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Autoimmune Thyroid Disorders in Autoimmune Addison´s Disease

helvella profile image
helvellaAdministratorThyroid UK
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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.

pubmed.ncbi.nlm.nih.gov/352...

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Rapunzel profile image
Rapunzel

Talk about a tangled web, helvella. I think this is all the same malarkey, pretty much all of it, Just presents in different ways in different people. My GP has just taken the easiest (as far as he's concerned) route. I test regularly for diabetes. I might just have a go at ruling out Addison's with its amazingly similar symptoms ( weight loss excluded...however I was losing weight before I got 'diagnosed'...cue 4 stones weight gain on levo)

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