Incidence Of Autoimmune Thyroid Disease Research Articles

A nationwide registry-based observational study of thyroid disease incidence in the Faroe Islands.

The occurrence of thyroid disease varies among populations. While the iodine nutrition level of the Faroese seems to have been decreasing over the past decades, there is no systematic evaluation of the thyroid disease pattern in the Faroe Islands. Such knowledge of thyroid disease occurrence in the North Atlantic region may support healthcare planning and prevention. To investigate incidence rates, including subtypes of thyroid diseases, and demographic characteristics of thyroid disease patients in the Faroe Islands, to improve understanding of the patterns and trends of these disorders. A registry-based observational study was conducted over 10 years, encompassing all adult Faroese individuals. Health records from general practitioners and hospitals were used to identify incident cases of thyroid diseases. Validation was performed using multiple data sources. The incidence rates were standardised using population data from the middle of the study period 2006-2018. Among the 1152 individuals diagnosed with thyroid disease, the standardised incidence rates per 100,000 person-years were 55 for hyperthyroidism and 112 for hypothyroidism, and around four times higher in women than in men. Hashimoto's thyroiditis was the dominant cause of hypothyroidism, while Graves' disease was the leading cause of hyperthyroidism. The incidence of hypothyroidism increases with age. A decreasing trend was observed over time for both hypothyroidism and hyperthyroidism. Considering the decrease in iodine nutrition levels over the past decades, we were surprised by the high incidence of autoimmune thyroid disease. The findings highlight the need for continuous monitoring of thyroid disease occurrence in coastal areas of the North Atlantic Ocean.

A detailed analysis of thyroid disorders in autoimmune liver diseases

Aims: Extrahepatic autoimmune diseases are frequently encountered in patients with autoimmune liver diseases (AILD). There is a very limited data in the literature on the incidence of autoimmune thyroid diseases in AILD and the characterization of thyroid diseases in these patients. This study evaluated frequency and clinical features of thyroid disorders in AILD. 
 Methods: We compared clinical and laboratory data and thyroid ultrasonography findings of 100 patients with AILD and 48 healthy controls.
 Results: The frequency of autoimmune thyroid disease and nodularity was higher in the AILD group compared to the control group (34 % vs 12.1 %; p

COVID-19-induced autoimmune thyroiditis: Exploring molecular mechanisms.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) damages multiple organs, including the thyroid, by direct invasion and cell entry via angiotensin-converting enzyme 2 or indirectly by promoting excessive inflammation in the body. The immune system is a critical factor in antiviral immunity and disease progression. In the context of SARS-CoV-2 infection, the immune system may become overly activated, resulting in a shift from regulatory to effector responses, which may subsequently promote the development and progression of autoimmune diseases. The incidence of autoimmune thyroid diseases, such as subacute thyroiditis, Graves' disease, and Hashimoto's thyroiditis, increases in individuals with COVID-19 infection. This phenomenon may be attributed to aberrant responses of T-cell subtypes, the presence of autoantibodies, impaired regulatory cell function, and excessive production of inflammatory cytokines, namely interleukin (IL)-6, IL-1β, interferon-γ, and tumor necrosis factor-α. Therefore, insights into the immune responses involved in the development of autoimmune thyroid disease according to COVID-19 can help identify potential therapeutic approaches and guide the development of effective interventions to alleviate patients' symptoms.

Study of thyroid disorders in vitiligo.

