Chronic recurrent stress due to panic disorder does not precipitate Graves’ disease

Chiovato, Luca; Marinò, Michele; Perugi, Giulio; Fiore, Emilio; Montanelli, Lucia; Lapi, Paola; Cavaliere, R.; Ciampi, M.; Patronelli, A.; Placidi, Gian Franco; Cassano, G.B.; Pinchera, Aldo

doi:10.1007/bf03348042

Cited by 19 publications

(7 citation statements)

References 32 publications

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“…However, the hypothesized relationship between panic disorder and GD was not confirmed in the study by Chiovato et al [41] in a group of 87 patients with panic disorder. More recently, Simon et al [42] on the bases of their own results and of the analysis of a number of other studies performed on small numbers of patients, suggested that some relationship between thyroid dysfunction and panic disorder exists; however, the time relationship between panic disorder and thyroid dysfunction was not clear nor was the nature of hyperthyroidism clearly defined.…”

Section: Clinical Studies About the Possible Role Of Stress In Gd Andmentioning

confidence: 46%

Stress and Autoimmune Thyroid Diseases

Bagnasco¹,

Bossert²,

Pesce³

2006

Neuroimmunomodulation

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Autoimmune thyroid diseases (AITD) are the far most common autoimmune disorders, their prevalence in Western countries exceeding 5% of the general population. In the large majority of individual cases the clinical impact of AITD is not severe, however, their widespread diffusion renders them a significant health problem. AITD are heterogeneous in their clinical presentation: the two main forms are autoimmune thyroiditis (AT) and Graves’ disease (GD). Although they probably share, at least in part, a common genetic background and may occur in the same family as well as in the same individual, they are definitely two distinct diseases both in their clinical presentation and their pathophysiology. In fact, AT causes structural thyroid damage (mainly via cell-mediated immune destruction of thyroid follicular cells) which results, as a rule, in functional impairment (hypothyroidism); however, depending on clinical variants, evolution towards hypothyroidism may be very low, or thyroid function impairment occurs after an initial phase of mild thyrotoxicosis due to relatively rapid gland destruction. GD patients have hyperthyroidism, often severe, due to autoantibody-mediated thyrotropin receptor stimulation, with thyroid cell hyperplasia and hyperfunction. Such a functional heterogeneity is a key feature for the clinical management: as a matter of fact, therapy of AITD is mainly therapy of thyroid dysfunction. Moreover, since hyperthyroidism is quite early perceived by the patient as a cause of discomfort, the timing of the natural history of GD is relatively well defined; on the other hand, AT may be asymptomatic for a long time and defining its natural history in a single patient may be difficult. In some AITD patients (mainly, but not exclusively, with GD), clinical features not directly related to thyroid dysfunction, such as orbitopathy, are present. Graves’ orbitopathy is probably related, at least in part, to autoantibodies directed to thyrotropin receptor; it may be, in a minority of patients, severe and sight-threatening, and represents an independent clinical problem.

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Section: Clinical Studies About the Possible Role Of Stress In Gd Andmentioning

confidence: 46%

Stress and Autoimmune Thyroid Diseases

Bagnasco¹,

Bossert²,

Pesce³

2006

Neuroimmunomodulation

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“…Chiovato et al (13,14), in prospective studies with well-defined criteria for thyroid autoimmune disorders in a group of patients with panic disorders and agoraphobia, showed no association between chronic recurrent stress and Graves' disease. Few studies are available on the relation between stress events and Hashimoto's thyroiditis.…”

Section: Discussionmentioning

confidence: 97%

“…The impact of stressful events on immune response and, in particular, on the onset or precipitation of autoimmune thyroid disorders is controversial. In fact, an association between stressful life events and the onset of Graves' disease has been observed in some (10)(11)(12) but not all studies (8,13,14). Most of these studies were retrospective, and the use of different diagnostic criteria for thyroid diseases, the difficult definition and quantification of stressful life events and the different criteria for control groups may account for these discrepancies.…”

