The Coexistence of Systemic Lupus Erythematosus and Thyrotoxicosis: The Diagnostic Value of Antihistone Antibodies

Baleva, M; Nikolov, K; Manov, Emil; Stoikov, A.; Shabani, R.; Dourmishev, Lyubomir; Nikolova, Milena

doi:10.1155/2012/517059

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…This same observation was made by Mokhtar [8]. In other cases lupus can occur after the diagnosis of Basedow disease as Toujani observed [7] and Baleva [9]. It is also possible that these two conditions are concomitant as observed by Baili.…”

Section: Discussionsupporting

confidence: 71%

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Association of Graves’ Disease and Systemic Lupus Erythematosus

Diagne

Pouye²,

Faye³

et al. 2015

OJIM

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Summary of Lupus and Basedow Disease Association: The association lupus auto-immune thyroid disease is well known. Lupus is most commonly associated with Hashimoto's thyroiditis. As for Graves' disease, it is most often associated with pernicious anaemia, vitiligo, idiopathic purpura and myasthenia gravis. To our knowledge, we report the first case of lupus associated with Graves' disease in sub-Saharan Africa. Observation: A female patient of 52 years old has been followed since February 2010 for systemic lupus diagnosed on biological and immunological clinical ACR criteria. There was no skin ailment and kidneys involved. Combined treatment with high-dose corticosteroids early and rapid decrease and hydroxychloroquine was established with good clinical and biological evolution. One year later the patient developed thyrotoxicosis syndrome and vascular goitre without exophthalmos associated with the presence of antibodies anti receptor of TSH leading to the diagnosis of Graves' disease. The patient has been treated with synthetic anti-thyroid and beta blocker allowing the regression of clinical symptoms and the normalization of thyroid hormones. Since then, the patient had not shown other signs of systemic affection. Conclusion: Systemic diseases are often associated with autoimmune thyreopathies. But association of lupus with Graves' disease has been rarely described in the literature. One should always watch out for the occurrence of thyroid disease in front of any systemic disease and vice versa.

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Section: Discussionsupporting

confidence: 71%

“…For the first case, it was systemic lupus associated with Graves 'disease and for the second Graves' disease associated with anti-phospholipids syndrome. Baili [3] has also described the association as well as Baleva [9], in 4 cases of systemic lupus erythematosus.…”

Section: Discussionmentioning

confidence: 94%

Association of Graves’ Disease and Systemic Lupus Erythematosus

Diagne

Pouye²,

Faye³

et al. 2015

OJIM

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“…The studies reported on the order of appearance of AITD and systemic autoimmune diseases are debatable [9, 22, 23]. The order of appearance of AITD and systemic autoimmune diseases had been reported in one study, but with a very low population size ( n = 4) [24]. We have reported here the most comprehensive analysis with 14825 subjects to show the order of emergence of the systemic autoimmunity in AITD subjects.…”

