashimoto’s

thyroiditis are examples of autoimmune thyroid disease. Other Autoimmune

disorders include: Type 1 diabetes mellitus, ’s disease (adrenal

insufficiency), vitiligo (loss of pigment of some areas of the skin),

systemic lupus erythematosus, pernicious anemia (B12 deficiency), celiac

disease, inflammatory bowel disease, myasthenia gravis, multiple

sclerosis and rheumatoid arthritis.

What is the study about?

The most common forms of autoimmune thyroid disease are

Hashimoto’s thyroiditis and Graves’ disease. Hashimoto’s thyroiditis

(also known as chronic thyroiditis) may lead to hypothyroidism, while

Graves’ disease is usually associated with hyperthyroidism. Both of

these disorders may be associated with other autoimmune problems

including Type 1 diabetes mellitus, ’s disease (adrenal

insufficiency), vitiligo (loss of pigment of some areas of the skin),

systemic lupus erythematosus, pernicious anemia, celiac disease,

inflammatory bowel disease, myasthenia gravis, multiple sclerosis and

rheumatoid arthritis. The present study examined a large number of

patients with autoimmune thyroid disease in order to determine the risk

for other autoimmune disorders and the factors which are associated with the

risk for and the type of other autoimmune problems.

The full article title: Boelaert et al. Prevalence and relative risk of other

autoimmune

diseases in subjects with autoimmune thyroid disease. Am J Med

2010;123:183.e1-9.

What was the aim of the study?

The aim of this study is to determine the risk for other

autoimmune disorders in patients with autoimmune thyroid disease.

Who was studied?

A total of 3286 individuals with autoimmune thyroid disease were

recruited from an onoging study in England on autoimmune thyroid

disease. In this group, 85% had Graves’ disease and 15% had Hashimoto’s

thyroiditis.

How was the study done?

Patients who stated that they had autoimmune thyroid

disease filled out a questionnaire and had their medical records and

medications reviewed by a physician. The type of underlying autoimmune

thyroid disease was recorded, as well as gender, age and parents’

history of hyperthyroidism or hypothyroidism and any associated

autoimmune disorders.

What were the results of the study?

About 10% of patients with Graves’ disease and 14% with

Hashimoto’s thyroiditis had another autoimmune disorder. The most common

associated autoimmune disorder for both conditions was rheumatoid

arthritis. Patients with Hashimoto’s thyroiditis had a 10-fold higher

risk for ’s disease and a 3-fold increased risk for pernicious

anemia compared to Graves’ disease. Men with Graves’ disease had higher

rates of Type 1 diabetes and myasthenia gravis compared to women, while

women, but not men, with Graves’ disease had an increased risk for

’s disease, celiac disease and multiple sclerosis. A total of

17.5% of mothers of patients with Graves’ disease and 23.6% of mothers

with children with Hashimoto’s thyroiditis had a history of thyroid

dysfunction. In contrast, 3.1% and 5.7% of the fathers of patients with

either Graves’ disease or Hashimoto’s thyroiditis, respectively, had

thyroid dysfunction. Graves’ disease and Hashimoto’s thyroiditis were

more common in the parents of patients with autoimmune thyroid disease

than in the regular UK population. Parents of patients with Hashimoto’s

thyroiditis also had an increased prevalence of inflammatory bowel

disease.

How does this compare with other

studies?

Several other studies have found an association between

autoimmune thyroid disease and other autoimmune diseases. This study

with more than 3000 patients is the largest study to examine the

relationship and quantify the risk.

What are the implications of this

study?

Other autoimmune disorders should be considered in patients with

autoimmune thyroid disease who develop new or nonspecific symptoms.

Also, there should be additional genetic research studies to try and

locate a gene or genes that make a patient susceptible for multiple

autoimmune disorders.

— Glen Braunstein, MD "