Coexistent findings of renal glomerular disease with Hashimoto's thyroiditis

Gülay Koçak1, Bülent Huddam, Alper Azak

  • 1Department of Nephrology, Ankara Education and Research Hospital, Ankara, Turkey. gulaykad@hotmail.com

Clinical Endocrinology
|November 24, 2011
PubMed

Insights

Hashimoto's thyroiditis (HT) is linked to various glomerular diseases, with membranous glomerulonephritis (MGN) and focal segmental glomerulosclerosis (FSGS) being most common. Renal involvement in HT does not correlate with thyroid hormone levels.

Area of Science:

  • Nephrology
  • Endocrinology
  • Autoimmune Diseases

Background:

  • Hashimoto's thyroiditis (HT) is a prevalent autoimmune thyroid condition with a higher incidence in females.
  • Renal involvement is a recognized, though not uncommon, complication of HT.

Purpose of the Study:

  • To determine the frequency and characteristics of glomerular diseases in patients with HT.
  • To explore potential shared pathogenic mechanisms between HT and glomerular diseases.

Main Methods:

  • Retrospective review of 28 HT patients with renal issues (hematuria, proteinuria, renal impairment) from 2007-2011.
  • Standard laboratory tests, 24-hour urine protein analysis.
  • Renal biopsies in 20 patients analyzed via light microscopy and immunofluorescence.

Main Results:

  • Identified FSGS (4), MGN (4), MCD (2), IgAN (3), CGN (3), and amyloidosis (1).
  • Three biopsies showed nonspecific findings.
  • Urinary protein excretion and GFR were not associated with thyroid hormone or autoantibody levels.

Conclusions:

  • Glomerular pathologies in HT patients mirror those in the general population.
  • Membranous glomerulonephritis (MGN), focal segmental glomerulosclerosis (FSGS), and IgA nephritis (IgAN) are the most frequent glomerular lesions observed in HT.
Abstract

Related Concept Videos

Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
Goiter01:27

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...