Association between thyroid autoimmune dysfunction and non-thyroid autoimmune diseases.
OBJECTIVE
To assess the prevalence of the association between thyroid autoimmune dysfunction in patients with and without Graves orbitopathy and non-thyroid autoimmune diseases.


METHODS
Retrospective review of the medical records of 254 consecutive patients with thyroid autoimmune disease with (n = 150) and without (n = 104) orbitopathy who had been followed at the same institution by ophthalmologists and general clinicians. All medical records contained information on any systemic diseases of the patients and a detailed description of their eye examinations. The mean follow-up period was 5.25 +/- 4.67 years.


RESULTS
Non-thyroid autoimmune diseases were detected in 24 (9.4%) patients. Type 1 diabetes was the most prevalent non-thyroid autoimmune disease diagnosed in the patients without orbitopathy (7 patients, 6.7%). For the patients with orbitopathy, vitiligo was the most prevalent condition, affecting 6 patients (4%). Other diseases including systemic sclerosis, systemic lupus erythematosus, myasthenia gravis, Sjögren syndrome, and rheumatoid arthritis were seen in a few patients in both groups. The time intervals between the diagnoses of the orbitopathy and the non-thyroid autoimmune disease were highly variable, ranging from none (concomitance of the 2 conditions) to decades.


CONCLUSIONS
The present data show that several non-thyroid autoimmune diseases may be associated with thyroid autoimmune dysfunction. Patients with Graves disease without orbitopathy are likely to develop polyglandular syndrome due to the occurrence of type 1 diabetes. Patients with Graves orbitopathy should be screened for other autoimmune conditions, especially vitiligo.
Cruz
Antonio Augusto Velasco
AA
School of Medicine of Ribeirão Preto, University of São Paulo, Department of Ophthalmology, Otolaryngology, and Head-Neck Surgery, Brazil. aavecruz@fmrp.usp.br
Akaishi
Patrícia Mitiko Santello
PM
Vargas
Márcia Abelin
MA
de Paula
Sheila A
SA
D000328:Adult; D001327:Autoimmune Diseases / Q000150:complications* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D049970:Graves Ophthalmopathy / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies