This new paper doesn't add much but at least includes some numbers of prevalence (even if questionable).
2022 Feb 28;dgac089.
doi: 10.1210/clinem/dgac089. Online ahead of print.
Autoimmune Thyroid Disorders in Autoimmune Addison´s Disease
Ann-Elin Meling Stokland 1 , Grethe Ueland 2 , Kari Lima 3 , Kaja Grønning 3 , Trine E Finnes 4 5 , Margrethe Svendsen 6 , Aneta Ewa Tomkowicz 7 , Synnøve Emblem Holte 8 , Stina Therese Sollid 9 , Aleksandra Debowska 10 , Hallvard Singsås 11 , Marthe Landsverk Rensvik 12 , Helle Lejon 13 , Dag-Erik Sørmo 14 , Anders Svare 15 , Sigrid Blika 16 , Petya Milova 16 , Elin Korsgaard 17 , Øystein Husby 18 , Lars Breivik 19 , Anders P Jørgensen 5 , Eystein Sverre Husebye 2 19 20
Affiliations
• PMID: 35226748
• DOI: 10.1210/clinem/dgac089
Abstract
Context: Autoimmune thyroid disease is the most common endocrine co-morbidity in autoimmune Addison's disease (AAD), but detailed investigations of prevalence and clinical course is lacking.
Objective: Provide comprehensive epidemiological and clinical data on autoimmune thyroid disorders in AAD.
Design and patients: A nationwide registry-based study including 442 patients with AAD and autoimmune thyroid disease, identified through the Norwegian National Registry of Autoimmune Diseases.
Results: Of 912 registered AAD patients, 442 (48%) were diagnosed with autoimmune thyroid disease. Three hundred and eighty (42%) had autoimmune hypothyroidism. Of the 302 with available thyroid function tests at time for diagnosis, 20% had overt hypothyroidism, 73% had subclinical hypothyroidism and 7% had thyroid levels in the normal range. Negative thyroid peroxidase antibodies was found in 32%. Ninety-eight percent were treated with levothyroxine, 5% with combination therapy with liothyronine or thyroid extracts, and 1% were observed without treatment. Seventy-eight patients (9%) were diagnosed with Graves' disease (GD), of whom 16 (21%) were diagnosed with autoimmune hypothyroidism either before onset or after remission of GD. At the end of follow-up 33% had normal thyroid hormone levels without antithyroid-drugs or levothyroxine treatment. The remaining had either active disease (5%), had undergone ablative treatment (41%), or had developed autoimmune hypothyroidism (21%).
Conclusion: The true prevalence of hypothyroidism in AAD is lower than reported in current literature. Careful consideration of the indication to start thyroxin therapy is warranted. Long-term remission rates in GD patients with AAD are comparable to recent reports on long-term follow-up of patients without AAD.
Keywords: Autoimmune Addison`s disease; Autoimmune Hypothyroidism; Autoimmune polyendocrine syndromes; Graves` Disease.
