Graves

Kacem Akid Faten Haj; Salah Raida Ben; Siddiqa Soomauroo; Missaoui Abdel Mouhaymen; Sarra Chouaib; Sameh Marzouk; Nadia Charfi; Zouheir Bahloul; Mohamed Abid

doi:10.1530/endoabs.90.EP1028

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Endocrine Abstracts (2023) 90 EP1028 | DOI: 10.1530/endoabs.90.EP1028

ECE2023 Eposter Presentations Thyroid (128 abstracts)

Graves’ disease and autoimmune bullous dermatosis

Faten Haj Kacem Akid ¹ , Raida Ben Salah ² , Siddiqa Soomauroo ¹ , Abdel Mouhaymen Missaoui ¹ , Sarra Chouaib ¹ , Sameh Marzouk ² , Nadia Charfi ¹ , Zouheir Bahloul ² & Mohamed Abid ¹

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¹Hedi Chaker University Hospital, Department of Endocrinology, Sfax, Tunisia, ²Hedi Chaker University Hospital, Department of Internal Medicine, Sfax, Tunisia

Introduction: Autoimmune bullous dermatoses (ABD) represent a heterogeneous group of AIDs that target different epidermal or subepidermal proteins of the skin and/or mucous membranes. As with any autoimmune disease (AID), it may be associated with other AIDs. We report a case of ABD associated with Graves’ disease (GD).

Observation: The ABD was a pemphigus vulgaris (PV) that was diagnosed at the age of 25 years in our patient and she was treated with corticosteroid therapy. After 19 years, in the course of the disease, she developed hyperthyroidism. clinical examination revealed a firm goiter and bilateral exophthalmos. Anti-thyroid antibodies (ATA) were positive as well as TSH receptor antibodies. The diagnosis of GD was retained and she was managed with radioactive iodine therapy with a good clinical course and obtaining biological hypothyroidism after 6 months. our patient also benefited from an HLA typing test which showed : HLA_AB:A1, A white, B17, B40(BW4,BW6).

Discussion/Conclusion: Pemphigus is a rare condition, usually affecting patients aged 50-60 years. Pemphigus vulgaris is the most common form (80% of cases). The association of pemphigus with other AIDs has long been reported and can affect up to 25% of patients. The most frequently reported AITs in association with pemphigus are autoimmune thyroid disease (AITD), rheumatoid arthritis, myasthenia and systemic lupus erythematosus. A higher prevalence of ATAs in patients with pemphigus vulgaris compared to healthy subjects is described (2.5% vs 1.2%). Hashimoto’s thyroiditis is the AITD most associated with pemphigus vulgaris according to the literature.