Harmony and complexity: unveiling the multifaceted nature of multiple autoimmune syndrome

Salah Raida Ben; Siddiqa Soomauroo; Faten Hadjkacem; Abdelmuhaymen Missaoui; Auckburally Ahmad Ridwaan; Wiem Feki; Mouna Mnif; Sameh Marzouk; Mohamed Abid; Nabila Rekik; Zouheir Bahloul

doi:10.1530/endoabs.99.EP574

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Endocrine Abstracts (2024) 99 EP574 | DOI: 10.1530/endoabs.99.EP574

ECE2024 Eposter Presentations Thyroid (198 abstracts)

Harmony and complexity: unveiling the multifaceted nature of multiple autoimmune syndrome

Raida Ben Salah ¹ , Siddiqa Soomauroo ² , Faten Hadjkacem ² , Abdelmuhaymen Missaoui ² , Ahmad Ridwaan Auckburally ³ , Wiem Feki ³ , Mouna Mnif ² , Sameh Marzouk ¹ , Mohamed Abid ² , Nabila Rekik ² & Zouheir Bahloul ¹

Err

Author affiliations

¹Hedi Chaker University Hospital, Department of Internal Medicine, Sfax, Tunisia; ²Hedi Chaker University Hospital, Department of Endocrinology, Sfax, Tunisia; ³Hedi Chaker University Hospital, Department of Radiology, Sfax, Tunisia

Introduction: Despite being organ-specific autoimmune diseases (AID), autoimmune thyroid diseases (AITD) may be associated with other AIDs either specific to other organs or systemic. These associations are not uncommon. They may be grouped in the form of an autoimmune polyendocrinopathy or multiple autoimmune syndrome (MAS). MAS is defined by the presence in the same person of at least three AIDs.

Patients and Methods: It is a retrospective study over a period of 18 years of patients with AITD associated with another type of AID. The aim of this study was to describe the characteristics of MAS in this population.

Results: one hundred and thirteen cases were collected. A female predominance was observed with a sex ratio (F/M) of 3.52. The average age at the diagnosis of thyroid dysfunction was 38.22 years. The etiology of the AITD was predominantly Hashimoto’s thyroiditis (69 patients), followed by Graves’ disease (19 patients). In each patient with thyroid disorder, one or more AID were found: 17 types of AIDs distributed into 10 organ-specific AID and 7 systemic AID. The AITD was the primary presenting condition in 35 cases (26.51%), diagnosed concomitantly with another AID in 40 cases (30.3%), and preceded by an AID in 54 cases (40.92%). In our study, we collected 11 patients who presented with a MAS. They were all female. Two of them presented with a MAS type 2 and the 9 others were of type 3. A Hashimotos’ thyroiditis was diagnosed in all the cases.

Conclusion: This syndrome was described by Humbert and Dupond¹ in 1988 as the association of at least three AIDs in the same patient. There are 3 types depending on associated pathologies. Family history, genetic, infectious, immunological and psychological factors have been implicated in the development of MAS. Generally, one of the autoimmune disease associated in the MAS, is a skin disease, such as psoriasis or vitiligo. According to the literature, vitiligo is the first AID to be diagnosed during the course of MAS associated with an autoimmune thyroid disease in the majority of cases.

Reference: 1. Humbert P, Dupond JL. Les syndromes auto-immuns multiples. Ann Med Interne. 1988;139:159-68.