Section: Discussionmentioning

confidence: 86%

Exploring Systemic Autoimmunity in Thyroid Disease Subjects

Siriwardhane

Krishna

Ranganathan

et al. 2018

Journal of Immunology Research

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Introduction. Individuals with one autoimmune disease are at risk of developing a second autoimmune disease, but the pathogenesis or the sequential occurrence of multiple autoimmune diseases has not been established yet. In this study, we explored the association and sequential occurrence of antibodies in thyroid disease and systemic autoimmune disease subjects. We evaluated thyroid hormones, thyroid-stimulating hormone (TSH), free thyroxine (FT4), thyroid autoantibodies, anti-thyroperoxidase (anti-TPO), and anti-thyroglobulin (Tg) to comprehend the association with systemic autoimmune autoantibodies, anti-nuclear antibodies (ANA), and autoantibodies to extractable nuclear antigens (ENA) in subjects with thyroid-related symptoms. Methods. A total of 14825 subjects with thyroid-related symptoms were tested at Vibrant America Clinical Laboratory for thyroid markers (TSH, FT4, anti-TPO, and anti-Tg) and an autoimmune panel (ANA panel and ENA-11 profile) from March 2016 to May 2018. Thyroid-positive (based on TSH and FT4 levels), anti-TPO-positive, and anti-Tg-positive subjects were assessed for the prevalence of ANA and anti-ENA antibodies. A 2-year follow-up study was conducted to assess the sequential order of appearance of autoimmune markers in thyroid and systemic autoimmune diseases. Results. In the retrospective analysis, 343/1671 (20.5%), 2037/11235 (18.1%), and 1658/9349 (17.7%) of thyroid+, anti-TPO+, and anti-Tg+ subjects were found to be seropositive for ANA. Anti-ENA was detected in a higher prevalence than ANA with 475/1671 (28.4%), 3063/11235 (27.3%), and 2511/9349 (26.9%) in the same groups of subjects, respectively. Our results are found to be much higher than the reported prevalence of anti-ENA in general population. During the 2-year follow-up study, anti-TPO appeared significantly earlier than ANA and anti-ENA in an average of 253 (±139) and 227 (±127) days, respectively. Conclusions. A high prevalence of anti-ENA and ANA was found to be coexisting with autoimmune thyroid disease subjects, with anti-TPO occurring prior to the onset of ANA and anti-ENA. Therefore, frequent follow-ups and evaluation of ANA and anti-ENA in subjects with anti-TPO positivity would be beneficial in early detection of other systemic autoimmune diseases.

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“…Systemic lupus erythematosus (SLE) is another autoimmune disease in which autoantibodies against a panoply of self‐antigens can affect multiple systems, including the skin, joints, and kidneys 2 . Some case reports have linked Graves' disease to incident SLE 3,4 . It has also been reported that antithyroid drugs used to treat Graves' disease can induce SLE 5 .…”

Section: Introductionmentioning

confidence: 99%

Association between Graves' disease and risk of incident systemic lupus erythematosus: A nationwide population‐based cohort study

Lee¹,

Chen

Yang

et al. 2020

Int J of Rheum Dis

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Objective Previous case reports have linked Graves' disease to incident systemic lupus erythematosus (SLE). It has also been reported that antithyroid drugs used to treat Graves' disease can induce SLE development. The purpose of this study was to investigate the risk of SLE in patients with Graves' disease. Methods A total of 8779 patients with Graves' disease and 8779 controls (without Graves' disease) matched by age, gender, index year, and Charlson Comorbidity Index (CCI) score were enrolled between 2000‐2012. Patients were then followed until the end of 2013 using Taiwan's National Health Insurance Research Database, at which time participants who developed SLE were identified. Cox regression analysis was used to calculate the hazard ratio (HR) with a 95% confidence interval (CI) of SLE incidence rate between patients with Graves' disease and unaffected controls. Results Patients with Graves' disease had a significantly increased risk of SLE than unaffected controls (8.81 vs 2.83 per 10 000 person‐years, HR: 5.45, 95% CI: 1.74‐17.0) after adjusting for antithyroid therapies (antithyroid drugs, radioactive iodine ablation, and surgery). Diagnostic bias may be present as patients with Graves' disease may seek more help from healthcare providers. After excluding the first 0.5 and 1 year of observation period, similar results were obtained (excluding 0.5 year ‐ HR: 4.30, 95% CI: 2.78‐8.57; excluding 1 year ‐ HR: 4.63, 95% CI: 2.33‐7.79). Conclusion This study shows that Graves' disease is associated with an increased risk of incident SLE. Further studies on the underlying pathogenesis linking Graves' disease and SLE are warranted.

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The Coexistence of Systemic Lupus Erythematosus and Thyrotoxicosis: The Diagnostic Value of Antihistone Antibodies

Cited by 4 publications

References 14 publications

Association of Graves’ Disease and Systemic Lupus Erythematosus

Association of Graves’ Disease and Systemic Lupus Erythematosus

Exploring Systemic Autoimmunity in Thyroid Disease Subjects

Association between Graves' disease and risk of incident systemic lupus erythematosus: A nationwide population‐based cohort study

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