title: Dermatitis herpetiformis is associated with atrophic but not with goitrous variant of Hashimoto's thyroiditis.
abstract: BACKGROUND
  Dermatitis herpetiformis (DH) is a gluten-sensitive skin disease that is associated with a variety of autoimmune disorders. Several investigations demonstrated an association between DH and autoimmune thyroid disease. However, it has not been shown if DH is associated with atrophic or goitrous variant of Hashimoto's thyroiditis.
  
  
  METHODS
  We investigated a cohort of 41 DH patients (18 male, 23 female) and a control group (11 male, 19 female; sex and age matched healthy volunteers) to find out which variant of Hashimoto's thyroiditis is associated with DH. All patients had thyroid hormones and antibodies measured. In addition to that, thyroid sonography as well as detailed history-taking of previous thyroid disease were performed.
  
  
  RESULTS
  In the control group no individual with elevated levels of thyroid antibodies nor abnormal thyroid hormones nor thyroid atrophy was found. Median thyroid volume in the control group was 11 mL (range 4.8-24.7 mL). However, in nine DH patients (22%) elevated levels of antithyroid microsomal (TM) antibodies were seen (P < 0.01). Three of them had abnormal thyroid hormones (7%). In the group of DH patients a significantly smaller thyroid volume was found (median 8 mL, range 1. 6-25.2 mL; P < 0001). Thyroid atrophy (volume < 4.4 mL) was found in 10 DH patients (24%) of whom 9 were females. All patients with elevated levels of TM antibodies or abnormal thyroid hormones and all patients with a history of previous hypothyroidism had a thyroid volume < 7 mL. Goitrous variant of Hashimoto's thyroiditis was not seen in any of the DH patients.
  
  
  CONCLUSIONS
  Our findings demonstrate that DH is associated with atrophic but not with goitrous variant of Hashimoto's thyroiditis.
authors.affiliation: University of Vienna, Austria. georg.zettinig@akh-wien.ac.at
authors.forename: G
authors.initials: G
authors.lastname: Zettinig
authors.forename: M
authors.initials: M
authors.lastname: Weissel
authors.forename: J
authors.initials: J
authors.lastname: Flores
authors.forename: R
authors.initials: R
authors.lastname: Dudczak
authors.forename: H
authors.initials: H
authors.lastname: Vogelsang
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D001324:Autoantigens / Q000276:immunology; D003874:Dermatitis Herpetiformis / Q000209:etiology*; D005260:Female; D006042:Goiter / Q000150:complications*; D006801:Humans; D007453:Iodide Peroxidase; D033862:Iron-Binding Proteins; D008297:Male; D008875:Middle Aged; D013954:Thyroglobulin / Q000276:immunology; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D013963:Thyroid Hormones / Q000097:blood; D013967:Thyroiditis, Autoimmune / Q000150:complications*; D014463:Ultrasonography
chemical_list: D001324:Autoantigens; D033862:Iron-Binding Proteins; D013963:Thyroid Hormones; D013954:Thyroglobulin; C056658:TPO protein, human; D007453:Iodide Peroxidase