Otoimmün Tiroid Hastalıklarıyla Birlikte Seyreden Otoimmün ve Allerjik Hastalıklar

Coexistence of Autoimmune and Allergic Diseases with Autoimmune Thyroid Diseases

Özet

Amaç: OTH için takipteki hastalardaki diğer otoimmün/ alerjik hastalıkları araştırmakGereç ve Yöntemler: Çalışma boyunca tanı konulan ya da takip altındaki 274 Hashimoto Tiroiditi (HT) ve 53 Graves' hastalığı (GH) hastası çalışmaya dahiledildi. Tüm hastalardan anamnez alınıp hastalar muayene edildikten sonra otoimmün /allerjik hastalıklar için şüphede olunanlara ek tetkik yapıldı. Bulgular: 65 (23.8%) HT hastası ve 7 (13.2%) GD hastasının ek olarak en az bir klinik otoimmün/allerjik hastalığı mevcuttu. HT hastalarında hastalıklarındağılımları: 28 (10.2%) gastrointestinal (kronik atro?k gastrit, çölyak hastalığı, vb), 19 (6.6%) allerjik (astım, kronik ürtiker, rinosinüzit), 12 (4.4%) romatolojik (romatoid artrit,vb), 10 (3.7%) cilt (vitiligo, psöriazis, vb), 4(1.5%) endokrinolojik (hipoparatiroidi, tip1 diabetes mellitus, hipo?zit), 1(0.4%) hematolojik (idiopatik trombositopenik purpura), 1(0.4%) renal (kresenterik glomerulonefrit) şeklindeydi. GD grubunda bu dağılım benzerdi. Ek olarak, 50(18.2%) HT hastasında ve1(1.9%) GD hastasında vitamin B12 eksikliği anemisi mevcuttu (p=0.001). 28 (10.2%) HT ve 1 (1.9%) GD hastasında dimor?k (vitamin B12 ve demir eksikliği birlikte) anemi mevcuttu.Tartışma: OTH hastaları ek otoimmün/allerjik hastalıklara yatkındırlar ve söylenebilir ki otoimmün nedenli tiroid hastalığı olanlarda sadece tiroid hastalığıyoktur. Her iki tip OTH'nda da en çok tutulan organ sistemi gastrointestinal sistemdir. Muhtemelen bu tutulum özellikle HT hastalarında hem vitamin B12hem demir eksikliğine neden olup anemiye yol açarak bazı semptomların artışına sebep olmaktadır

Abstract

Purpose: To document the other autoimmune/allergic disorders in patients during follow-up for ATDs. Materials and Methods: During the study period, 274 patients diagnosed with, and/or at follow-up for Hashimoto’s thyroiditis (HT), and 53 with Graves’ disease (GD) were included in the study. All the patients were examined and were subjected to further investigations when the presence of other autoimmune/allergic diseases was suspected.Results: A total of 65 patients with HT (23.8%) and seven patients with GD (13.2%) had at least one additional clinical autoimmune/allergic disorder. Twentyeight (10.2%) patients with HT had gastrointestinal disorders (chronic atrophic gastritis and celiac disease), 19 (6.6%) had allergies (asthma, chronic urticaria, and rhinosinusitis), 12 (4.4%) had rheumatological disorders (rheumatoid arthritis), 10 (3.7%) had skin problems (vitiligo and psoriasis), four (1.5%) hadendocrinological disorders (hypoparathyroidism, type–1 diabetes mellitus, and hypophysitis), one (0.4%) had hematological disease (idiopathic thrombocytopenic purpura), and one (0.4%) had renal disorder (crescentic glomerulonephritis). The prevalence patterns were similar in the patients with GD. Inaddition, 50 (18.2%) patients with HT and one (1.9%) with GD were observed to have vitamin B12 decient-anemia (p=0.001). Furthermore, 28 (10.2%) patients with HT and one (1.9%) with GD had dimorphic anemia (both vitamin B12 and iron deciencies).Discussion: The patients with ATDs are prone to additional autoimmune/allergic diseases, and it can be said that the patients with autoimmune thyroid diseases sometimes have more than just thyroid disease. The most involved organ system in both HT and GD is the gastrointestinal tract. This involvementprobably plays a role in the exacerbation of some symptoms by causing anemia resulting from a deciency of both vitamin B12 and iron, especially in patients with HT