D1.334 - Association of Multiple Endocrinopaties with Immune Dysregulation, Allergies and Primary Immunodeficiency

Neural and endocrine factors influence immune responses, while the immune system, in turn, modulates both neural and endocrine functions. Immune dysregulation refers to an inappropriate or imbalanced immune response arising from various components of the immune system. It is associated not only with increased susceptibility to infections but also with allergic diseases, autoimmunity, autoinflammatory conditions, lymphoproliferation and malignancies. This study aimed to investigate the relationship between multiple endocrinopathies and immune dysregulation. While the literature includes studies exploring associations between individual endocrine disorders and immune- related conditions, research focusing on patients with multiple endocrine disorders remains limited. This study sought to investigate the presence and frequency of allergic, autoimmune, autoinflammatory diseases, primary immunodeficiencies, and malignancies in patients with multiple endocrinopathies.

This prospective cross-sectional study was conducted in the Internal Medicine and Endocrinology outpatient clinics of Ankara University. Adult patients (aged ≥18) were classified into three age- and sex-matched groups (140 subjects each, total: 520 participants) The study evaluated the presence and frequency of allergic and immunological diseases in three groups: (1) patients with autoimmune thyroid disease (Graves’ disease or Hashimoto’s thyroiditis) alone, (2) patients with autoimmune thyroid disease plus additional endocrinopathies, and (3) a control group without any endocrinopathy. All participants completed a 24-item data collection form assessing demographic information, clinical features, allergic diseases, autoimmune and autoinflammatory conditions, history of malignancy, presence of primary immunodeficiency, and the 10 warning signs of primary immunodeficiency. Data were analyzed using SPSS version 27.0.

A higher burden of endocrine disease was significantly associated with an increased prevalence of autoimmune diseases (p < 0.001). Among patients with three or more endocrinopathies, the autoimmune disease prevalence reached 33.3% (Autoimmune endocrinopathies were NOT included in autoimmunity evaluation). Likewise, allergic diseases—particularly asthma—were significantly more common in patients with multipleendocrinopathies (p < 0.001). Additionally, rate of positive responses to “10 warning signs of PID” was significantly higher in this group (p = 0.038), indicating a greater likelihood ofunderlying immune dysregulation in patients with a higher endocrine disease load. One patient in the multiple endocrinopathies group had warning signs and she underwent immune work- up, which resulted in the diagnosis of CVID.

This study reveals that immune dysregulation—including autoimmunity, allergic disease, and features suggestive of immunodeficiency—is significantly more prevalent in individuals with multiple endocrinopathies. Our findings underscore the importance of integrating immunological screening into the routine clinical assessment of patients with multiple endocrine disorders. These results may serve as a foundation for future research into the immunoendocrine interface.