Atopy as a risk factor for thyroid autoimmunity in children affected with atopic dermatitis

Pedullà, Marcella; Fierro, Vincenzo; Papacciuolo, V.; Alfano, Rossella; Ruocco, Eleonora

doi:10.1111/jdv.12281

Cited by 44 publications

(47 citation statements)

References 19 publications

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“…In contrast, several clinical studies have reported the co-incidence of autoimmune and allergic diseases recently, and there is an increasing interest in the relationship between autoimmune and allergic diseases (29). Immune dysregulation secondary to an infectious agent or excessive exposure to a cross-reactive inciting antigen that promotes Th1 response leading to progressive inflammation and autoimmunity is the generally accepted model in the pathogenesis of autoimmune diseases (29). In mutually exclusive patient populations, Th1-type autoimmune disorders and Th2-type mediated allergic disorders would occur and this was predicted by the reciprocal counter-regulation of Th1 and Th2 cells (30).…”

Section: Discussionmentioning

confidence: 98%

“…However, there have not been enough studies in the literature showing the relationship of ITP with pollens, other allergens or with atopy. In contrast, several clinical studies have reported the co-incidence of autoimmune and allergic diseases recently, and there is an increasing interest in the relationship between autoimmune and allergic diseases (29). Immune dysregulation secondary to an infectious agent or excessive exposure to a cross-reactive inciting antigen that promotes Th1 response leading to progressive inflammation and autoimmunity is the generally accepted model in the pathogenesis of autoimmune diseases (29).…”

Section: Discussionmentioning

confidence: 99%

“…In mutually exclusive patient populations, Th1-type autoimmune disorders and Th2-type mediated allergic disorders would occur and this was predicted by the reciprocal counter-regulation of Th1 and Th2 cells (30). Other lymphocyte subtypes such as Th17 cells, soluble factors such as IL-9 and regulatory T cells were also identified recently as a common link between autoimmunity and atopy (29,(31)(32)(33)(34). Since ITP is an autoimmune disorder and T-cell abnormalities including Th1, Th2, Th17 and regulatory T cells play a role in its pathogenesis, the excessive exposure to the increasing number of atmospheric pollens reaching maximum levels in spring may trigger autoantibody formation against platelets, especially in genetically predisposed and maybe in atopic individuals who have a dysregulated immune system.…”

Section: Discussionmentioning

confidence: 99%

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Seasonal Association of Immune Thrombocytopenia in Adults

Tombak¹,

Boztepe²,

Tiftik³

et al. 2015

Balkan Med J

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Background:Immune thrombocytopenia (ITP) is an autoimmune disorder. It is characterized by thrombocytopenia due to thrombocyte destruction mediated by autoantibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogenesis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied. Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP. Study Design: Descriptive study. Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hospitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Relation between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated. Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resistant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149). Conclusion: This is the first study showing seasonal association of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Mediterranean climate is seen.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Seasonal Association of Immune Thrombocytopenia in Adults

Tombak¹,

Boztepe²,

Tiftik³

et al. 2015

Balkan Med J

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“…First, the normal-weight children without ADHD also compromised children with atopic diseases such as bronchial asthma and atopic dermatitis. Atopic diseases have been reported to be associated with elevated TSH levels in childhood [31, 32]. However, this alteration of TSH has mainly been attributed to autoimmune thyroiditis [31, 32], which formed an exclusion criterion in our study.…”

Section: Discussionmentioning

confidence: 71%

Thyroid Hormone Status in Overweight Children with Attention Deficit/Hyperactivity Disorder

et al. 2018

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Background: There is an ongoing discussion whether thyroid hormones are involved in the development and course of attention deficit/hyperactivity disorder (ADHD). Since obesity is associated with both higher thyroid-stimulating hormone (TSH) and free triiodothyronine (fT3) concentrations and increased rates of ADHD, we hypothesized that overweight children with ADHD show higher TSH and fT3 concentrations compared to overweight children without ADHD. Methods: TSH, fT3, fT4, and leptin levels were analyzed in 230 children (60.9% boys, 9.3 ± 1.7 years old, 35.7% migration background). The children were divided into four groups (I = 26 overweight children with ADHD, II = 56 normal-weight children with ADHD, III = 66 overweight children without ADHD, and IV = 82 normal-weight children without ADHD). Severity of ADHD was determined by the parent version of the Connors 3® rating scales. Results: Overweight children with ADHD did not differ significantly from overweight children without ADHD with respect to TSH, fT3, or fT4 concentrations. Comparing the thyroid hormones between the four groups also demonstrated no significant differences for TSH and fT4 concentrations. fT3 concentrations were significantly higher in normal-weight children with ADHD compared to normal-weight children without ADHD. Inattention and hyperactivity/impulsivity scores were not significantly related to TSH or fT3 in multiple regression analyses adjusted for age, gender, and migration background. In these analyses, TSH was associated with BMI SDS (β coefficient 0.19 ± 0.12, p = 0.002) and leptin (exp[β coefficient] 1.87 ± 1.36, p < 0.001). fT3 (β coefficient 0.06 ± 0.05, p = 0.009) and leptin (exp[β coefficient] 1.17 ± 1.13, p = 0.009) were also associated with BMI SDS. Conclusions: Our findings confirm the relation between overweight and thyroid hormones but point against the hypothesis that thyroid hormones might link overweight and ADHD in children.

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“…Представляет интерес также факт обнаружения существенной ассоциации выявления ААТ к тирео идной пероксидазе у женщин с БА [28], что свиде тельствует о высоком риске наличия скрытого ауто иммунного тиреоидита (относительный риск -3,3; р < 0,01). Повышенный уровень антитиреоидных АТ был обнаружен и в сыворотке крови у детей с атопи ческим дерматитом и БА [29], следовательно, лица с аллергической патологией нуждаются в обязатель ном и раннем обследовании функции щитовидной железы [30].…”

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