What other medical conditions are associated with Hashimoto's (Hashimoto's thyroiditis)?

Medical Conditions Associated with Hashimoto's Thyroiditis

Hashimoto's thyroiditis is most commonly associated with other autoimmune conditions, with autoimmune thyroid disease (AITD) being the most frequent concurrent condition, affecting 10-23% of patients with autoimmune diseases. 1

Common Associated Autoimmune Conditions

Endocrine Disorders

• Type 1 Diabetes: More prevalent in pediatric/adolescent Hashimoto's patients (25.4%) compared to adults with Hashimoto's 2, 3
• Adrenal autoimmunity: Found in approximately 9.0% of Hashimoto's patients, significantly higher than in Graves' disease patients (3.3%) 3
• Graves' disease: About 3-6% of patients with autoimmune thyroid disorders may have Graves' disease 1

Gastrointestinal Disorders

• Celiac disease: More common in pediatric/adolescent patients with Hashimoto's, though overall prevalence is relatively low at approximately 1.2% 4, 3
• Autoimmune hepatitis (AIH): Hashimoto's thyroiditis is the most common concurrent autoimmune disease in AIH patients, accounting for approximately 10.2-14.1% of all concomitant autoimmune diseases 1
• Primary biliary cholangitis (PBC): AIH-PBC overlap syndrome occurs in 8-10% of AIH patients 1

Rheumatologic Conditions

• Systemic lupus erythematosus (SLE): Found in approximately 2.2-3% of patients with Hashimoto's 1
• Rheumatoid arthritis (RA): Develops in approximately 2-4% of patients with autoimmune hepatitis and Hashimoto's 1
• Sjögren syndrome: Observed in about 2.8-7% of patients with autoimmune conditions including Hashimoto's 1
• Systemic sclerosis: Reported in 0.2% of patients with autoimmune hepatitis and thyroid disorders 1

Dermatologic Conditions

• Vitiligo: The most common skin condition associated with Hashimoto's thyroiditis in both adults and children 2, 4
• Alopecia: Frequently associated with Hashimoto's thyroiditis, particularly in pediatric patients 4
• Urticaria and leukocytoclastic vasculitis: Associated with type 2 autoimmune thyroid disease 1

Hematologic Conditions

• Autoimmune hemolytic anemia (AIHA): Can occur concurrently with Hashimoto's thyroiditis 1
• Idiopathic thrombocytopenic purpura: Associated with autoimmune thyroid conditions 1

Age-Related Differences in Associated Conditions

• Adult patients with Hashimoto's thyroiditis show a significantly higher prevalence of associated non-thyroidal autoimmune diseases compared to pediatric/adolescent patients 2

• Adults more commonly present with:

  • Arthropathies and connective tissue diseases 2
  • Multiple concurrent autoimmune conditions (two or more) 2
  • Combined clustering of gastric and adrenal autoimmunity 3

• Children/adolescents more commonly present with:

  • Type 1 diabetes 2, 4
  • Celiac disease 2, 4

Cardiovascular and Metabolic Associations

• Dyslipidemia: Present in approximately 63.7% of Hashimoto's patients 5
• Diabetes: Found in about 29.5% of patients with Hashimoto's thyroiditis 5
• Increased cardiovascular risk: Hashimoto's thyroiditis is associated with higher cardiovascular risk, with complex interrelationships between thyroid function, autoimmunity, and cardiovascular disease risk factors 5

Clinical Implications and Monitoring

• Screening for additional autoimmune conditions is recommended in patients with Hashimoto's thyroiditis, especially for the most common associations 1
• Regular monitoring of thyroid function is essential as thyroid function at presentation may vary from transient hyperthyroidism to frank hypothyroidism 4
• Female predominance is evident in both adult and pediatric Hashimoto's patients, but is significantly more pronounced in adults 2
• Extended diagnostic screening for other autoimmune diseases should be conducted both at diagnosis and at regular intervals during follow-up 1

Genetic Considerations

• Human leukocyte antigen (HLA) status appears to play a role in the development of Hashimoto's thyroiditis and its associated conditions 6
• Family history should be carefully evaluated as first-degree relatives of Hashimoto's patients have an increased risk of developing autoimmune diseases 1