COVID‐19‐induced autoimmune thyroiditis: Exploring molecular mechanisms

Mohammadi, Bita; Dua, Kamal; Saghafi, Mohammadreza; Singh, Sachin Kumar; Heydarifard, Zahra; Zandi, Milad

doi:10.1002/jmv.29001

Cited by 10 publications

(7 citation statements)

References 123 publications

(277 reference statements)

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“…There have been reports of new cases of GD after COVID-19 and an increase in the incidence of GD during the COVID-19 pandemic 23 , 24 . Possible mechanisms include aberrant T-cell subtype responses, presence of autoantibodies, regulatory cell dysfunction, and excessive inflammation and immunity due to cytokine overproduction 25 . In patients with post-COVID-19 symptoms, complement activation in patients with brain fog and high serum ferritin levels in patients with ME/CFS after COVID-19 have been reported, suggesting that attention should also be paid to autoimmune abnormalities after COVID-19 26 , 27 .…”

Section: Discussionmentioning

confidence: 99%

Occult endocrine disorders newly diagnosed in patients with post-COVID-19 symptoms

Nakano,

Sunada,

Tokumasu

et al. 2024

Sci Rep

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Determination of long COVID requires ruling out alternative diagnoses, but there has been no report on the features of alternative diagnoses. This study was a single-center retrospective study of outpatients who visited our clinic between February 2021 and June 2023 that was carried out to determine the characteristics of alternative diagnoses in patients with post-COVID-19 symptoms. In a total of 731 patients, 50 patients (6.8%) were newly diagnosed with 52 diseases requiring medical intervention, and 16 (32%) of those 50 patients (2.2% of the total) were considered to have priority for treatment of the newly diagnosed disorders over long COVID treatment. The proportion of patients with a new diagnosis increased with advance of age, with 15.7% of the patients aged 60 years or older having a new diagnosis. Endocrine and metabolic diseases and hematological and respiratory diseases were the most common, being detected in eight patients (16%) each. Although 35 of the 52 diseases (67%) were related to their symptoms, endocrine and metabolic diseases were the least associated with specific symptoms. Other disorders that require attention were found especially in elderly patients with symptomatic long COVID. Thus, appropriate assessment and differentiation from alternative diagnoses are necessary for managing long COVID.

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Section: Discussionmentioning

confidence: 99%

Occult endocrine disorders newly diagnosed in patients with post-COVID-19 symptoms

Nakano,

Sunada,

Tokumasu

et al. 2024

Sci Rep

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“…The chronic release of cytokines triggers inflammatory cascades that can lead to changes in thyroid tissue, altering its function. Likewise, an acute upregulation of proinflammatory cytokines is assumed to facilitate autoimmune thyroiditis in viral infections, including COVID-19 and Epstein-Barr virus infection [53][54][55][56]. Similar effects on endocrine organs, particularly the thyroid gland, are known from the use of PD1 or CTLA4 inhibitors in the treatment of skin cancer [57][58][59][60].…”

Section: Discussionmentioning

confidence: 99%

Primary Thyroid Dysfunction Is Prevalent in Hidradenitis Suppurativa and Marked by a Signature of Hypothyroid Graves’ Disease: A Case–Control Study

Abu Rached,

Dietrich,

Ocker

et al. 2023

JCM

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Hidradenitis suppurativa (HS) is a chronic skin disease that can have an association with endocrine disorders. There is conflicting information in the literature regarding the role of the thyroid gland in HS. This study aimed to close this knowledge gap and investigate how thyroid disease is involved in patients with HS. We carried out a case–control study with a total of 160 patients, of whom 108 were patients with HS and 52 were controls matched for age and sex. Parametric and non-parametric methods were used to analyze the results. We calculated structural parameters of thyroid homeostasis to detect subclinical thyroid disease, non-thyroid disease syndrome and other forms. The severity of HS was not associated with thyroid hormone levels and antibodies (p > 0.05). HS patients with or without hypothyroidism had decreased FT4 levels and a decreased thyroid secretory capacity (SPINA-GT). Titers of TSH receptor autoantibodies (TRAb) were significantly higher in smoking HS patients compared to non-smokers (median: 1.18 vs. 1.08; p = 0.042). The rate of subclinical hypothyroidism was significantly higher in HS patients; thus, subclinical hypothyroidism is an important comorbidity of HS (p < 0.05). Further studies are needed to investigate whether the chronic inflammation of HS is a cause of increased rates of (subclinical) hypothyroidism.