Vitiligo, an acquired sometimes familial depigmentary disorder of the skin and hair that results from selective destruction of melanocytes or pigment cells. It is the single most important non-neo plastic disease that involves both the immune system and melanocytes which are subsequently destroyed and the affected area turns pale and becomes white. The prevalence of the disease is between 1% and 2% in general population. It is a prospective, randomized, and controlled study. Over 90 vitiligo patients attending Dermatology OPD and vitiligo clinic are enrolled in the study. About 35 apparently healthy, age and sex matched individuals are selected to serve as control. A prescribed proforma containing all the demographic data, relevant questionnaire were recorded for each and every case with brief clinical history suggestive of any thyroid disease as well as those referred by the clinicians. P value <0.05 is considered significant. The Quantitative Determination of Thyroglobulin (Tg) Autoantibodies in Human Serum or Plasma by a Microplate Enzyme Immunoassay. Vitiligo group, thirty four (37.78%) patients have clinical hypothyroidism while 9 (10%) patients have clinical hyperthyroidism. This difference in the distribution is statistically significant (P < 0.05) with a Chi-square value of 10.08. The data are entered, analyzed and computed with SPSS version 15 software and well-known statistical test like Chi-square, students' 't' test have been advocated wherever found applicable. P value <0.05 is considered significant. There is increased incidence of autoimmune thyroid diseases among vitiligo patients. The reason being vitiligo usually precedes the onset of thyroid dysfunction.

SCREENING OF THYROID AUTOANTIBODIES ANTI-TG, ANTI-TPO AND ITS CORRELATION WITH CLINICAL THYROID DISEASES IN VITILIGO IN THE NORTH-EASTERN REGION OF INDIA

Background and aims: Vitiligo is an acquired sometimes familial depigmentary disorder of the skin and hair that results from selective destruction of melanocytes or pigment cells. It is the single most important non-neo plastic disease that involves both the immune system and melanocytes which are subsequently destroyed and the affected area turns pale and becomes white. The precise cause of vitiligo is complex but some evidences are always suggesting that it is caused by a combination of autoimmune, genetic and environmental factors. Over half of the people with vitiligo have acquired some loss of pigment cells before the age of 20 years. The prevalence of the disease is between 1-2% in general population. Therefore, the present study is taken up to evaluate the prevalence of thyroid diseases in vitiligo patients. Methods:It is a prospective, randomized and controlled study. 90 vitiligo patients attending the Dermatology OPD and vitiligo clinic are enrolled in the study. Thirty five apparently healthy, age and sex matched individuals are selected to serve as control. A prescribed proforma containing all the demographic data, relevant questionnaire were recorded for each and every case with brief clinical history suggestive of any thyroid disease as well as those referred by the clinicians.interpretationsare made. P value &lt; 0.05 is considered significant. The Quantitative Determination of Thyroglobulin (Tg) Autoantibodies in Human Serum or Plasma by a Microplate Enzyme Immunoassay. Results:Vitiligo group, thirty four (37.78%) patients have clinical hypothyroidism while 9(10%) patients have clinical hyperthyroidism. This difference in the distribution is statistically significant (P&lt;0.05) with a chi-square value of 10.08. The datas are entered, analysed and computed with SPSS version 15 software and well known statistical test like Chi-square, students t test have been advocated wherever found applicable. The necessary interpretations are made. P value &lt; 0.05 is considered significant. Conclusion:There is increased incidence of autoimmune thyroid diseases among vitiligopatients. Various thyroid antibodies were detected in thyroid disorders, suggesting that these thyroid antibodies could act as sensitive markers for detection of early and subclinical autoimmune disorders of thyroid gland including Graves disease and Hashimotos thyroiditis. The reason beingvitiligo usually precedes the onset of thyroid dysfunction. Therefore, these thyroid autoantibodies specially anti-TPO, anti-TG should be included along with thyroid parameters TSH, T3,T4 in routine investigation of vitiligo, as association of vitiligo with autoimmune thyroid disease is very much common in the North - Eastern region of India.

Urban Air Pollution Associated with the Incidence of Autoimmune Thyroid Diseases.

