Association of pelvic endometriosis with alopecia universalis, autoimmune thyroiditis and multiple sclerosis

Abstract

An adult Caucasian female developed a previously unreported association of pelvic endometriosis (PE) with the triad of alopecia universalis (AU), autoimmune thyroiditis (AT) and multiple sclerosis (MS). Molecular human leukocyte antigen (HLA)-tissue typing of this subject showed the presence of the DR(2) 15 and DR(3) 17 alleles, which are associated to an increased risk of MS and AT, respectively. Clinical onset of AT followed withdrawal of corticosteroid treatment for AU, whereas MS become clinically evident after withdrawal from long-term estroprogestin therapy for PE. This clinical case is presented to discuss the autoimmune origin of PE, its possible association with multiple autoimmune disorders as well as the effect of other factors, such as administration and/ or discontinuation of specific hormonal regimens, on genetic autoimmunity-prone background.

Associations between alopecia areata and multiple sclerosis: a report of two cases and review of the literature

“…Previously, Alviggi et al described a single case of a Caucasian female patient affected by alopecia universalis, MS, autoimmune thyroiditis, and pelvic endometriosis. In this particular case, alopecia universalis occurred at the age of 13, while the onset of MS followed at the age of 27.…”

Periodontal disease and endometriosis: analysis of the National Health and Nutrition Examination Survey

“…This so-called global immune dysregulation could account for the increased incidence of other systemic, autoimmune disorders for each ailment. For example, systemic lupus erythematosus and rheumatoid arthritis as well as other autoimmune inflammatory conditions, hypothyroidism, allergies, fibromyalgia, asthma, and multiple sclerosis are more common in women with endometriosis (15,16). In parallel, associations have been found between periodontal disease and systemic disorders such as diabetes mellitus (8,17), cardiovascular disease (18)(19)(20), pulmonary disease (21)(22)(23), and preterm delivery (22,(24)(25)(26)(27)(28)(29).…”

Endometriosis and the risks of systemic lupus erythematosus and rheumatoid arthritis in the Nurses’ Health Study II

“…Case reports have suggested co-morbidity of endometriosis with the autoimmune disorders alopecia universalis, autoimmune thyroiditis, multiple sclerosis, and autoimmune progesterone dermatitis,[10 11] and a comparative evaluation of clinical and humoral immunologic abnormalities between SLE and endometriosis has also suggested similarities. [12] A cross-sectional survey of women with endometriosis who were members of a national endometriosis support organization, compared to the general U.S. population, reported a prevalence odds ratio for SLE of 20.7 (CI=14.3-29.9) and for RA of 1.5 (CI=1.2-1.9);[13] however this survey was limited by its highly self-motivated study population with self-reported endometriosis and autoimmune diseases and lack of control for confounders.…”