1/9. Subcutaneous sarcoidosis associated with vitiligo, pernicious anaemia and autoimmune thyroiditis.We report a patient with pernicious anaemia, primary autoimmune hypothyroidism and vitiligo, who presented with subcutaneous nodules. Histopathology of the nodules revealed noncaseating granulomas, consistent with a diagnosis of sarcoidosis. Mild pulmonary sarcoid was also detected. Although an association between sarcoidosis and other autoimmune diseases is well-recognized, the presence of the particular autoimmune diseases in our patient and the involvement of subcutaneous fat in the sarcoidal inflammation, appears to represent a most unusual clinicopathological combination.- - - - - - - - - - ranking = 1keywords = thyroiditis (Clic here for more details about this article) |
2/9. Slowly progressive type 1 diabetes mellitus associated with vitiligo vulgaris, chronic thyroiditis, and pernicious anemia.A 81-year-old woman was diagnosed as having diabetes mellitus (DM) at 58 years of age. She started insulin therapy the following year, but her blood sugar levels were poorly controlled. At the age of 75, she tested positive for the anti-GAD antibody (7.8 U/ml) and was diagnosed as having slowly progressive type 1 DM (SPIDDM), as well as vitiligo vulgaris. At 78 years of age, chronic thyroiditis was diagnosed after positive tests for anti-thyroid peroxidase antibody and anti-thyroglobulin antibody. At the age of 81, general fatigue and jaundice appeared concomitantly with severe anemia, with Hb levels at 5.2 g/dl. Low serum vitamin B12 levels and the finding of erythroblastic hyperplasia with megaloblasts in bone marrow led to the diagnosis of pernicious anemia. anemia was alleviated by intramuscular injections of vitamin B12. The patient developed chronic thyroiditis, vitiligo vulgaris, and pernicious anemia concomitantly with SPIDDM, and was diagnosed as having polyglandular autoimmune syndrome type III. attention should be paid to these potentially associated autoimmune diseases in daily practice during the follow-up of SPIDDM patients.- - - - - - - - - - ranking = 1.5keywords = thyroiditis (Clic here for more details about this article) |
3/9. Coexistence of megaloblastic anemia and iron deficiency anemia in a young woman with chronic lymphocytic thyroiditis.Pernicious anemia is a megaloblastic anemia caused by vitamin B12 deficiency, and is the end-stage of autoimmune gastritis that typically affects persons older than 60 years. It is the most common cause of vitamin B12 deficiency. Pernicious anemia can also be diagnosed concurrently with other autoimmune diseases. We report the occurrence of megaloblastic anemia in a 22-year-old woman with chronic autoimmune thyroiditis for 10.5 years. Recently, she presented with microcytic anemia, and iron deficiency anemia was diagnosed initially. After administration of ferrous sulfate, macrocytic anemia was revealed and vitamin B12 deficiency was detected. Pernicious anemia was highly suspected because of the endoscopic finding of atrophic gastritis, and high titer of antigastric parietal cell antibody, as well as elevated serum gastrin level. After intramuscular injections of hydroxycobalamine 100 microg daily for 10 days, and monthly later, her blood counts returned to normal.- - - - - - - - - - ranking = 1.25keywords = thyroiditis (Clic here for more details about this article) |
4/9. insulin-dependent diabetes mellitus, myasthenia gravis, pernicious anaemia, autoimmune thyroiditis and autoimmune adrenalitis in a single patient.Two classical autoimmune polyendocrine deficiency syndromes with heritable tendencies are described, Type 1 diabetes mellitus being associated with the Type 2 polyendocrine deficiency syndrome (Schmidt's syndrome). A man with Type 1 diabetes mellitus is described who developed an unusual combination of five autoimmune conditions (myasthenia gravis, Addisonian pernicious anaemia, adrenalitis and thyroiditis) which did not fit into the Type 1 or Type 2 classical polyendocrine deficiency syndromes. This suggests that the autoantibody, biochemical and haematological screening of affected individuals and their relatives should be extended to anticipate a wider range of potential autoimmune conditions.- - - - - - - - - - ranking = 1.25keywords = thyroiditis (Clic here for more details about this article) |