Background:Endocrine disrupting air pollutants such as sulphur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), fine particle matter (PM2.5), and ozone (O3) can affect thyroid gland function on the level of synthesis, metabolism, and the action of its hormones.Objective:The aim of this study was to establish whether increased air pollution could contribute to an increased incidence of autoimmune thyroid diseases (AITD).Methods:A retrospective analysis was conducted of the medical records of 82000 patients at the University Clinical Centre in Tuzla, Bosnia and Herzegovina. The target group of this study comprised a total of 174 patients from the Lukavac area. Daily data on concentrations of air pollutants were collected from the air quality monitoring station located in Lukavac. The study covered the period from 2015 to 2020.Results:The results of the monitoring confirmed the presence of air pollutants in concentrations above the permitted limits throughout the entire observed period. Concentrations of PM2.5, SO2, NO2, CO, and O3 were in the range of 1.90–431.40 μg/m3, 3.60-620.50 μg/m3, 3.40-66.20 μg/m3, 48.00-7002.00 μg/m3, and 0.70-89.40 μg/m3, with means of 64.08 μg/m3, 77.48 μg/m3, 22.57 μg/m3, 1657.15 μg/m3, and 31.49 μg/m3, respectively. During the six-year period, 174 cases of AITD were registered, of which 150 (86.21%) were women and 24 (13.79%) men. Hashimoto’s thyroiditis was found in 33 patients (18.97%), whilst 141 patients (81.03%) were diagnosed with atrophic thyroiditis. The highest total incidence of autoimmune thyroiditis was recorded in 2017, when it reached 99.49, 95% CI.Conclusion:The effects of chronic exposure to a mixture of air pollutants on the function of the thyroid gland are still not sufficiently well-known, but the numerical tendency towards a higher incidence of AITD in this study, albeit without statistical significance (p>0.05), still underlines the need for additional research.

Possible interplay between estrogen and the BAFF may modify thyroid activity in Graves\u2019 disease

A link between sex hormones and B-cell activating factor (BAFF), a crucial immunoregulator of autoimmune thyroid disease (AITD), may exist. The study aimed to elucidate the role of estrogen (E2) in regulating BAFF in Graves' disease (GD). In clinical samples, serum BAFF levels were higher in women than in men in both the GD and control groups. serum BAFF levels were associated with thyroid-stimulating hormone receptor antibody levels and thyroid function only in women and not in men. BAFF transcripts in peripheral blood mononuclear cells were higher in women with GD than those in the control group. Among GD patients with the AA genotype of rs2893321, women had higher BAFF transcripts and protein levels than men. In the progression of a spontaneous autoimmune thyroiditis (SAT) murine model, NOD.H-2h4, serum free thyroxine and BAFF levels were higher in female than in male mice. Moreover, exogenous E2 treatment increased serum BAFF levels in male SAT mice. Meanwhile, female SAT mice exhibited higher thyroid BAFF transcripts levels than either the E2-treated or untreated male SAT mouse groups. Our results showed that E2 might be implicated in modulating BAFF expression, and support a possible mechanism for the higher incidence of AITD in women.

A preliminary assessment of the impact of women’s susceptibility to Hashimoto's thyroiditis on the occurrence of anxiety and depressive disorders

Aim of the studyThere huge differences in the incidence of autoimmune thyroid diseases between women and men, which is caused by sexual differentiation of the immune system. Hashimoto’s thyroiditis is now one of the most prevalent autoimmune disorders. Its diagnosis is challenging, and its effects on mental health can often impose a greater burden on the patients than physical symptoms. The aim of this study was to make a preliminary assessment of anxiety levels and depressive symptoms in women with diagnosed Hashimoto’s disease.Subject or material and methodsThe study included 205 women with Hashimoto’s thyroiditis. The study consisted of two parts. Part one employed the diagnostic survey method with the use of standardised questionnaires and a proprietary interview questionnaire. Part two involved the analysis of biochemistry parameters in blood serum to determine thyroid status.ResultsThe analysis revealed moderate anxiety levels in women with Hashimoto’s disease. Women with moderate and severe depression were in the minority, while mild depression was observed in 40% of the participants. A statistically significant relationship was demonstrated between state anxiety and TSH level.DiscussionPatients with autoimmune thyroiditis are at risk for the development of depression, social phobia, anxiety disorders and sleep disorders.ConclusionsDepressive symptoms co-occur with anxiety disorders in the group of women with Hashimoto’s thyroiditis. The studied group of patients presented mild depressive symptoms and moderate anxiety disorders. A higher level of state anxiety in the group of women with Hashimoto’s disease is correlated with higher serum TSH. Lower serum FT4 co-occurs with more severe symptoms of depression and anxiety.

