Thyroid-associated orbitopathy is linked to gastrointestinal autoimmunity

Area of Science:

• Endocrinology and Immunology
• Ophthalmology
• Gastroenterology

Background:

• Autoimmune disorders often co-occur and aggregate within families.
• Autoimmune thyroid disease (AITD) encompasses conditions like Graves' disease (GD) and Hashimoto's thyroiditis (HT).
• Thyroid-associated orbitopathy (TAO) is a common complication of AITD, particularly GD.

Purpose of the Study:

• To investigate the prevalence of autoimmune co-morbidities in patients with AITD.
• To compare co-morbidity rates between AITD patients with and without TAO.
• To identify specific autoimmune conditions associated with GD and HT, and their relationship with TAO.

Main Methods:

• Cross-sectional study involving 1310 AITD patients at a tertiary referral center.
• Data collected on co-existing autoimmune diseases, including autoimmune polyglandular syndrome, type 1 diabetes, coeliac disease, autoimmune gastritis, vitiligo, and Addison's disease.
• Statistical analysis, including odds ratios (OR), to determine associations and protective effects of co-morbidities with GD, HT, and TAO.

Main Results:

• Among 1310 AITD patients, prevalent co-morbidities included autoimmune polyglandular syndrome (13.4%), type 1 diabetes (9.8%), and coeliac disease (8.5%).
• Coeliac disease and autoimmune gastritis were positively associated with GD, while type 1 diabetes and Addison's disease were protective for GD (linked to HT).
• In 610 AITD patients with TAO (primarily GD), coeliac disease (94%) and autoimmune gastritis showed significantly higher prevalence and association with TAO.

Conclusions:

• Co-morbid autoimmune conditions are frequent in AITD patients.
• Coeliac disease and autoimmune gastritis are significantly associated with TAO, especially in Graves' disease patients.
• Identifying these co-morbidities is crucial for comprehensive patient management, particularly in those with TAO.