5/9. Pernicious anemia and giant cell myocarditis. New association.The association of pernicious anemia, an autoimmune disease, with other immunologic disorders such as dermatitis herpetiformis, Hashimoto's thyroiditis, hypothyroidism, hyperthyroidism, vitiligo, adrenal insufficiency, adult-onset immunoglobulin deficiency, hypoparathyroidism, and possibly diabetes mellitus has been reported. The association of pernicious anemia with giant cell myocarditis, a rare fatal illness believed by some to represent an autoimmune abnormality occurring with other autoimmune diseases such as thymoma, systemic lupus erythematosus, dermatomyositis, thyrotoxicosis, Wegener's granulomatosis, and sjogren's syndrome, is reported for the first time. A common underlying autoimmune abnormality is suggested.- - - - - - - - - - ranking = 0.25keywords = thyroiditis (Clic here for more details about this article) |
6/9. myasthenia gravis, pernicious anemia, and Hashimoto's thyroiditis.A 68-year-old woman with clinical, electromyographic, and pharmacologic evidence of myasthenia gravis experienced increasing proximal and bulbar muscular weakness. The diagnosis of pernicious anemia was established by typical abnormalities in the peripheral blood and bone marrow aspirate, the serum B12 level, by results of the schilling test, and by the presence of serum parietal cell antibody. The diagnosis of Hashimoto's thyroiditis was established by the presence of diffuse thyroid enlargement, microsomal thyroid antibodies, an increased thyroid stimulating hormone level, and depressed T2 and T4 levels.- - - - - - - - - - ranking = 1.25keywords = thyroiditis (Clic here for more details about this article) |
7/9. Hashimoto thyroiditis, distal renal tubular acidosis, pernicious anaemia and encephalopathy: a rare combination of auto-immune disorders in a 12-year-old girl.A case of a 12-year-old girl with a multiple auto-immune disorder is reported. She showed Hashimoto thyroiditis which subsequently developed to hashitoxicosis and distal renal tubular acidosis at 5 years of age, pernicious anaemia at the age of 9 and severe encephalopathy at the age of 12. Laboratory studies revealed very high titres of anti-microsomal and anti-thyroglobulin antibodies and positive gastric parietal cell antibody. As to the encephalopathy, positive oligoclonal IgG bands and high values of IgG index and IgG synthesis ratio in CSF were observed with aggravation of her neurological symptoms. High-dose steroid therapy was effective toward the encephalopathy. Paediatricians should pay careful attention to patients with Hashimoto thyroiditis for association with other autoimmune disorders.- - - - - - - - - - ranking = 1.5keywords = thyroiditis (Clic here for more details about this article) |
8/9. Polyautoimmunity in a young woman.A young woman with the HLA phenotype A1, A2, B5, B8, DR3, DR4 developed RA, idiopathic thrombocytopenic purpura (ITP), pernicious anaemia (PA), Hashimoto's thyroiditis (HT), systemic sclerosis (SS), pancreatic exocrine insufficiency (PEI) and coeliac disease (CD) before dying from vasculitic complications. A family study revealed RA, PA and insulin-dependent diabetes mellitus (IDDM) amongst her first degree relatives. Her case emphasizes the clinical and immunogenetic links between the autoimmune diseases.- - - - - - - - - - ranking = 0.25keywords = thyroiditis (Clic here for more details about this article) |
9/9. Chronic angio-oedema of the tongue associated with pernicious anaemia and Hashimoto's thyroiditis.The cause of chronic urticaria and angio-oedema (CUA) often remains undetermined. CUA has been associated with thyroid disease and most recently with thyroid autoimmunity (i.e. elevated titres of thyroid microsomal and/or thyroglobulin antibody). There is growing speculation that in this subset of patients, CUA may represent an autoimmune phenomenon. We describe a case in which chronic angio-oedema of the tongue was the sole presenting complaint in a patient with underlying quiescent pernicious anaemia and Hashimoto's thyroiditis. awareness of the association of Hashimoto's thyroiditis with pernicious anaemia and CUA resulted in correct diagnosis and treatment of the underlying diseases.- - - - - - - - - - ranking = 1.5keywords = thyroiditis (Clic here for more details about this article) |