Immune mechanisms involved in the coexistence of oral lichen planus and autoimmune thyroid diseases.

Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease with unclear etiology. Autoimmune thyroid diseases (AITD) is a type of autoimmune disease characterized by increased thyroid-specific antibodies. In recent years, more and more studies have found that the incidence of AITD is increased in OLP patients. The occurrence and development of OLP and AITD may be related to the expression of thyroid autoantigen in oral keratinocytes, the imbalance of thyroid hormone （Th）1/Th2 and Th17/Treg cell subsets, the abnormal quantity and function of follicular helper T cells and chemokines and the specific killing ability of CD8 T cells to target cells. In this article, the possible immune mechanisms involved in the coexistence of OLP and AITD are reviewed to provide insights for the diagnosis, treatment and prevention of these two diseases from the perspective of immunology.

Incidence of Autoimmune Thyroid Disease in Patients with Type 1 Diabetes

Incidence of Autoimmune Thyroid Disease in Patients with Type 1 Diabetes

Vitamin D and Autoimmune Thyroid Diseases - a Review.

The essential biological action of vitamin D is regulation of calcium and phosphorus metabolism and preserving bone health. In recent years there have been reports about the extraskeletal actions of vitamin D and its role in the regulation of immune system. Vitamin D supplementation appears to reduce the incidence of cardiovascular diseases, cancer, and infections and be able to reduce all-cause mortality. Deficiency of vitamin D has been found to correlate with the increased incidence of autoimmune diseases, including type 1 diabetes mellitus, rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis. Autoimmune thyroid diseases (AITD), including Graves' disease, Hashimoto's thyroiditis are relatively common autoimmune disorders affecting more than 5% of general population. It has been shown that vitamin D receptors (VDR) and 1-alpha hydroxylase are expressed in papillary thyroid cancer and normal thyroid tissue, suggesting local synthesis of 1,25(OH)2D in the thyroid. While VDR gene polymorphism has been found in much research to be associated with AITDs, very few studies have examined the impact of vitamin D deficiency on the incidence of AITDs in humans with conflicting results. This review focuses on the association between vitamin D and autoimmune thyroid diseases and summarizes the results of vitamin D supplementation studies in patients with AITD.

Radioiodine (RAI) in combination with durvalumab for recurrent/metastatic thyroid cancers.

6587 Background: Immune checkpoint blockade (ICB) has limited efficacy for radioiodine-refractory thyroid cancer. The high incidence of autoimmune thyroid disease and ICB-induced hypothyroidism suggests that loss of T cell tolerance to thyroid protein epitopes is common and can be activated by ICB to induce immune responses. We hypothesize that RAI can enhance presentation of thyroid protein immunogens and putative neoantigens in thyroid cancers to amplify the effectiveness of ICB. We studied the safety and efficacy of RAI plus the anti-PD-L1 agent durvalumab (durva) in recurrent/metastatic (R/M) patients (pts). Methods: Pts. had at least one RAI-avid tumor on the most recent RAI scan or one tumor on FDG PET with an SUVmax &lt; 10. RECIST measurable disease was required. Any number of prior therapies was allowed. Pts were treated with durva 1500 mg IV every 4 weeks with recombinant human TSH (rhTSH)-stimulated RAI (100 mCi) administered in Cycle 1. Treatment beyond progression was allowed. The primary objective was to assess safety. Durva related dose limiting toxicities (DLTs) were monitored for 6 weeks after the first dose. Since no durva DLTs were observed in the first 6 pts, per protocol rules the trial accrued 11 pts total. Secondary objectives were assessing best overall response (BOR) per RECIST and progression-free survival (PFS). Results: 11 pts (7 female) were enrolled. Eight had prior drug therapy. No DLTs or &gt; Grade 3 durva related adverse events (AEs) were observed. The most common non-laboratory AEs (regardless of attribution) were cough (7), hypertension (7), pain (6), edema (5), and fatigue/nausea/diarrhea/arthralgia/dry skin/dyspnea/edema (4 each). As of 2/6/20, 2 had partial response, 7 stable disease, and 2 progression of disease as BOR. Six pts had tumor regression. Four pts received treatment for &gt; 6 months. Six are still on treatment. Analyses of research biopsies (bxs) (8 had pre-treatment bxs, 6 had an additional on-treatment bx) will be presented. Conclusions: Durva plus RAI is safe and well tolerated. The preliminary efficacy signal in this small cohort is promising. Understanding how RAI plus PD-L1 targeting impacts the tumor immune microenvironment may guide how RAI should be evaluated in future ICB trials. Clinical trial information: NCT03215095 .