Section: Discussionmentioning

confidence: 99%

Thyroid autoimmunity in patients with malignant and benign breast diseases before surgery

et al. 2006

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Background: Previous studies have demonstrated a high prevalence of thyroperoxidase antibodies (TPOAb) and autoimmune hypothyroidism in breast cancer (BC). These studies have been performed in BC patients generally 20-30 days after mastectomy. It is known that stress may have an influence on the immune system and a relation between stressful events and the onset or worsening of autoimmune thyroid disorders has been reported by several authors. The aim of the study was to evaluate the prevalence of autoimmune thyroid disease in patients with nodular breast disease selected for surgery before any treatment. Our hypothesis was that the high prevalence of thyroid autoimmune disorders in BC is independent of stressful events represented by surgery and/or anaesthetic procedures. Methods: Our series included 61 consecutive women aged 52.8G10.2 yrs (mean ageGS.D.) with nodular breast disease selected for breast surgery: 36 out of 61 of them (59%) had BC and 25 out of 61 had benign breast disease (BBD). Controls included 100 healthy age-matched women. All patients and control subjects were submitted to clinical, ultrasound thyroid evaluation and serum-free thyroxine (FT4), serum-free tri-iodothyronine (FT3), TSH, TPOAb and thyroglobulin antibodies (TgAb) determination. Results: Mean FT3, FT4 and TSH concentration showed no differences between BC patients, BBD patients and controls. The prevalence of TPOAb in BC patients (12/36: 33.33%) was significantly higher than in BBD patients (5/25: 20%) (P!0.01) and in controls (8/100: 8%) (P!0.01). Similarly, the prevalence of TgAb in BC patients was 12 out of 36 (33.33%) significantly higher than that detected in BBD patients (4/25: 16%) (P!0.01) and in controls (12/100: 12%) (P!0.01). Of the 36 BC patients, 20 showed a diffuse hypoechogenicity of the thyroid gland to ultrasound evaluation, significantly higher than in BBD (7/25: 28%) (PZ0.03). Of the 20 BC patients who showed a hypoechogenic pattern of thyroid gland, 10 (50%) were associated with antithyroid antibodies positivity (TAb). This finding was present in two of seven BBD (28.57%) (P!0.0001). Only two controls showed focal hypoechogenicity of the thyroid gland. Generally, 24 out of 36 (66.7%) of BC and 9 out of 25 (36%) of BBD (PZ0.02) had signs of thyroid autoimmunity consistent with the hypoechogenic pattern of thyroid gland associated or not with TAb; 2 out of 36 (5.55%) of BC and 1 out of 25 (4%) of BBD patients had autoimmune hypothyroidism and no hypothyroidism was found in controls. Conclusions: The results of this study confirm the strong relation between thyroid autoimmunity and BC. This finding is independent of stressful events represented by surgery or anaesthetic procedures. The present data call attention to the usefulness of screening for autoimmune thyroid disorders in patients with nodular breast disease selected for surgery.

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“…[26] Chiovato et al ., could not find past or present Graves′ hyperthyroidism in patients with panic disorder. [27]…”

Section: Stress As a Precipitating Factor/cause Of Endocrine Disordersmentioning

confidence: 99%

Stress and hormones

Ranabir

Reetu

2011

Indian J Endocr Metab

335

185

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In the modern environment one is exposed to various stressful conditions. Stress can lead to changes in the serum level of many hormones including glucocorticoids, catecholamines, growth hormone and prolactin. Some of these changes are necessary for the fight or flight response to protect oneself. Some of these stressful responses can lead to endocrine disorders like Graves’ disease, gonadal dysfunction, psychosexual dwarfism and obesity. Stress can also alter the clinical status of many preexisting endocrine disorders such as precipitation of adrenal crisis and thyroid storm.

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Chronic recurrent stress due to panic disorder does not precipitate Graves’ disease

Cited by 19 publications

References 32 publications

Stress and Autoimmune Thyroid Diseases

Stress and Autoimmune Thyroid Diseases

Thyroid autoimmunity in patients with malignant and benign breast diseases before surgery

Stress and hormones

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