Clinical-pathogenetic parallels in the combined course of autoimmune tyreoiditis and gastroesophageal reflux disease among young adults

N.A. Yarantseva

Kharkіv Medical Academy of Postgraduate Education, Department of Therapy, Rheumatology and Clinical Pharmacology

 The purpose of this article is to study the general pathogenetic mechanisms and features of the clinical picture in the combined course of GERD and AIT. The autoimmune process leads to inflammation in the tissues of the thyroid gland its degeneration and further fibrosis. A decrease in the synthesis of thyroid hormones enhances the production of TSH, which according to the feedback principle provokes the growth of the thyroid epithelium. The presence of gastrointestinal effects in thyroid hormones suggests that the thyroid gland plays an important role in the development of gastrointestinal diseases. Thyroid hormones affect speed and intensity of the secretion of digestive glands as well as muscle tone, motor-evacuation function of the digestive tract and the speed of repair of damaged tissues.

Conclusions:

  1. A clear correlation was established between a decrease in the motor-evacuation function of the stomach, an increase in the acidity of gastric juice, a decrease in thyroid hormones and an increase in TSH in the comorbid course of GERD and AIT in hypothyroidism;
  2. It was noted that patients with GERD with concomitant AIT compared with patients with isolated GERD had an increased level of anxiety, neurotism and a lower level of life quality;
  3. The data obtained indicate a direct effect of thyroid hormones on the pathogenetic links of GERD and the aggravation of the clinical picture in the combined course of GERD and AIT.

Key Words: gastroesophageal reflux disease, autoimmune thyroiditis, thyroid hormones.

https://dx.doi.org/10.15407/internalmed2020.01.106

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For citing:

1. Яранцева, Н.А. Клинико-патогенетические параллели при сочетанном течении аутоиммунного тиреоидита и гастроэзофагеальной рефлюксной болезни у лиц молодого возраста // Східноєвропейський журнал внутрішньої та сімейної медицини. – 2020. – № 1. – С. 106-110. doi: 10.15407/internalmed2020.01.106

2. Yarantseva NA. [Clinical-pathogenetic parallels in the combined course of autoimmune thyroiditis and gastroesophageal reflux disease among young adults.]. Shidnoevr. z. vnutr. simejnoi med. 2020;1:106-110. doi: 10.15407/internalmed2020.01.106. Russian.

References:

1. Ametov AS . Izbrannye lekcii po endokrinologii [Selected Lectures on endocrinology]. Moskva: OOO «Medicinskoe informacionnoe agentstvo; 2012. 544 p. Russian.

2. Baranov IV, Majkova TV. Endoskopicheskaja harakteristika pishhevoda, zheludka i dvenadcatiperstnoj kishki u bol’nyh s gastrojezofageal’noj refljuksnoj bolezn’ju v sochetanii s pervichnym gipotireozom. Gazeta «Novosti mediciny i farmacii» gastrojenterologija. 2010;337.

3. Bolgov MJu. Hronicheskij autoimmunnyj tireoidit kak zabolevanie v praktike vracha [Chronic autoimmune thyroiditis as a disease in the practice of a doctor]. Ukraїns’kij medichnij chasopis. 2009;2(70):47-50. Russian.

4. Gendeleka GF. Autoimmunnyj sindrom perekresta (Overlap-sindrom) pri zabolevanijah shhitovidnoj zhelezy – terra incognita tireoidologii [Autoimmune crossover syndrome (overlap syndrome) in thyroid diseases – terra incognita thyroidology]. Mezhdunarodnyj endokrinologicheskij zhurnal. 2016;2(74):140-151. Russian.
https://doi.org/10.22141/2224-0721.2.74.2016.70960

5. Dedov II, Mel’nichenko A. Endokrinologija: nacional’noe rukovodstvo 2-e izd, pererab i dop [Endocrinology: national leadership]. Moscow (Russian): GeOTAR-Media; 2016. 1112p. Russian.