Gender Differences at the Onset of Autoimmune Thyroid Diseases in Children and Adolescents.

Background: The incidence of autoimmune thyroid diseases (ATD) may vary with the beginning of reproductive function, although few reports differentiate the incidence before and during the onset of puberty, examining gender bias. We analyzed onset of ATD in a pediatric population to assess gender differences in onset age, disease subtype, pubertal status, autoimmune co-morbidity, family history and treatment, focusing on the interaction between gender and pubertal stage.Patients and methods: We retrospectively recorded 382 children and adolescents with ATD. In each patient physical examination was considered. The presence of other associated autoimmune diseases (AAD) and familial predisposition was also recorded.Results: Predominant prevalence was noted in females compared to males (p < 0.001), both in Hashimoto's diseases (HD or HT) and Graves' disease (GD) (p < 0.001). Mean age at diagnosis showed no significant difference between sexes (p > 0.05). A higher prevalence in pubertal subjects was noted compared to prepubertal (p < 0.001, particularly HT in early and GD in late pubertal stage), without sexes difference intra-(prepubertal vs. pubertal) and inter-puberty groups (prepubertal vs. early pubertal vs. late pubertal). Both in HT and in GD, the prevalence of autoimmune associated diseases (AAD) was higher in males compared to females (p = 0.04), with similar distribution according to the pubertal maturation. The familial predisposition was similarly distributed in both genders (p > 0.05) and into pubertal stages (p > 0.05).Conclusions: Females are more prone to develop ATD during puberty, earlier in HT than in GD. The effect of puberty is not different between genders, suggesting the role of additional factors other than hormones. The screening for detection of ATD is recommended in all patients with positive family history and other autoimmune diseases, mostly in males. Considerations of gender in pediatrics could be important to define pathogenic mechanisms of ATD and to help in early diagnosis and clinical management.

Anti-tumour necrosis factor α therapy - Does it increase the risk of thyroid disease or protect against its development?

Tumour necrosis factor α (TNF-α) is a cytokine involved in the pathogenesis of many diseases, primarily those associated with auto-immunisation. Anti-TNF-α drugs are used in the therapy of many of them, such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, psoriasis, or inflammatory bowel disease. TNF-α is also a key factor in the pathogenesis of autoimmune thyroid disease (AITD). The incidence of AITD in people with other autoimmune diseases is increased compared to the general population. Therefore, it would be interesting to find out if anti-TNF-α therapy of other autoimmune diseases could influence the possible development or re-gression of thyroid gland dysfunction, especially AITD. The main aim of the study is to assess the effect of anti-TNF-α therapy used in inflammatory and immunological diseases on thyroid function and the development of AITD. The real impact of anti-TNF-α therapy on the development of AITD remains an open question. The available studies concern the adult population; there are no data regarding this problem in children. Due to the increasing use of anti-TNF-α therapy also in the paediatric population, it seems reasonable to evaluate this subject in this group of patients.

Association between mixture of persistent organic pollutants and thyroid pathologies in a Belgian population

