The association of other autoimmune diseases in patients with autoimmune thyroiditis: Review of the literature and report of a large series of patients

Psoriasis (PsO) is a chronic relapsing/remitting autoimmune skin disease, associated with an increased risk of other autoimmune disorders. Psoriatic arthritis (PsA) is a chronic inflammatory arthritis occurring approximately in 30% of PsO patients. Sporadic cases of association between PsO and autoimmune thyroid disorders (AITDs) have been reported. However, two different recent studies did not find any association between them. In patients with PsO and PsA, an association with AITD has been shown by most of the studies in adults, but not in the juvenile form. In PsA women and men, thyroid autoimmunity [positive antithyroid peroxidase (AbTPO) antibodies, hypoechoic thyroid pattern] and subclinical hypothyroidism were more prevalent than in the general population. An association has been shown also in patients with PsO, arthritis, and inflammatory bowel disease, who have more frequently AITD. A Th1 immune predominance has been shown in early PsO, and PsA, with high serum CXCL10 (Th1 prototype chemokine), overall in the presence of autoimmune thyroiditis. This Th1 immune predominance might be the immunopathogenetic base of the association of these disorders. A raised incidence of new cases of hypothyroidism, thyroid dysfunction, positive AbTPO, and appearance of a hypoechoic thyroid pattern in PsA patients, especially in women, has been shown recently, suggesting to evaluate AbTPO levels, thyroid function, and thyroid ultrasound, especially in PsA women. Thyroid function follow-up and suitable treatments should be performed regularly in PsA female patients at high risk (thyroid-stimulating hormone within the normal range but at the higher limit, positive AbTPO, hypoechoic, and small thyroid).

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“…The results of our study demonstrated a significant increase of the prevalence of PsA in AT patients (24). …”

Section: Pso Psa and Aitdsupporting

confidence: 52%

Psoriasis, Psoriatic Arthritis, and Thyroid Autoimmunity

et al. 2017

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“…Even though sarcoidosis patients have a risk of developing autoimmune thyroiditis [34], no such cases were found in our control group. An increased uptake in the head and neck region and bone marrow was noticed in both NF1 patients (73%) and controls, with an increased uptake in the thyroid gland.…”

Section: Discussionmentioning

confidence: 96%

Thyroid Gland <sup>18</sup>F-FDG Uptake in Neurofibromatosis Type 1

et al. 2018

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Purpose: To investigate thyroid gland characteristics on ¹⁸F-FDG positron emission tomography/computed tomography (PET/CT) imaging in patients with neurofibromatosis type 1 (NF1). Subjects and Methods: Thyroid gland characteristics of patients with a clinical diagnosis of NF1 who underwent ¹⁸F-FDG PET/CT imaging for the first time to distinguish benign neurofibroma from malignant peripheral nerve sheath tumor (MPNST) at our institution (n = 69) were compared to PET/CT imaging of sarcoidosis (n = 25) and early stage lung cancer (T₁N₀M₀ tumors, n = 15) patients. Results: Two NF1 patients (3%) showed a diffuse ¹⁸F-FDG uptake in the thyroid gland, 2 patients (3%) had an irregular uptake, and 7 patients (10%) had a focal uptake. Among the sarcoidosis patients, 1 showed a diffuse uptake (4%) and 1 had an irregular uptake (4%). In the early stage lung cancer group, 1 patient showed a diffuse uptake (7%) and 1 had a focal uptake (7%). NF1 patients had larger mean thyroid volume and mean SUV_max compared to sarcoidosis patients but not compared to early stage lung cancer patients. Four NF1 patients were diagnosed with multinodular goiter, 2 patients were diagnosed with benign chronic lymphocytic thyroiditis, 1 patient had metastasis to the thyroid, and 1 patient had medullary thyroid cancer. Conclusion: Even though NF1 patients did not show an increased risk of thyroid incidentaloma on PET/CT compared to previous studies on non-thyroid cancer patients, the incidence shows that awareness of possible thyroid disease is important.

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“…It affects ~2% of the female population and 0.2% of the male population (1). This condition is well known to be associated with other autoimmune diseases, the most common of which are chronic autoimmune gastritis, vitiligo, rheumatoid arthritis, polymyalgia rheumatica, celiac disease, type 1 diabetes, Sjögren’s syndrome, systemic lupus erythematosus (SLE), multiple sclerosis, and sarcoidosis (2). Also glomerular disease may be related to autoimmune disease with several mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Autoimmune Thyroiditis and Glomerulopathies

et al. 2017

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Autoimmune thyroiditis (AIT) is generally associated with hypothyroidism. It affects ~2% of the female population and 0.2% of the male population. The evidence of thyroid function- and thyroid autoantibody-unrelated microproteinuria in almost half of patients with AIT and sometimes heavy proteinuria as in the nephrotic syndrome point to a link of AIT with renal disease. The most common renal diseases observed in AIT are membranous nephropathy, membranoproliferative glomerulonephritis, minimal change disease, IgA nephropathy, focal segmental glomerulosclerosis, antineutrophil cytoplasmic autoantibody (ANCA) vasculitis, and amyloidosis. Different hypotheses have been put forward regarding the relationship between AIT and glomerulopathies, and several potential mechanisms for this association have been considered. Glomerular deposition of immunocomplexes of thyroglobulin and autoantibodies as well as the impaired immune tolerance for megalin (a thyrotropin-regulated glycoprotein expressed on thyroid cells) are the most probable mechanisms. Cross-reactivity between antigens in the setting of genetic predisposition has been considered as a potential mechanism that links the described association between ANCA vasculitis and AIT.

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The association of other autoimmune diseases in patients with autoimmune thyroiditis: Review of the literature and report of a large series of patients

Cited by 170 publications

References 29 publications

Psoriasis, Psoriatic Arthritis, and Thyroid Autoimmunity

Psoriasis, Psoriatic Arthritis, and Thyroid Autoimmunity

Thyroid Gland <sup>18</sup>F-FDG Uptake in Neurofibromatosis Type 1

Autoimmune Thyroiditis and Glomerulopathies

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