Achalasia and thyroid disease: possible autoimmune connection? Acalasia e doença tireoidiana: uma conexão autoimune possível?

1 SUMMARY Many cases have been published showing a co-existence of autoimmune thyroid diseases (AITDs) and other autoimmune diseases. About a quarter of patients with achalasia have a con- current thyroid disease, most commonly associated with hypothyroidism. Although relatively rare, the association of achalasia and hyperthyroidism requires attention. The physiopathology of Grave's Disease (GD) involves B- and T-mediator lymphocytes, which have an affinity for known thyroid antigens: thyroglobulin, thyroid-peroxidase, and thyrotrophin receptor. Curren- tly, however, the real physiopathogenesis of achalasia continues to be unknown. Some impor- tant findings are suggestive of an autoimmune mechanism: significant infiltration of the myo - enteric plexus by monocytes, presence of the class II-Human Histocompatibility Complex DQwl antigen and antibodies to myoenteric neurons. The present case reports a patient who, despite testing negative for Chagas' disease, had achalasia, progressed to developing significant wa - sting and worsening of his quality of life, was later diagnosed with hyperthyroidism. After en- doscopic esophageal dilatation and radioiodine ablation of the thyroid gland, there was great improvement in the patient clinical condition. Arq Bras Endocrinol Metab. 2012;56(9):677-82