Previous years, the incidence of autoimmune thyroid diseases has increased worldwide. The presence of many pollutants in the environment suspected to be thyroid disruptors may have contributed to the observed increase. Unfortunately, the results from epidemiological studies assessing the association between pollution and thyroid disorders remain inconsistent, maybe due to a nearly complete neglect of the mixture effect. The blood levels of 12 brominated flame retardants, 3 polychlorinated biphenyls, 16 organochlorine pesticides, 7 perfluoroalkyl substances and 16 phenolic organohalogens were measured in 35 hypothyroid and 44 hyperthyroid volunteers and in 160 individuals from the general population designed as controls. Weighted quantile sum (WQS) regressions were performed to compute indexes representing the mixture of POPs, and we assessed the relations with thyroid disorders. Nineteen pollutants were detected in more than 40% of the individuals and were thus included in the WQS indexes. The WQS index was statistically significantly associated with an increased odds of hypothyroidism (odds ratio (OR) = 98.1; 95% CI: 5.51–1747) with the highest weights attributed to PCB 138 (w = 0.210), 3-OH-CB 180 (w = 0.197), 4-OH-CB 146 (w = 0.188), 4’,4-DDE (w = 0.156) while there were no evidence of a relation with increased odds of hyperthyroidism. Given the relative low number of individuals included in the present investigation, standard WQS methodology could not be used, this study should thus be considered as a preliminary, hypothesis-generating study. Nevertheless, these results highlighted the importance of considering the potential effect of chemical mixture when studying endocrine disruptors.

The Role of Cell Growth-Related Gene Copy Number Variation in Autoimmune Thyroid Disease.

Autoimmune thyroid disease (AITD) is a recurrent and refractory clinical endocrine disease. Some studies have shown that the incidence of AITD is not only related to iodine, a kind of environmental factor, but that susceptibility genes also play a crucial role in its pathogenesis. Since research on susceptibility genes is still underway, the aims of this study were to assess the association between copy number variations (CNVs) and AITD, to identify genes related to susceptibility to AITD, and to explore the risk factors in the occurrence of AITD. Blood samples from five AITD patients and five controls from each area were assessed by chromosome microarray to identify candidate genes. The copy number (CN) of the candidate genes and urinary iodine levels were determined in adults, including 158 AITD patients and 181 controls, from areas having different iodine statuses. The cell growth-related genes, glypican 5 (GPC5), B9 domain containing 2 (B9D2), and ankyrin repeat and suppressor of cytokine signaling [SOCS] box-containing protein family 11 (ASB11), were selected as the candidate genes. The distribution of GPC5, B9D2, and ASB11 CNVs in AITD patients and controls was significantly different, and high urinary iodine levels and GPC5 CNVs are risk factors for AITD. There was no significant association between urinary iodine level and CNVs of the candidate genes. High urinary iodine levels and GPC5 CNVs are risk factors for AITD, but an association with the occurrence of AITD was not found.

Raised incidence of autoimmune thyroiditis among females in 2nd, 3rd and 4th decades: a randomized study

Background: Autoimmune thyroid disease (AITD), a mutual organ specific autoimmune disorder is seen mostly in women between 30-50 years of age. The rationale behind the study is to determine increased incidences of auto immune thyroiditis. The objective of the present study was to evaluate the incidence of autoimmune thyroiditis and thyroid dysfunction in healthy females with no previously known thyroid disease, in an urban area.Methods: The study was conducted on female volunteers with no known thyroid disease. 370 subjects among the hospital’s medical and administration personnel were recruited. All underwent thyroid ultrasound (US) and thyroid anti-peroxidase (TPOAb) and anti-thyroglobulin (TgAb) antibodies were measured. Hypoechogenicity and thyroid volume were determined by sonography.Results: the incidence of autoimmune thyroiditis was 23.2% and 20-30 years were most commonly affected (P = 0.008); when including cases of atrophic thyroid, the frequency decreased to 14.7%.Conclusions: The frequency of autoimmune thyroiditis is clearly elevated in the studied population. Further studies are necessary in order to define the increased incidence of autoimmune thyroid disease.

Diabetes Mellitus and Autoimmune Hepatitis: Demographical and Clinical Description of a Relatively Rare Phenotype.

