The old adage about public transport – you wait ages for a bus then three turn up at once – appears to also hold true with regards autoimmune disorders. Whilst no-one ‘waits’ to get one, once one autoimmune disease is diagnosed it is likely that more may also present.
A number of thyroid conditions, including Graves’ disease and Hashimoto thyroiditis, are known to be autoimmune in nature so it is clear why medical professionals wanted to explore associations between the two types of conditions.
Interestingly, researchers from dermatology departments at The Catholic University of Korea in Suwon, have found that – in addition to there being clear links, people with certain types of autoimmune alopecia may be more likely to develop thyroid conditions.
Nationwide Korean study
The results of a nationwide Korean ‘population-based, cross-sectional study’ was published on 17th September 2018 in the Journal of Dermatology via the Japanese Dermatological Association.
Information on the patients studied was taken from the Korea National Health Insurance claims database. It involved those professionally diagnosed with Alopecia Areata (that causes patchy hairloss of the scalp only), Alopecia Totalis (where the head becomes bald and there is often facial hair loss, such as eyebrows and eyelashes falling out) and Alopecia Universalis (total baldness from head to toe). These were split into two sub-groups: a mild to moderate AA group comprising Alopecia Areata patients only, and a severe AA group consisting of those with Alopecia Totalis or Alopecia Universalis.
A control group without Alopecia Areata was also established whereby patients were matched to the Alopecia Areata groups participants by age and gender.
Researchers outlined their findings in the published paper, noting ‘significant associations’ between Alopecia Areata and overt thyroid diseases. The team discovered that patients with a confirmed diagnoses of any kind of Alopecia Areata were more likely to develop Graves’ disease or Hashimoto thyroiditis than those without. Furthermore, those in the severe AA group – those with Alopecia Totalis or Alopecia Universalis – were found to have a stronger increased risk of developing either of these thyroid conditions.
Those with scalp-only Alopecia Areata were found to have an risk of odds ratio [OR], 1.415; 95% confidence interval [CI], 1.317–1.520 for Graves’ disease and OR, 1.157; 95% CI, 1.081–1.237 for Hashimoto thyroiditis.
Those with Alopecia Totalis or Alopecia Universalis registered even more prone, with statistics provided as OR, 1.714; 95% CI, 1.387–2.118 for Graves’ disease and 1.398; 95% CI, 1.137–1.719 for Hashimoto thyroiditis.
What are autoimmune disorders?
The immune system protects our bodies from infection and disease. If there are issues with the normal functioning of this system – either over-activity or under-activity – then health issues can arise.
Where there is under-activity or low activity, this immune deficiency may reduce the body’s ability to fight infections, leaving those affected more vulnerable to illness.
Where there is over-activity, autoimmune diseases may occur but the specific reason as to why remains a mystery. This involves the body attacking its tissues and cells; in the case of Alopecia Areata it is the hair follicles which are targeted in various hair bearing areas of the head and body, depending on the phenotype.
Mild to moderate Alopecia Areata, the form which causes rounded bald patches to the scalp only, currently has the most effective treatment options available. Whilst Alopecia Totalis and Universalis treatments are generally considered to have low success rates, there are a number of novel therapies currently in development, with the backing of the USA’s Food and Drug Administration (FDA), and it is currently hoped that effective remedies for these more severe iterations may be available by 2022.
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