MON-594 Report Of A Large Series Of Patients With Graves' Disease (with/without Graves' Ophthalmopathy) And Review Of The Literature, About The Association With Other Autoimmune Diseases

Abstract

The two main clinical presentations of autoimmune thyroid disorders (AITD) are Graves’ disease (GD) and autoimmune thyroiditis (AT). The associations between thyroid disorders and other organ specific, or systemic autoimmune diseases in the same patient has been suggested, albeit discordant results have been reported in the literature. We focused on the association between GD and other autoimmune syndromes by searching in the literature. Moreover, we have carried out a prospective study investigating about the prevalence of other autoimmune disorders in 3209 GD patients [984 of whom with Graves’ ophthalmopathy (GO)], with respect to 1069 healthy controls, or 1069 with multinodular goiter, or 1069 patients with AT. Patients and controls were matched by age and gender, come from the same area, and had a similar iodine intake. A significant increase of the prevalence of autoimmune disorders in GD patients, with respect to the controls, has been observed. In particular, the most frequently observed associations were: vitiligo
 (2.6%), chronic autoimmune gastritis (2.4%), rheumatoid arthritis
 (1.9%), polymyalgia rheumatica (1.3%), multiple sclerosis (0.3%), celiac disease (1.1%), type 1 diabetes (0.9%), systemic lupus erythematosus and sarcoidosis (<0.1%), Sjogren disease (0.8%). In addition, 1.5% patients with GD had three associated autoimmune disorders. The prevalence of autoimmmune disorder in GO patients is higher (18.9%), with respect to GD patients without GO (15.6%). The pattern of the associated autoimmune disorders in GD was not significantly different from that observed in AT patients. These findings suggest to appropriately screen GD patients, who are still sick, or who develop new unspecific symptoms (even if during an appropriate treatment of hyperthyroidism), for the presence of other autoimmune disorders.