Do Hashimoto's and Graves' cluster to the same extent with other autoimmune disorders?

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Eur

J Endocrinol. 2011 May;164(5):789-94. Epub 2011 Mar 4.

Clustering

of additional autoimmunity behaves differently in Hashimoto's patients compared

with Graves' patients.

Wiebolt

J, Achterbergh

R, den

Boer A, van

der Leij S, Marsch

E, Suelmann

B, de

Vries R, van

Haeften TW.

Source- Department of Endocrinology,

University Medical Centre, Utrecht, The Netherlands. j.wiebolt@...

Abstract

OBJECTIVE:

It

is unclear whether Hashimoto's thyroiditis and Graves' disease (often referred

to as autoimmune thyroid disease, AITD) cluster to the same extent with other

autoimmune disorders.

METHODS:

We

assessed adrenal, â-cell, celiac and gastric antibodies in a cohort of 523

adult patients with Graves' disease and 359 patients with Hashimoto's disease

and compared their clustering.

RESULTS:

Adrenal

autoimmunity associated more often with Hashimoto's disease (9.0%) than with

Graves' disease (3.3%, P=0.001). â-cell autoimmunity was seen more frequently

in Hashimoto's disease (25.4%) than in Graves' disease (15.6%, P=0.001)

patients. We found low prevalences of celiac autoimmunity (1.2% for Graves' and

1.2% for Hashimoto's disease). Celiac and gastric autoimmunity were not

statistically different in Hashimoto's and Graves' disease patients. Although

gastric autoimmunity itself was equally prevalent (around 20%), Hashimoto's

disease often showed significantly more clustering of adrenal autoimmunity with

gastric autoimmunity (5.3%) than Graves' disease (1.2%, P=0.001). Similarly,

clustering of adrenal autoimmunity was seen with â-cell autoimmunity in

Hashimoto's patients (3.2%), while such clustering was much less encountered in

359 Graves' patients (0.9%, P=0.029).

CONCLUSION:

In

conclusion, Hashimoto's disease shows a markedly higher clustering of

additional autoimmunity, especially with adrenal and â-cell autoimmunity.

Combined clustering of gastric and adrenal autoimmunity and combined clustering

of adrenal and â-cell autoimmunity were both seen more often in Hashimoto's

patients. Clustering with celiac disease appears to be low. These findings

indicate that Hashimoto's and Graves' disease differ in their clinical

expression regarding additional autoimmunity, which argues against the

indiscriminate use of AITD as an entity.

PMID: 21378091  [PubMed

- indexed for MEDLINE]