A possible link between genetic hemochromatosis and autoimmune thyroiditis.

The systemic involvement that often characterizes genetic hemochromatosis is well known. Although evidence of iron storage in endocrine glands has been reported, the possible functional changes due to altered thyroid in course of hemochromatosis have been not clearly defined so far. Thyroid may be directly affected by iron storage in the gland as well as functionally altered due to iron accumulation occurring in the pituitary. The prevalence and the pathogenetic mechanisms of primary thyroid illness in patients with genetic hemochromatosis are still largely unknown. Hereby, we describe two patients affected by genetic hemochromatosis who developed Hashimoto's thyroiditis. Taking into consideration the possible links occurring among iron overload, thyroid gland damage and thyroid dysfunction, we hypothesize that hemochromatosis could have been an enhancing factor for the development of primary thyroid disease in these patients. Potentially, this process might also determine new onset anti-thyroid autoimmunity or overlap it. We conclude that systematic studies in large and heterogeneous populations will be necessary in order to assess the risk of development of primary thyroid disorders in course of genetic hemochromatosis and, more generally, chronic iron overload conditions. In our mind, thyroid function should be periodically checked in all patients with chronic iron overload conditions.