Abstract
It has been suggested that autoimmune thyroid disease could be combined with other autoimmune diseases such as idiopathic thrombocytopenic purpura, sarcoidosis and inflammatory bowel disease. In inflammatory bowel diseases, ulcerative colitis is more strongly associated with autoimmune thyroid diseases than Crohn's disease. However, there is no clear explanation for the concurrent existence of the two diseases, although immunological mechanisms seem to play a significant role. We report here on a case of a 48-years-old woman who had ulcerative colitis with Graves' disease. Her chief complaint was abdominal pain and mucinous diarrhea. She was diagnosed with Graves' disease 1 year ago and had been taking medication. Colonoscopic biopsy was performed and she was diagnosed with ulcerative colitis. We suggest that a clinician should be aware of the coexistence of Graves' disease and ulcerative colitis in some patients, which is obviously very important for the patient's outcome.
References
1. Weetman AP. Graves' Disease. N Engl J Med. 2000. 343:1236–1248.
2. Sood A, Midha V, Sood N, Bhatia AS, Avasthi G. Incidence and prevalence of ulcerative colitis in Punjab, North India. Gut. 2003. 52:1587–1590.
3. Bonapace ES, Srinivasan R. Simultaneous occurrence of inflammatory bowel disease and thyroid disease. Am J Gastroenterol. 2001. 96:1925–1926.
4. Jenkins RC, Weetman AP. Disease Associations with Autoimmune Thyroid Disease. Thyroid. 2002. 12:977–988.
5. Triantafillidis JK, Cherakakis P, Zervakakis A, Theodorou M. Coexistence of hyperthyroidism and ulcerative colitis: report of 4 cases and a review of the literature. Ital J Gastroenterol. 1992. 24:494–497.
6. Jarnerot G, Azad Khan AK, Truelove SC. The thyroid in ulcerative colitis and Crohn's disease. II. Thyroid enlargement and hyperthyroidism in ulcerative colitis. Acta Med Scand. 1975. 197:83–87.
7. Snook JA, de Silva HJ, Jewell DP. The association of autoimmune disorders with inflammatory bowel disease. Q J Med. 1989. 72:835–840.
8. Monsen U, Sorstad J, Hellers G, Johansson C. Extracolonic diagnoses in ulcerative colitis: An epidemiological study. Am J Gastroentero. 1990. 85:711 –716.
9. Peretianu D, Dumitrescu C, Lotreanu V. Association of hyperthyroidism and ulcerative colitis. Report of two cases. Med Interne. 1990. 28:41–45.
10. Nishimura M, Yamamoto T, Iijima H, Moriwaki Y, Takahashi S, Hada T. Basedow's disease and chronic ulcerative colitis: A case report and review of the Japanese literature. Intern Med. 2001. 40:44–47.
11. Inokuchi T, Moriwaki Y, Takahashi S, Tsutsumi Z, KA T, Yamamoto T. Autoimmune Thyroid Disease (Graves' Disease and Hashimoto's Thyroiditis) in Two Patients with Crohn's Disease: Case Reports and Literature Review. Intern Med. 2005. 44:303–306.
12. Volpé R. The pathogenesis of Graves' disease. Endocr Pract. 1995. 1:103–115.
13. Volpé R. Autoimmunity causing thyroid dysfunction. Endocrinol Metab Clin North Am. 1991. 20:565–587.
14. Hodgson HJ, Wands JR, Isselbacher KJ. Decreased suppressor cell activity in inflammatory bowel disease. Clin Exp Immunol. 1978. 32:451–458.