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
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
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
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