Friday, June 04, 2010

Autoimmune thyroid disease and other autoimmune disease

The association was robust in the largest study to date:

The frequency of another autoimmune disorder was 9.67% in Graves' disease and 14.3% in Hashimoto's thyroiditis index cases (P=.005). Rheumatoid arthritis was the most common coexisting autoimmune disorder (found in 3.15% of Graves' disease and 4.24% of Hashimoto's thyroiditis cases). Relative risks of almost all other autoimmune diseases in Graves' disease or Hashimoto's thyroiditis were significantly increased (greater than 10 for pernicious anemia, systemic lupus erythematosus, Addison's disease, celiac disease, and vitiligo). There was relative “clustering” of Graves' disease in the index case with parental hyperthyroidism and of Hashimoto's thyroiditis in the index case with parental hypothyroidism. Relative risks for most other coexisting autoimmune disorders were markedly increased among parents of index cases.

This is one of the largest studies to date to quantify the risk of diagnosis of coexisting autoimmune diseases in more than 3000 index cases with well-characterized Graves' disease or Hashimoto's thyroiditis. These risks highlight the importance of screening for other autoimmune diagnoses if subjects with autoimmune thyroid disease present with new or nonspecific symptoms.

1 comment:

Julie said...

Agree this is something I've seen clinically. However, I'm concerned about the misconception of the ANA as a screening test. Rheumatologists get lots and lots of consults for "+ANA" where the patient is terrified because they've been told their "lupus test is positive." Not only is ANA not a screening test and definitely not a "lupus test," but can be an incidental finding or false positive, be positive in relatives of those with autoimmune disease, or be positive in those with thyroid disorders. I end up ordering TPO (thyroid peroxidase Ab). Thanks for pointing out this article.