March 4, 2004
Thyroid
Question from Alaska:
My 14 year old sister has been going to the doctor now for the past month. She has had these same tests run three times and all are saying the same thing. She has tested positive for Grave’s disease and for Hashimoto’s thyroid disease. Our family doctor has been in touch with a pediatric endocrinologist out of Seattle Children’s Hospital that has said the same thing. They have no clue what is happening here. They told my mother today that they have never seen this in any other patient before. My sister is pushing 200 pounds, has all the classic symptoms of Hashimoto’s thyroid disease, and some of Graves. Is there something else that could causing her to test positive for both? Or, is this a common thing to happen? Then I have no clue what to think of this. But, we now have three children all in the same home with autoimmune diseases. The first one was my son diagnosed over three years ago, now my sister, and then my daughter two weeks ago with SLE (lupus). Is there a connection here? Could this be related to environment? I really am worried about my sister. She is 14 years younger than me, and has been very healthy pretty much her whole life. My mom is stressed because no one has any answers as to why my sister is testing positive for both conditions. Is there a link? Please help.
Answer:
Go talk to the endocrinologist since you are not describing anything dramatically new. Autoimmune problems often run in families since there is a genetic susceptibility. We don’t know exactly why one or another pops up and there certainly could be an environmental trigger but none has yet been discovered. Usually, this indicates one of the common HLA genotypes, i.e. HLA B8 or DR3.
Positive antibodies in Grave’s disease does not indicate Hashimoto’s thyroiditis, just that Grave’s disease also has positive antibodies. Some with Graves start as hyperthyroid and then go into a euthyroid or hypothyroid phase. Following the thyroid blood work sequentially and, with someone expert in thyroid problems, is the key to knowing how to respond.
An association with lupus is less common, but certainly more common as another autoimmune disorder.
SB
