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The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases

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Abstract

Purpose

Graves’ disease (GD) can present as an isolated disease (iGD) or in association with other autoimmune diseases (aGD). The aim of this study, performed in two Endocrine referral centers settled in different geographical areas of Italy, was to compare the anthropometric, clinical, and biochemical phenotype of iGD patients with that of the aGD ones.

Methods

Clinical history, physical examination data, serum levels of TSH, FT4, FT3, thyroglobulin (TgAb), thyroid-peroxidase (TPOAb) and TSH-receptor (TRAb) antibody, presence of Graves’ orbitopathy (GO), and thyroid ultrasound examination at disease diagnosis were recorded.

Results

68 aGD and 136 iGD patients were consecutively recruited. At diagnosis, aGD and iGD patients did not differ for F/M ratio, age at presentation, thyroid function parameters, serum levels of TRAb, TgAb, TPOAb, presence of GO, and thyroid volume. The serum levels of TRAb were strongly correlated with the circulating concentrations of both FT3 (ρ = 0.667; p < 0.0001) and FT4 (ρ = 0.628; p < 0.001) in iGD patient, but not in the aGD ones (FT3: ρ = 0.231; p = 0.058; FT4: ρ = 0.096; p = 0.435). Compared with iGD patients, the aGD ones displayed a higher rate of transition from the previous hypothyroidism to hyperthyroidism (χ2 = 6.375; p = 0.012).

Conclusion

Despite similar anthropometric, clinical, and biochemical features at diagnosis, aGD patients display a higher rate of transition from a thyroid functional status to the other as compared with iGD patients.

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This paper was not supported by any grant or funding.

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Authors and Affiliations

  1. Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, Via S. Maugeri 4, 27100, Pavia, Italy

    M. Rotondi, S. Pinto, F. Coperchini, L. Croce & L. Chiovato

  2. Endocrinology Unit, Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, Latina, Italy

    C. Virili & M. Centanni

  3. Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy

    L. Croce & L. Chiovato

  4. Department of Medical and Surgical Sciences and Biotechnology, Sapienza University of Rome, Rome, Italy

    N. Brusca

  5. Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy

    N. Brusca

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  1. M. Rotondi
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  2. C. Virili
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  3. S. Pinto
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  4. F. Coperchini
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  5. L. Croce
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Correspondence to L. Chiovato.

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Formal approval by the ethical committee was not required in accordance with the Italian regulation for non-interventional (observational) retrospective studies concerning human beings (AIFA Guidelines for Observational Studies, see www.AIFA.gov).

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Rotondi, M., Virili, C., Pinto, S. et al. The clinical phenotype of Graves’ disease occurring as an isolated condition or in association with other autoimmune diseases. J Endocrinol Invest 43, 157–162 (2020). https://doi.org/10.1007/s40618-019-01094-7

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  • DOI: https://doi.org/10.1007/s40618-019-01094-7

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