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Seasonal allergic rhinitis may lead to recurrence of hyperthyroidism in women with Graves’ disease

(March 2004)

The background of the study. Patients with seasonal allergic rhinitis induced by Japanese cedar pollen and patients with hyperthyroidism caused by Graves’ disease have high serum immunoglobulin (Ig) E concentrations (IgE is a type of antibody). This study was designed to determine the effect of seasonal allergic rhinitis on the course and serum concentrations of antithyroid antibodies in patients with hyperthyroidism caused by Graves’ disease. In Japan, cedar pollens are disseminated in February and March.

How the study was done. Ten women who had had Graves’ hyperthyroidism were studied; six were in remission and four were taking a low dose of methimazole. Five had a history of seasonal allergic rhinitis caused by Japanese cedar pollen. The women were studied at 2- to 4-month intervals for 18 months starting in August.

The results of the study. At base line, all five women with allergic rhinitis, but not the other five women, had high serum concentrations of IgE antibodies that reacted with cedar pollen. All of the women with a history of rhinitis, but none without this history, had an episode of allergic rhinitis the following March. This episode was followed by increases in serum concentrations of cedar-pollen-specific IgE and, later, thyroid-stimulating, antithyroid peroxidase, and antithyroglobulin antibodies. Three of the five women in this group had recurrent hyperthyroidism after the episode of allergic rhinitis. None of the women who did not have allergic rhinitis had a rise in serum thyroid antibodies or recurrent hyperthyroidism during the study period.

The conclusions of the study. Seasonal allergic rhinitis induced by cedar pollen may be followed by a rise in serum concentrations of thyroid antibodies and recurrent hyperthyroidism in women with Graves’ disease.

The original article. Takeoka K, Hidaka Y, Hanada H, Nomura T, Tanaka S, Takano T, Amino N. Increase in serum levels of autoantibodies after attack of seasonal allergic rhinitis in patients with Graves’ disease. Int Arch Allergy Immunol 2003;132:268-76.

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Autoimmune Thyroid Disease