6. Ivanova OI, Solomina MS, Logvinov SV, Solomatina TV. Sovremennye aspekty etiologii i patogeneza hronicheskogo autoimmunnogo tireoidita [Modern aspects of the etiology and pathogenesis of chronic autoimmune thyroiditis]. Sibirskij onkologicheskij zhurnal. 2006;1(17):55-60. Russian.

7. Ivashkin VT, Maev IV, Truhmanov AS, Baranskaja EK, Dronova OB, Zajrat’janc OV, Sajfutdinov RG, Sheptulin AA, Lapina TL, Pirogov SS, Kucherjavyj JuA, Storonova OA, Andreev DN. Klinicheskie rekomendacii Rossijskoj gastroenterologicheskoj associacii po diagnostike i lecheniju gastroezofageal’noj refljuksnoj bolezni [Clinical recommendations of the Russian Gastroenterological Association for the diagnosis and treatment of gastroesophageal reflux disease]. Rossijskij zhurnal gastrojenterologii, gepatologii i koloproktologii. 2017;27(4):75-95. Russian. DOI: 10 .22416/1382-4376-2017-27-4-75-958.

8. Krjuchko TA, Nesina IN, Peshij NN, Rumjance-va MA. Ocenka nejrogumoral’nogo statusa detej s gastroezofageal’noj refljuksnoj bolezn’ju [Assessment of the neurohumoral status of children with gastroesophageal reflux disease]. Pediatrija.Vostochnaja Evropa. 2014;4:123-130. Russian.

9. Kuznecov AP, Smelysheva LN, Sidorov RV, Kiseleva MM, Vasil’eva JuA. Endokrinnaja reguljacija zheludochnoj sekrecii pri dejstvii myshechnogo naprjazhenija [ Endocrine regulation of gastric secretion under the action of muscle tension]. Vestnik JuUrGU. Serija «Obrazovanie, zdravoohranenie, fizicheskaja kul’tura». 2014;14(1):96-101. Russian.

10. Oparin AA, Oparin AG, Korenovskij IG, Lavrova NV. Algoritmy i kriterii UZI-diagnostiki v klinike vnutrennih boleznej: uchebnoe posobie [Algorithms and criteria for ultrasound diagnostics in the clinic of internal diseases: a training manual]. Kharkiv (Ukraine): Fakt; 2012. 80 p. Russian.

11. Parhomenko LK, Eshhenko AV. Patologija pishhevaritel’noj sistemy u detej i podrostkov s zabolevanijami shhitovidnoj zhelezy [Digestive system pathology in children and adolescents with thyroid diseases]. Zdorov’e rebenka. 2010;5(26): 126-130. Russian.

12. Sinel’nik VP, Oparin AA. Pokazatel’ kachestva zhizni kak kriterij effektivnosti lechenija likvidatorov avarii na Chernobyl’skoj AES, bol’nyh gipertonicheskoj bolezn’ju komorbidnoj s gastrojezofageal’nym refljuksom [Quality of life indicator as a criterion for the effectiveness of treatment of the liquidators of the Chernobyl accident in patients with hypertensive comorbid disease and gastroesophageal reflux]. Georgian Medical News. 2017;4(265):54-60. Russian.

13. Solodenova ME, Luzina EV, Suvorova TV. Osobennosti funkcii shhitovidnoj zhelezy u pacientov s gastroezofageal’noj refljuksnoj bolezn’ju [Features of thyroid function in patients with gastroesophageal reflux disease]. Dal’nevostochnyj medicinskij zhurnal. 2008;1:21-24. Russian.

14. Sorokopyt ZV. Osobennosti techenija hronicheskoj gastroduodenal’noj patologii u detej s razlichnymi voljumometricheskimi i funkcional’nymi pokazateljami shhitovidnoj zhelezy [Features of the course of chronic gastroduodenal pathology in children with various volumetric and functional indicators of the thyroid gland]. Zhurnal GrGMU. 2006;4:104-109. Russian.

