AJM onlineClinical research studyPrevalence and Relative Risk of Other Autoimmune Diseases in Subjects with Autoimmune Thyroid Disease
Section snippets
Materials and Methods
We designed the protocol for our national UK collection of DNA for studies of genetic susceptibility to autoimmune thyroid diseases14, 15, 16 to include prospective and systematic collection of clinical data, including information regarding the coexistence of other common autoimmune disorders in index cases and their parents. Patients were recruited between February 2002 and July 2007.
The study cohort (n = 3286) comprised 2791 Caucasian subjects with Graves' disease (2317 female/474 male) and 495
Results
Some 9.67% of the 2791 subjects with Graves' disease and 14.3% of the 495 patients with Hashimoto's thyroiditis had another autoimmune disorder (P = .005). Among index cases with Graves' disease and Hashimoto's thyroiditis, rheumatoid arthritis was most common (Table 2A,B). There were higher prevalences of Addison's disease (10-fold higher, P < .001) and pernicious anemia (3-fold higher, P = .004) in those with Hashimoto's thyroiditis, when compared with subjects with Graves' disease. There were no
Discussion
We have quantified the risk of coexisting autoimmune diseases in more than 3000 index cases with well-characterized Graves' disease or Hashimoto's thyroiditis. Rheumatoid arthritis was the most prevalent coexisting autoimmune disease in subjects with autoimmune thyroid disease and in their parents. We demonstrated high relative risks for the diagnosis of several organ-specific autoimmune disorders, including pernicious anemia, Addison's disease, and celiac disease. There were quantitative
Conclusions
Overall, our data provide strong evidence of significantly increased risks of coexisting autoimmune diseases in subjects with autoimmune thyroid disease. Given the strikingly increased relative risks for other autoimmune diseases compared with the general UK population, as well as the nonspecific symptoms and thus well-documented frequent delay in diagnosis of these disorders,32, 33 we propose that a low threshold for screening for these diagnoses should be used. This applies especially to
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Funding: The study was supported by the Wellcome Trust. The study sponsor had no role in the study design; the collection, analysis, or interpretation of the data; the writing of the report; or the decision to submit the paper for publication.
Ethical Approval: The study was approved by a Multi Center Research Ethics Committee and corresponding Local Ethics Research Committees.
Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript. The corresponding author had full access to all the data in the study and had final responsibility for submission for publication.