Primary Sjogren's Syndrome and Autoimmune Thyroid Disease

[sage]

Can you still be considered to have primary sjogren's and have autoimmune thyroid disease at the same time?
I have tried to figure that out from the literature but it is confusing:

Sj?gren's Syndrome Foundation - Glossary

"thyroiditis: A disease in which autoantibodies cause immune system cells (lymphocytes) to destroy the thyroid gland.
www.sjogrens.org/home/about-sjogrens-​syndrome/glossary - Cached"---

Excerpt from Merck Manual: http://www.merckmanuals.com

"Hashimoto's Thyroiditis (Autoimmune Thyroiditis; Chronic Lymphocytic Thyroiditis; Hashimoto's Struma)

Hashimoto's thyroiditis is chronic autoimmune inflammation of the thyroid with lymphocytic infiltration. Findings include painless thyroid enlargement and symptoms of hypothyroidism. Diagnosis involves demonstration of high titers of thyroid peroxidase antibodies. Lifelong l-thyroxine replacement is typically required.

Hashimoto's thyroiditis is believed to be the most common cause of primary hypothyroidism in North America. It is twice as prevalent in women. Incidence increases with age ................................................"

[anita]

I believe the "primary" means NO other autoimmune process and "secondary" is when there IS another autoimmune disease.  Doesn't make a difference "which" other autoimmune  disease is present.

This said, I have been told I am "primary" SjS yet I have APS (antiphospholipid Syndrome) which is an autoimmune "process", but not a disease in it's own right (as far as I know).  So who really knows.  Maybe I am "secondary, like most everyone else".

Until they isolate the EXACT mechanism of the neurological manifestations in SjS, I wonder if that is "another" process as well.

[sage]

Thanks Anita:

I found this reference which is very recent:

J Clin Rheumatol. 2010 Jun;16(4):164-7.

Primary antiphospholipid syndrome and thyroid involvement.
de Carvalho JF, Caleiro MT.

Rheumatology Division, Hospital das Cl?nicas da Faculdade de Medicina da Universidade de S?o Paulo e Faculdade de Medicina da Universidade de S?o Paulo, S?o Paulo, Brazil. jotafc@gmail.com

CONCLUSION: Hypothyroidism is present among 22% of PAPS patients and thyroid autoantibodies in 18% of them. These findings suggest a common pathophysiologic mechanism between antiphospholipid syndrome and autoimmune thyroid diseases.

[DragonflyC]

Thyroid diseases are not related to connective tissue, so you can have primary Sjogren's and Hashimoto's or Graves.

From the Sjogren's Syndrome Foundation: "Primary Sjogren's occurs by itself and secondary Sjogren's occurs when another connective tissue disease is present." (http://www.sjogrens.org/home/about-sjogrens-syndrome/sjoegrens-faqs)

[CAT1962]

I have Primary SjS, and a goiter...about 2 CMs on one side and 4 mm on the other side of my thyroid. I have to be checked in a  few months for any growth.

[anita]

Good point dragonfly.  This is why APS (which is not connective tissue disease) does not pull me from the "primary" status...even though APS is autoimmune in nature.

[Nathan]

Yes. Those with pSS are 10x more likely to have an (autoimmune) thyroid condition, and those with an autoimmune thyroid condition are 9x more likely to have SS.
They are tightly related.

[sage]

Dragonfly said: "Thyroid diseases are not related to connective tissue, so you can have primary Sjogren's and Hashimoto's or Graves. ......."

Got it Dragonfly!  I was thinking "autoimmune" not "connective tissue" - back to the drawing board - sigh!

[sage]

Good luck with the goiter CAT.

Thanks to everyone for the good input