Endocrine Abstracts (2008) 15 P385

Risk of co-existing autoimmune diseases in 3309 index cases with auto-immune thyroid disease and their relatives

Kristien Boelaert, Paul Newby, Matthew Simmonds, Jackie Carr-Smith, Joanne Heward, Stephen Gough & Jayne Franklyn

Division of Medical Sciences, The Medical School, University of Birmingham, IBR Building 2nd floor, Birmingham, UK.

Autoimmune thyroid diseases (AITD), Graves’ disease (GD) and Hashimoto’s thyroiditis (HT) are common, but there is limited information on the prevalence of co-existing auto-immune diseases (AID). We prospectively collected 3309 patients with AITD and determined prevalences of other autoimmune diseases in index cases and relatives. Overall, 10.3% of 2806 GD patients and 18.1% of 503 HT subjects reported a co-existing AID. Rheumatoid arthritis was the commonest AID in GD (3.17%) and HT (4.17%, P=NS). Addison’s disease (0.29% vs 2.98%, P<0.001), pernicious anemia (1.43% vs 3.98%, P=0.005) and vitiligo (2.58% vs 0.89%, P=0.015) were more common in HT than GD. Type1 diabetes (2.74% vs 0.77%, P=0.01) and coeliac disease (1.07% vs 0.89%, P=0.015) were more prevalent in female than male GD patients. In HT index cases Addison’s disease was more common in males (4.35% vs 2.76%, P<0.001), with higher rates for pernicious anaemia (4.61% vs 0%, P=0.005) and vitiligo (2.76% vs 1.45%, P=0.011) in females. All AIDs examined were more common in patients with AITD than UK prevalence rates, especially Addison’s disease (RR in GD: 32.3, P<0.001; HT: 331.1, P<0.001), rheumatoid arthritis (5.76, P<0.001; 7.58, P<0.001) pernicious anaemia (11.2, P<0.001; 30.6, P<0.001) and lupus (19.6, P<0.001; 30.6, P<0.001). Mothers of GD and HT subjects were reported to have thyroid dysfunction in 17.4% and 23.5% of cases. Mothers of GD patients were more likely to report hyperthyroidism than those of HT (8.84% vs 4.37%, P<0.001); both mothers and fathers of HT reported hypothyroidism more commonly than hyperthyroidism (19.1% vs 8.59%, P<0.001) and 4.17% vs 1.14%, P<0.001). Parents of index cases had increased RR for all AIDs including thyroid. Prevalences of thyroid dysfunction in siblings revealed markedly high lamda s values for brothers of female (9.61) and male (11.36) GD patients and for brothers of female (11.52) and male (16.72) HT subjects.

Conclusion: AITD patients and their parents are at increased risk of co-existing autoimmune diseases; brothers of AITD subjects are particularly likely to have thyroid dysfunction.

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