Vestibular disorders in euthyroid patients with Hashimoto's thyroiditis: role of thyroid autoimmunity

Chiarella, Giuseppe; Tognini, Sara; Nacci, Andrea; Sieli, Roberta; Costante, Giuseppe; Petrolo, Claudio; Mancini, Valentina; Guzzi, Pietro Hiram; Pasqualetti, Giuseppe; Cassandro, Ettore; Fattori, Bruno; Russo, Diego; Monzani, Fabio

doi:10.1111/cen.12471

Cited by 32 publications

(23 citation statements)

References 31 publications

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“…Mechanical movements of thyroid autoantibodies in the inner ear fluid or the development of autoimmune microangiitis in the labyrinth can result in BPPV in the presence of hyperthyroidism or hypothyroidism 51. Other studies support a role for thyroid hormone fluctuations52 and circulating anti-thyroid autoantibodies53 related to vestibular dysfunction in subsequent BPPV development. Therefore, dysregulation of the immune system may play a vital role between hyperthyroidism and BPPV as documented by our study.…”

Section: Discussionmentioning

confidence: 99%

Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study

et al. 2019

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ObjectiveThe association between depression and benign paroxysmal positional vertigo (BPPV) remains debated. This study aimed to investigate the risk of BPPV in patients with depressive disorders.DesignLongitudinal nationwide cohort study.SettingNational health insurance research database in Taiwan.ParticipantsWe enrolled 10 297 patients diagnosed with depressive disorders between 2000 and 2009 and compared them to 41 188 selected control patients who had never been diagnosed with depressive disorders (at a 1:4 ratio matched by age, sex and index date) in relation to the risk of developing BPPV.MethodsThe follow-up period was defined as the time from the initial diagnosis of depressive disorders to the date of BPPV, censoring or 31 December 2009. Cox proportional hazard regression analysis was used to investigate the risk of BPPV by sex, age and comorbidities, with HRs and 95% CIs.ResultsDuring the 9-year follow-up period, 44 (0.59 per 1000 person-years) patients with depressive disorders and 99 (0.33 per 1000 person-years) control patients were diagnosed with BPPV. The incidence rate ratio of BPPV among both cohorts calculating from events of BPPV per 1000 person-years of observation time was 1.79 (95% CI 1.23 to 2.58, p=0.002). Following adjustments for age, sex and comorbidities, patients with depressive disorders were 1.55 times more likely to develop BPPV (95% CI 1.08 to 2.23, p=0.019) as compared with control patients. In addition, hyperthyroidism (HR=3.75, 95% CI 1.67–8.42, p=0.001) and systemic lupus erythematosus (SLE) (HR=3.47, 95% CI 1.07 to 11.22, p=0.038) were potential risk factors for developing BPPV in patients with depressive disorders.ConclusionsPatients with depressive disorders may have an increased risk of developing BPPV, especially those who have hyperthyroidism and SLE.

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Section: Discussionmentioning

confidence: 99%

Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study

et al. 2019

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“…HT is also related to dysfunction of the vestibular system, which can be identified by abnormal caloric test and vestibular-evoked myogenic potential. The dysfunction was linked to increased anti-TPO antibodies without identification of the pathogenic mechanism (124). …”

Section: Anti-thyroid Antibody Types: the Key To The Diagnosismentioning

confidence: 99%

Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases

2017

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Autoimmune diseases have a high prevalence in the population, and autoimmune thyroid disease (AITD) is one of the most common representatives. Thyroid autoantibodies are not only frequently detected in patients with AITD but also in subjects without manifest thyroid dysfunction. The high prevalence raises questions regarding a potential role in extra-thyroidal diseases. This review summarizes the etiology and mechanism of AITD and addresses prevalence of antibodies against thyroid peroxidase, thyroid-stimulating hormone receptor (TSHR), and anti-thyroglobulin and their action outside the thyroid. The main issues limiting the reliability of the conclusions drawn here include problems with different specificities and sensitivities of the antibody detection assays employed, as well as potential confounding effects of altered thyroid hormone levels, and lack of prospective studies. In addition to the well-known effects of TSHR antibodies on fibroblasts in Graves’ disease (GD), studies speculate on a role of anti-thyroid antibodies in cancer. All antibodies may have a tumor-promoting role in breast cancer carcinogenesis despite anti-thyroid peroxidase antibodies having a positive prognostic effect in patients with overt disease. Cross-reactivity with lactoperoxidase leading to induction of chronic inflammation might promote breast cancer, while anti-thyroid antibodies in manifest breast cancer might be an indication for a more active immune system. A better general health condition in older women with anti-thyroid peroxidase antibodies might support this hypothesis. The different actions of the anti-thyroid antibodies correspond to differences in cellular location of the antigens, titers of the circulating antibodies, duration of antibody exposure, and immunological mechanisms in GD and Hashimoto’s thyroiditis.

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“…Although these abnormalities can occur as a direct consequence of hypothyroidism [1], it has been suggested that the circulating antithyroid autoantibodies can lead to T-cell mediated vestibulocochlear dysfunction. A review of the literature shows various case studies documenting the association of these two autoimmune entities [12–15] which demonstrate the existence of a clear relationship between thyroid autoimmunity and the inner ear damage, regardless of thyroid function. Furthermore, it is postulated that the immune complexes precipitation in the inner ear with concomitant autoimmune inflammation may be the pathogenic mechanism shared with HT.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune inner ear disease secondary to Hashimoto’s thyroiditis: a case report

Fayyaz

Upreti

2018

Journal of Community Hospital Internal Medicine Perspectives

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Autoimmune inner ear disease is an important yet incompletely understood cause of hearing loss which can present to different medical disciplines. Its diagnostic significance is indicated by the fact that it is a reversible medical condition if recognized early with an excellent response to immunosuppressive agents. Therefore, it should be considered in the differential diagnosis of hearing disorders especially in the context of another autoimmune disease such as Hashimoto’s thyroiditis.

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Vestibular disorders in euthyroid patients with Hashimoto's thyroiditis: role of thyroid autoimmunity

Cited by 32 publications

References 31 publications

Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study

Risk of benign paroxysmal positional vertigo in patients with depressive disorders: a nationwide population-based cohort study

Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases

Autoimmune inner ear disease secondary to Hashimoto’s thyroiditis: a case report

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