We studied demographic, metabolic, and clinical characteristics of patients with diabetes and autoimmune hepatitis (AIH) from the German/Austrian DPV registry. A total of 139 patients with diabetes and AIH were analyzed and compared to 437 728 patients with diabetes without AIH. The prevalence of AIH in patients with T1DM (44.8/100 000) seems higher than in the general population, the prevalence of AIH in patients with T2DM (23.6/100 000) does not seem to be increased. Patients with T2DM and AIH had a shorter duration of diabetes (p=0.007) and a higher proportion of females (p<0.001) compared to T2DM without AIH. Patients with diabetes (T1DM or T2DM) and AIH required higher insulin doses (p<0.001 and p=0.03, respectively) and showed increased liver enzymes (aspartate transaminase, alanine transaminase, gamma-glutamyltransferase) compared to diabetes patients without (all p<0.001). We detected a lower percentage of patients treated with oral antidiabetic drugs (p=0.01) and a higher percentage of patients treated by insulin in patients with T2DM and AIH (p<0.001) compared to patients with T2DM alone. We observed a higher incidence of autoimmune thyroid disease (AIT) in patients with diabetes (T1DM or T2DM) and AIH (p<0.001) compared to diabetes patients without AIH. AIH seems more frequent in patients with T1DM. Patients with diabetes and AIH require intensification of antidiabetic therapy and seem to have a higher prevalence of AIT.

Autoimmune Thyroid Disorder in Children and Adolescents with Type I Diabetes Mellitus

Background Type one diabetes mellitus (Type 1 DM) is the most common type of diabetes in children and adolescents, arising through a complex interaction of immune, genetic and environmental factors. Autoimmune thyroid disease is the most frequent disorder associated with Type one diabetes mellitus. This study aimed to evaluate incidence of autoimmune thyroid disease in children and adolescents with type I diabetes mellitus. Materials and Methods Cross sectional case control study was made on forty diabetic children with regular attending to the Endocrinology clinic and patients from pediatric ward in Al-Imamain Al-Kadhimain Medical City, Eraq, and forty healthy children matching in aged (1-15 years) and gender were taken as control. History taking, clinical examination, measurement of hemoglobin A1C, serum thyroid peroxidase autoantibodies and serum thyroid stimulating hormone levels were carried out. Serum thyroxine and triiodothyronine were measured. Results Serum thyroid peroxidase antibodies was positive in 15 % of diabetic patients, while it was negative in controls. In those with positive thyroid peroxidase antibodies 100% had subclinical hypothyroidism, 50% had hyperthyroidism. Risk of autoimmune thyroid disease was more in patients older than 5 years and it was neither related to the degree of control of diabetes nor to the duration, but it was more common in females. Conclusion There is higher incidence of autoimmune thyroid disease in children and adolescents with type one diabetes compared with normal children and this risk is not related to duration of diabetes, but it is more common in those older than 5 years. The risk of hypothyroidism is double the risk of hyperthyroidism in these patients.

The autoimmune burden in juvenile idiopathic arthritis

BackgroundJuvenile idiopathic arthritis (JIA) is a chronic inflammatory arthritis of unknown origin which can be considered an autoimmune disease (AD). The aim of this study is to analyse the presence of two or more autoimmune diseases (polyautoimmunity) in patients suffering from JIA and to evaluate the occurrence of ADs in their families.MethodsSeventy-nine patients diagnosed with JIA aged 0–21 years, admitted to the Paediatric Rheumatology Unit, Sant’Orsola-Malpighi Hospital, Bologna were screened for ADs. Parents were asked about the presence of ADs in the living relatives of first and second degree.ResultsTwelve of 79 patients (15.2%) had at least 1 AD associated with JIA. Eight patients (10.1%) suffered from autoimmune thyroid disease (AITD), three patients had celiac disease, three patients suffered from psoriasis, one from alopecia and 1 from insulin-dependent diabetes mellitus. The average age at diagnosis was 13.2 years and the cumulative incidence of AITD was 36%. Seventy-six families were studied for a total of 438 relatives. The prevalence of ADs was 13%, greater in first-degree relatives (16.7%) than in second-degree ones (11.1%). The most common AD was AITD; there was no difference in JIA’s age of presentation between patients with positive and negative familiarity with ADs (p > 0.05).ConclusionChildren and adolescents with JIA present a high autoimmunity burden, most commonly represented by AITD. Familial autoimmunity is not negligible in patients suffering from JIA (almost 50% of patients have at least one relative with an AD) and it should always be carefully examined.