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Katharina A. Ponto, George J. Kahaly, Susanne Pitz, Alireza Mirshahi, Norbert Pfeiffer; Prevalence of Autoimmune Disorders in Thyroid Associated Orbitopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1266.
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To determine the prevalence of autoimmune diseases (endocrine and non-endocrine) in patients with Graves’ disease without (GD) and with thyroid associated orbitopathy (TAO).
A total of 878 consecutive patients with TAO (N=614, 69.9%) and GD (N=264, 30.1%) were included in this retrospective cross-sectional study. All patients were carefully followed at the university joint thyroid-eye-clinic with complete ophthalmic and thyroid investigations. Precise demographic and medical information as well as detailed descriptions of their objective eye findings were available in the record files of all patients.
The groups of patients with TAO and with GD consisted of 102 (16.6%) and 50 (18.9%) males and of 512 (83.4%) and 214 (81.1%) females, respectively. Mean age was 48.6 ± 0.6 (SE) years in patients with TAO and 40.4 ± 0.2 years in the GD group. Non-endocrine autoimmune diseases were detected in 86 (32.6%) and in 138 (22.5%) patients with GD and TAO, respectively (P=0.002). An autoimmune polyglandular syndrome was present in 27 (10.2%) patients with GD and in 38 (6.2%) patients with TAO as type 1 diabetes was less prevalent in patients with TAO (n=38, 6.2%) in comparison to the GD group (n=24, 9.8%, P=0.006). In contrast, chronic autoimmune gastritis was more frequently detected in patients with TAO (n=88, 14.3%) vs. in those with GD (n=9; 3.5%, P<0.001). The same holds true for celiac disease with n=66, 10.7% in patients with TAO versus n=5, 2.2%, P<0.001 in patients with GD. Myasthenia gravis (n=6, 1%) was detected in patients with TAO exclusively, whereas vitiligo (n=9, 3.5%) and rheumatoid arthritis (n=7, 2.7%) were solely present in patients with GD (p<0.001, respectively).
There is a high prevalence of concomitant autoimmune diseases in patients with Graves’ disease with the rate of non-endocrine autoimmune disorders being higher in patients with associated orbitopathy. Particularly, patients with TAO should be screened for the presence of coexisting autoimmune gastrointestinal diseases.
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