Chapter 17 Autoimmune Hypothyroidism and Hyperthyroidism in Systemic Autoimmune Disease

Abstract

Publisher Summary This chapter discusses the autoimmune hypothyroidism and hyperthyroidism in systemic autoimmune disease. Autoimmune disease can be divided into systemic diseases in which there are autoantibodies binding ubiquitously expressed antigens such as double stranded DNA in systemic lupus, tRNA synthetases in dermato- and polymyositis, or the spliceo-some complex in mixed connective tissue disease and systemic lupus erythematosus (SLE). The presence of two or more organ-specific autoimmune diseases is generally considered a polyglandular autoimmune syndrome. In organ-specific autoimmune disease, there are circulating antibodies binding antigens generally expressed in only the affected organ. Among the most common of organ-specific autoimmune diseases is autoimmune thyroid disease. Autoimmunity and autoimmune disease are usually defined as such by the presence of antibody binding self-structures or the presence of lymphocytic infiltrates without infection. When considered together, autoimmune diseases are extremely common in the human population. SLE is a prototype systemic autoimmune disease with protean clinical manifestations ranging from life-threatening renal, neurologic, hematologic, pulmonary, or heart disease to skin or mucous membrane involvement.