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“…Recently, the COVID-19 pandemic has placed numerous multidisciplinary conditions in relationship with a new cause, namely, the viral infection itself [150,151]. Some reports showed an exacerbation of LP following coronavirus-associated diseases or even the vaccination against the virus [152][153][154][155], while others highlighted similar data on ATD exacerbation (apart from subacute thyroiditis which is a direct, viral consequence) [156][157][158]. Of note, coronavirus infection might trigger thyroid eye disease in GD or exacerbate TH in previously diagnosed (endocrine) patients, since the virus might interfere with the immune and autoimmune systems as well as the hormonal panel [159][160][161].…”

Section: Infectious Diseasesmentioning

confidence: 99%

Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies

Radu,

Carsote,

Nistor

et al. 2023

Biomedicines

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In this narrative review, we aimed to overview the interplay between lichen planus (LP) and thyroid conditions (TCs) from a dual perspective (dermatologic and endocrine), since a current gap in understanding LP-TC connections is found so far and the topic is still a matter of debate. We searched PubMed from Inception to October 2023 by using the key terms “lichen planus” and “thyroid”, (alternatively, “endocrine” or “hormone”). We included original clinical studies in humans according to three sections: LP and TC in terms of dysfunction, autoimmunity, and neoplasia. Six studies confirmed an association between the thyroid dysfunction (exclusively hypothyroidism) and LP/OL (oral LP); of note, only one study addressed cutaneous LP. The sample size of LP/OLP groups varied from 12–14 to 1500 individuals. Hypothyroidism prevalence in OLP was of 30–50%. A higher rate of levothyroxine replacement was identified among OLP patients, at 10% versus 2.5% in controls. The highest OR (odd ratio) of treated hypothyroidism amid OLP was of 2.99 (p < 0.005). Hypothyroidism was confirmed to be associated with a milder OLP phenotype in two studies. A single cohort revealed a similar prevalence of hypothyroidism in LP versus non-LP. Non-confirmatory studies (only on OLP, not cutaneous LP) included five cohorts: a similar prevalence of hypothyroidism among OLP versus controls, and a single cohort showed that the subjects with OLP actually had a lower prevalence of hypothyroidism versus controls (1% versus 4%). Positive autoimmunity in LP/OLP was confirmed in eight studies; the size of the cohorts varied, for instance, with 619 persons with LP and with 76, 92, 105, 108, 192, 247, and 585 patients (a total of 1405) with OLP, respectively; notably, the largest control group was of 10,441 individuals. Four clusters of approaches with respect to the autoimmunity in LP/OLP were found: an analysis of HT/ATD (Hashimoto’s thyroiditis/autoimmune thyroid diseases) prevalence; considerations over the specific antibody levels; sex-related features since females are more prone to autoimmunity; and associations (if any) with the clinical aspects of LP/OLP. HT prevalence in OLP versus controls was statistically significantly higher, as follows: 19% versus 5%; 12% versus 6%; and 20% versus 9.8%. A single study addressing LP found a 12% rate of ATDs. One study did not confirm a correlation between OLP-associated clinical elements (and OLP severity) and antibody values against the thyroid, and another showed that positive TPOAb (anti-thyroperoxidase antibodies) was more often found in erosive than non-erosive OLP (68% versus 33%). Just the reverse, one cohort found that OLP subjects had a statistically significantly lower rate of positive TPOAb versus controls (9% versus 15%). Five case-control studies addressed the issue of levothyroxine replacement for prior hypothyroidism in patients that were diagnosed with OLP (no study on LP was identified); three of them confirmed a higher rate of this treatment in OLP (at 8.9%, 9.7%, and 10.6%) versus controls. In conclusion, with regard to LP/OLP-TC, we note several main aspects as practical points for multidisciplinary practitioners: OLP rather than LP requires thyroid awareness; when it comes to the type of thyroid dysfunction, mostly, hypothyroidism should be expected; female patients are more prone to be associated with ATDs; a potential higher ratio of OLP subjects taking levothyroxine was found, thus a good collaboration with an endocrinology team is mandatory; and so far, OLP individuals have not been confirmed to be associated with a higher risk of thyroid nodules/cancer.

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COVID‐19‐induced autoimmune thyroiditis: Exploring molecular mechanisms

Cited by 10 publications

References 123 publications

Occult endocrine disorders newly diagnosed in patients with post-COVID-19 symptoms

Occult endocrine disorders newly diagnosed in patients with post-COVID-19 symptoms

Primary Thyroid Dysfunction Is Prevalent in Hidradenitis Suppurativa and Marked by a Signature of Hypothyroid Graves’ Disease: A Case–Control Study

Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies

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