15. Trofimov VI, Bezrukov JuN. Psihosomaticheskie aspekty lechenija gastroezofageal’noj refljuksnoj bolezni [Psychosomatic aspects of the treatment of gastroesophageal reflux disease]. Arhiv” vnutrennej mediciny. 2015;5(25): 55-61. Russian.

16. Fediv OI Pidkhody do antysekretornoji terapiji GERKh u praktyci simejnogho likarja [Approaches to antisecretory therapy of GERD in the practice of family doctor]. Zdorov’ja Ukrajiny. 2015;6(355):47-48. Ukrainian.

17. Chesnokova NP, Ponukalina EV, Morrison VV, Zhevak TN, Bizenkova MN. Rol’ shhitovidnoj, parashhitovidnyh zhelez i endokrinnyh kletok podzheludochnoj zhelezy v reguljacii vodno-elektrolitnogo obmena v norme i patologii [The role of the thyroid, parathyroid glands and endocrine cells of the pancreas in the regulation of water-electrolyte metabolism in normal and pathological conditions]. Nauchnoe obozrenie. Medicinskie nauki. 2016;1:64-67. Russian.

18. Shagalova NJa. Osobennosti patogeneza autoimmunnyh tireopatij [Features of the pathogenesis of autoimmune thyropathies]. Sovremennye problemy nauki i obrazovanija. 2017;1:19. Russian.

19. Schalin-Jäntti C. Autoimunnyj tyreojidyt. Nastanovy na zasadakh dokazovoji medycyny [Autoimmune thyroiditis. Guidelines on evidence-based medicine]. DUODECIM Medical Publications, Ltd [Internet]. 2017 Aug 08; Available from: https://guidelines .moz .gov .ua/documents/3348

20. Douglas S. Ross, Henry B. Burch, David S. Cooper, M. Carol Greenlee, Peter Laurberg, Ana Luiza Maia, Scott A. Rivkees, Mary Samuels, Julie Ann Sosa, Marius N. Stan, and Martin A. Walter. American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis.Thyroid 2016;26:1343-1421. DOI: 10.1089/thy.2016.0229
https://doi.org/10.1089/thy.2016.0229

21. Fuya Z, Jing F, Jun L, Lei Z, Yang L, Huinan C, Ye J, Biqiang Z, Yunwei W. Alterations of the Gut Microbiota in Hashimoto’s Thyroiditis Patients. Thyroid. 2018:175-186. http://doi.org/10.1089/thy.2017.039522.
https://doi.org/10.1089/thy.2017.0395

22. Jacqueline J, Bianco AC, Sawka AM. Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670-1751. doi:10.1089/thy.2014.002823.
https://doi.org/10.1089/thy.2014.0028

23. Jarosz M, Taraszewska A. Risk factors for gastroesophageal refux disease: the role of diet. Prz.Gastroenterol. 2014;9(5):297-301. https://doi.org/10.5114/pg.2014.46166.
https://doi.org/10.5114/pg.2014.46166

24. Oparin A, Beziazychna N. Implementation mechanisms of psychosomatic disorders in gastroesophageal reflux disease with concomitant chronic obstructive pulmonary disease. Medica Jadertina. 2016;46(3-4):125-132.

25. Oparin A, Vnukova A. The role of endothelial Dysfunction in the Mechanism of gastroesophageal reflux disease development in patients with ischemic heart disease. Acta clinica Croatica. 2017;56(4):635-639. DOI: 10.20471/acc.2017.56.04.08.
https://doi.org/10.20471/acc.2017.56.04.08

26. Oparin A, Кornienko D. Formaion process of motor-evacuatory disorders in patient with gastroesophageal reflux disease concomitat obesity. Gastronterology and hepatology. 2017;71(2):145-149. https://doi.org/10.14735/amgh2017csgh.info01.
https://doi.org/10.14735/amgh2017csgh.info01