PREVALENCE OF OTHER AUTOIMMUNE DISEASES IN PACIENTS WITH AUTOIMMUNE THYROID DISEASE

Student: Halip(Asofronie) GeorgianaCoordinator: Sef lucrari Pop-Radu Corina Cristina

Department of Endocrinology Targu Mures

AUTOIMMUNITY

• Disbalance of the immune system• Global growing incidence• Among the leading causes of death in young

and middle-aged women

AUTOIMMUNE THYROID DISEASES

Genetic, environmental and immunological factors

T cell mediated autoimmune process

TSH receptor, peroxidase,thyroglobulin

Most common organ-specific autoimmune diseases

Prevalence: 500 per 100.000 persons

Autoimmune Autoimmune

hypothyroidism hyperthyroidism

Classification

Hashimoto

thyroiditis

Basedow-Graves disease

TSH TSH T3, T4 T3,T4 TPO AB TRAB

Diagnosis

Disbalance in the immune system Unable to recognize self tissues Tissues tagged as non-self Autoantibodies attack or direct distruction

Autoreactivity is present in all individuals but it doesn’t necessary imply pathogenic responses

AUTOIMMUNE DISEASES

Autoimmune diseases tend to coexist in the same pacients

Tendency mostly seen in organ specific autoimmune diseases

Genetic evidences – some genes are responsible for more autoimmune diseases

Jan 2011

Dec 2013

Retrospective study

407 pacients with TAD

Department of endocrinology

Sex distribution

females males0

50

100

150

200

250

300

350

349

58

Mean ages

females males47.5

47.6

47.7

47.8

47.9

48

48.1

48.2

48.3

48.4

48.5

47.8825214899713

48.5

Pacients without other AID

92%

Pacients presenting other AID8%

Prevalence of other autoimmune diseases

Women without an AiD as-sociated92,6%

Women with an AiD asso-ciated7,4%

AiD prevalence in women

90%

10%

Prevalence of other AiD in men

Males without an AID associated Males with an AID associated

0

1

2

3

4

5

6

7

8

1

4 4

1

2

3

2

1 1 1 1 1 1 1 1

7

Coexisting autoimmune diseases

Autoimmune diseases found in women with ATD

Sjog

ren

synd

rom

e

Diabe

tes m

ellit

us ty

pe I

Psor

iazis

Autoi

mm

une

hypo

phys

itis

Mia

sten

ia G

ravis

Vitilig

o

Rheum

atoi

d ar

tritis

Celia

c di

seas

e

Autoi

mm

une

trom

bocy

tope

nia

Scle

rode

rma

Autoi

mm

une

cirrh

osis

Antip

hosp

holip

idic

synd

rom

e

Syst

emic

lupu

s er

ytem

atos

us

Vascu

litis

Polim

yosit

is

Addiso

n di

seas

e0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

1

2

3

1

2

3

2

1 1 1 1 1 1 1 1

4

Diabetes mellitus type I Psoriasis Addison disease0

0.5

1

1.5

2

2.5

3

3.5

2

1

3

5,17%

3,44%

1,72%

Autoimmune diseases found in men with ATD

The sex distribution shows a female prevalence for ATD The mean age showed no significant difference

women/men Study – 16 associated AiD The most prevalent coexisting AiD in subjects with ATD

was Addison’s disease (HLA-DR3/DR4 correlation, AD pattern)

The other AiD following Addison’s disease in prevalence were DM type I and psoriasis (Studies regarding autoimmune correlations, demonstrated a high interrelationship between ATD and DM type I: 2,9-3,2 % in adults and 19-23,4% in children <Kakleas 2009> )

There were major differences in the associated AiD in men and women. The women were affected by more different AiD(all 16 AiD), meanwhile in men were reported only 3 other AiD associated(Addison d., psoriasis and DM I)

There weren’t AiD found exclusively in men

Discussions

Assessing the fact that in general population the prevalence of autoimmune diseases is smaller (5,3%) and includes the autoimmune thyroid diseases who are on a high prevalence, we can conclude that in pacients with a thyroid autoimmune disease, other autoimmune diseases are more frequent associated(p=0,02)

Autoimmune thyroid diseases aprear more frequently in women

Associated autoimmune diseases appear more frequently in men who were affected by a thyroid autoimmune disease.

Conclusions

Thank you very much for paying attention!