The Evolution of Thyroid Function after Presenting with Hashimoto Thyroiditis Is Different between Initially Euthyroid Girls with and Those without Turner Syndrome

Waśniewska, Małgorzata; Salerno, Mariacarolina; Corrias, Andrea; Mazzanti, Laura; Matarazzo, Patrizia; Corica, Domenico; Aversa, Tommaso; Messina, Maria Francesca; Luca, Filippo De; Valenzise, Mariella

doi:10.1159/000452722

Cited by 17 publications

(14 citation statements)

References 32 publications

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“…All the studied patients with TA were asymptomatic and no one fulfilled the criteria of overt hypothyroidism. Although the presence of thyroid-specific autoantibodies was the only manifestation of thyroid dysfunction in half of our patients with TA, they may develop an overt disease in the future, as presented in previous studies (21–23). By comparing the phenotypic aspects of HD in TS patients and non-TS population, Aversa et al showed that the biochemical features of thyroid functions are less severe in TS-patients; this may be caused by a less aggressive autoimmune process as well as the increased vigilance of the physicians taking care of TS-patients, thus leading to earlier diagnosis (24).…”

Section: Discussionsupporting

confidence: 52%

Autoimmunity Predisposition in Girls With Turner Syndrome

et al. 2019

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Background: Turner Syndrome is associated with an increased risk of autoimmune diseases, such as autoimmune thyroiditis, coeliac disease, type 1 diabetes mellitus, inflammatory bowel disease, alopecia areata, or vitiligo. The presence of isochromosome iXq and exposure to estradiol may contribute to the development of the autoimmune process. The aim of this study was to determine the prevalence of autoimmune diseases in a group of TS patients and to assess the impact of karyotype and puberty on the development of autoimmune diseases. Patients and Methods: The analysis encompassed clinical and biochemical data of 134 patients treated between 2001 and 2018. All the patients were examined for autoimmune disease symptoms and tested for the presence of antithyroperoxidase (anti-TPO) and antithyreoglobulin (anti-TG) antibodies. In 73 of the patients, anti-transglutaminase (anti-tTG) antibodies were measured. Thyroid function was assessed by measuring TSH and fT4 levels. Results: The mean follow-up was 5.7 ± 3 years. An autoimmune disease was diagnosed in 46 (34.3%) patients: 39 (29.1%) had only one disorder, whilst 7 (5.2%) presented two disorders. The most common disorder, observed in 40 (29.9%) patients, was thyroid autoimmunity. Hashimoto disease was diagnosed in 20 (14.9%) patients. Of the 73 patients tested for coeliac disease, 4 (5.5%) had anti-tTG and 2 (2.7%) presented overt coeliac disease. Vitiligo was diagnosed in 3 (2.2%) patients, type 1 diabetes mellitus or psoriasis were diagnosed in 2 (1.5%) patients, whilst alopecia areata or lichen sclerosus were diagnosed in 1 (0.7%) patient. The impact of karyotype or estradiol exposure on developing autoimmune diseases were not statistically significant. Conclusions: Our study showed a higher incidence of autoimmune diseases in TS, which is in line with the literature; however, the impact of iXq, or spontaneous/inducted puberty was not confirmed.

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Section: Discussionsupporting

confidence: 52%

Autoimmunity Predisposition in Girls With Turner Syndrome

et al. 2019

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“…Turner syndrome (TS) is another common chromosomopathy, that has been reported to be associated with an increased risk of various ADs, but especially HT and CD (40, 41). The link with TS has been shown to have negative repercussions on the evolution over time of thyroid function in girls with TS (37, 38, 42, 43), which suggested the opportunity of a strict monitoring of thyroid tests in these patients, in order to recognize at a proper time a possible deterioration from euthyroidism to hypo- or hyperthyroidism (42, 43). The association with TS, however, seems that it is not able to modify the clustering of NTADs in the girls with HT (42).…”

Section: Discussionmentioning

confidence: 99%

Phenotypic Expression of Autoimmunity in Children With Autoimmune Thyroid Disorders

et al. 2019

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Autoimmune thyroid diseases (AITDs), including Hashimoto's thyroiditis (HT) and Graves' disease (GD), tend to aggregate with other non-thyroidal autoimmune diseases (NTADs). Aim of this Mini-review is to report the most recent insights concerning the clustering of NTADs in pediatric patients with either HT or GD, the pathophysiology of AITDs and the metamorphic thyroid autoimmunity. A systematic literature research of the last 15 years, according to EQUATOR statement, was carried out through MEDLINE via PubMed ( http://www.ncbi.nlm.nih.gov/pubmed/ ) Embase, CINAHL, Cochrane Library, based on the following keywords: (autoimmune thyroid disease OR Hashimoto thyroiditis OR Grave's disease) AND (autoimmune comorbidities OR extra-thyroidal autoimmune disorders) AND (children OR adolescents OR pediatrics) AND (celiac disease OR type 1 diabetes mellitus OR arthropathies OR cutaneous diseases) AND (Turner syndrome OR Down syndrome). One-hundred and twenty-eight manuscripts were extrapolated but only seventeen were eligible. On the basis of the available reports it may be inferred that clustering of NTADs can be significantly modified by both patients' age at AITDs presentation and association with Down's syndrome (DS). Particularly, the association of AITDs with celiac disease and type 1 diabetes was most commonly reported in children than in adults. A sequential shifting from HT to GD has been described in children with AITDs, and it seems to be more frequent in children with DS than in those without DS. Coexistence of autoimmune diseases might be the result of a complex interaction among genetics, environment and epigenetic modifications that are able to affect gene expression, immune system response and, finally, the pathogenesis of autoimmune diseases.

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“…ATDs had been reported to be more frequent in girls with TS than in the general population [ 6 , 10 , 11 ], covering a spectrum of phenotypes. They include Hashimoto’s thyroiditis (HT)—which is considered the most common autoimmune thyroid disease, and Graves’ disease (GD)—which causes hyperthyroidism [ 7 , 12 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of autoimmune thyroid diseases among the Turner Syndrome patients: meta-analysis of cross sectional studies

et al. 2018

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ObjectiveThis meta-analysis was done to estimate the prevalence of autoimmune thyroid diseases (ATDs) in Turner Syndrome patients, and to determine the clinical status of thyroid autoimmune diseases that occur frequently in association with Turner Syndrome.ResultsA total of 18 studies were included in the meta-analysis. The pooled overall prevalence of autoimmune thyroid diseases in Turner Syndrome patients was 38.6% (95% CI 29.7–47.6%), with 12.7% (95% CI 9.30–16.1%) of them had clinical hypothyroidism and 2.6% (95% CI 1.5–3.8%) had hyperthyroidism. I-squared test had a high result of heterogeneity. In subgroup analyses, the prevalence of ATDs was higher in the European region than Asian region. Autoimmune thyroid diseases are commonly associated with Turner Syndrome. Early detection of thyroid diseases by optimal screening among children with Turner Syndrome is required to ensure effective management.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3950-0) contains supplementary material, which is available to authorized users.

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The Evolution of Thyroid Function after Presenting with Hashimoto Thyroiditis Is Different between Initially Euthyroid Girls with and Those without Turner Syndrome

Cited by 17 publications

References 32 publications

Autoimmunity Predisposition in Girls With Turner Syndrome

Autoimmunity Predisposition in Girls With Turner Syndrome

Phenotypic Expression of Autoimmunity in Children With Autoimmune Thyroid Disorders

Prevalence of autoimmune thyroid diseases among the Turner Syndrome patients: meta-analysis of cross sectional studies

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