Allergy, Asthma and Immunology: The unusual association of Graves' disease, chronic spontaneous urticaria, and premature ovarian failure: report of a case and HLA haplotype characterization

Arquivos Brasileiros de Endocrinologia & Metabologia

Print version ISSN 0004-2730

Arq Bras Endocrinol Metab vol.57 no.9 São Paulo Dec. 2013

CASE REPORT

Rosaria Maddalena Ruggeri^I; Giuseppe Vita^II; Anna Grazia D'Angelo^III; Paolina Quattrocchi^III; Rosaria Certo^I; Salvatore Benvenga^I,IV; Salvatore Cannavò^I; Sebastiano Gangemi^III,V

^IUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Italy
^IIUnit of Tissue Typing, Department of Pathology and Experimental Microbiology, University of Messina, Italy
^IIISchool and Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, Italy
^IVInterdepartmental Program of Molecular and Clinical Endocrinology & Women's Health; A.O.U. Policlinico "G. Martino", Messina Italy
^VInstitute of Biomedicine and Molecular Immunology-National Research Council, Palermo, Italy
Correspondence to

SUMMARY

Chronic spontaneous urticaria (CSU), defined as the occurrence of spontaneous wheals for more than six weeks, has been associated with autoimmune diseases. Herein, we report the unusual association of CSU, Graves' disease, and premature ovarian failure. Human leukocyte antigen (HLA) studies were performed. A 36-year-old woman presented symptoms and signs of hyperthyroidism for three months. In the same period, the patient complained of widespread urticarial wheals, intensely itchy, and poorly responsive to therapy with antihistaminic agents. Hyperthyroidism was confirmed biochemically, and treatment with methimazole was started. As hyperthyroidism improved, a marked improvement in her urticaria was also observed. However, the patient continued to complain of amenorrhea. Endocrine evaluation, at the age 38, was consistent with premature ovarian failure. This is the first report of coexistence of GD, CSU, and POF. The genetic background of such unusual association is a specific combination of HLA.