Association of seasonal allergic rhinitis is high in Graves' disease and low in painless thyroiditis

Hashimoto's thyroiditis is thought to be a T-helper cell type 1 (T(H)1)-dependent disease, but it is not clear whether Graves' disease is T-helper cell type 2 (T(H)2)-predominant or not. T(H)1-predominant diseases are infrequently and T(H)2-predominant diseases are frequently associated with allergic diseases. We examined the prevalence of seasonal allergic rhinitis to Japanese cedar pollen, a typical T(H)2-associated disease, in patients with Graves' disease (n = 126), painless thyroiditis (n = 46) and Hashimoto's thyroiditis (n = 88), and compared them to healthy controls (n = 766). Gender and age distribution were not different among patient groups and healthy controls, except for the higher age of patients with Hashimoto's thyroiditis. The prevalence of seasonal allergic rhinitis was significantly high in patients with Graves' disease (42.9%, p < 0.05) and low in patients with painless thyroiditis (13.0%, p < 0.01) but was not different in patients with Hashimoto's thyroiditis (26.1%) compared to that of healthy controls (32.6%). When patients with painless thyroiditis were included in Hashimoto's thyroiditis group, the prevalence of seasonal allergic rhinitis was 21.6% and significantly different from that of healthy controls (p < 0.05). These data indicate that Graves' disease is T(H)2 predominant and painless thyroiditis is a T(H)1-predominant disease. Our findings suggest that the shift from T(H)2 toward T(H)1 immunogenesis may be important for achieving earlier remission of Graves' disease.