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Annals of General Psychiatry

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Open Access 01-12-2017 | Case report

HLA DRB1*03 as a possible common etiology of schizophrenia, Graves’ disease, and type 2 diabetes

Authors: Aicha Sayeh, Cheker Ben Cheikh, Ali Mardessi, Meriem Mrad, Brahim Nsiri, Abdelaziz Oumaya, Najiba Fekih-Mrissa

Published in: Annals of General Psychiatry | Issue 1/2017

Abstract

Background

Autoimmune diseases and schizophrenia share many common features. Association studies confirm a shared genetic association in the human leukocyte antigen (HLA) region between schizophrenia and most autoimmune diseases. To our knowledge, the simultaneous syndromes of Graves’ disease (GD) and type 2 diabetes (T2D) in schizophrenia are rare in Tunisia.

Case presentation

We report a case of a 42-year-old woman admitted to the department of psychiatry for an acute relapse of chronic schizophrenia. Her medical history revealed that she was followed for Graves’ disease and for a type 2 diabetes mellitus. A low-resolution HLA typing was performed by polymerase chain reaction sequence-specific primer (PCR-SSP) techniques according to determine the patient’s haplotype.

Conclusions

Our study suggests that the HLA DRB1*03 allele may explain a common etiology underlying the co-morbidity of Graves’ disease, type 2 diabetes, and schizophrenia in our patient.

Jones AL, Mowry BJ, Pender MP, Greer JM. Immune dysregulation and self-reactivity in schizophrenia: do some cases of schizophrenia have an autoimmune basis? Immunol Cell Biol. 2005;83:9–17.CrossRefPubMed

Strous RD, Shoenfeld Y. Schizophrenia, autoimmunity and immune system dysregulation: a comprehensive model updated and revisited. J Autoimmun. 2006;27:71–80.CrossRefPubMed

Irani SR, Gelfand JM, Diwani A, Vincent A. Cell-surface central nervous system autoantibodies: clinical relevance and emerging paradigms. Ann Neurol. 2014;76:168–84.CrossRefPubMedPubMedCentral

Vincent A, Bien CG, Irani SR, Waters P. Autoantibodies associated with diseases of the CNS: new developments and future challenges. Lancet Neurol. 2011;10:759–72.CrossRefPubMed

Eaton WW, Byrne M, Ewald H, Mors O, Chen CY, Agerbo E, Mortensen PB. Association of schizophrenia and autoimmune diseases: linkage of Danish national registers. Am J Psychiatry. 2006;163:521–8.CrossRefPubMed

Othman SS, Kadir KA, Hassan J, Hong GK, Singh BB, Raman N. High prevalence of thyroid function test abnormalities in chronic schizophrenia. Aust NZ J Psychiatry. 1994;28:620–4.CrossRef

Chen SJ, Chao YL, Chen CY, Chang CM, Wu ECH, Wu CH, et al. Prevalence of autoimmune diseases in in-patients with schizophrenia: nationwide population-based study. Br J Psychiatry. 2012;200:374–80.CrossRefPubMed

Schizophrenia Working Group of the Psychiatric Genomics Consortium. Biological insights from 108 schizophrenia-associated genetic loci. Nature. 2014;511:421–7.CrossRefPubMedCentral

Ramos PS, Shedlock AM, Langefeld CD. Genetics of autoimmune diseases: insights from population genetics. J Hum Genet. 2015;60:657–64.CrossRefPubMedPubMedCentral

10.

Boehm BO, Kuhnl P, Manfras BJ, Chen M, Lee JC, Holzberger G, et al. HLA-DRB3 gene alleles in Caucasian patients with Graves’ disease. Clin Investig. 1992;70:956–60.CrossRefPubMed

11.

Chen QY, Huang W, She JX, Baxter F, Volpe R, Maclaren NK. HLA-DRB1*08, DRB1*03/DRB3*0101, and DRB3*0202 are susceptibility genes for Graves’ disease in North American Caucasians, whereas DRB1*07 is protective. J Clin Endocrinol Metab. 1999;84:3182–6.PubMed

12.

Omar MA, Hammond MG, Desai RK, Motala AA, Aboo N, Seedat MA. HLA class I and II antigens in South African blacks with Graves’ disease. Clin Immunol Immunopathol. 1990;54:98–102.CrossRefPubMed

13.

Tuomi T, Carlsson A, Li H, Isomaa B, Miettinen A, Nilsson A, et al. Clinical and genetic characteristics of type 2 diabetes with and without GAD antibodies. Diabetes. 1999;48:150–7.CrossRefPubMed

14.

Horton V, Stratton I, Bottazzo GF, Shattock M, Mackay I, Zimmet P, et al. Genetic heterogeneity of autoimmune diabetes: age of presentation in adults is influenced by HLA DRB1 and DQB genotypes (UKPDS 43). Diabetologia. 1999;42:608–16.CrossRefPubMed

15.

Richens ER, Abdella N, Jayyab AK, Al-Saffar M, Behbehani K. Type 2 diabetes in Arab patients in Kuwait. Diabet Med. 1988;5:231–4.CrossRefPubMed

16.

Gambelunghe G, Forini F, Laureti S, Murdolo G, Toraldo G, Santeusanio F, et al. Increased risk for endocrine autoimmunity in Italian type 2 diabetic patients with GAD65 autoantibodies. Clin Endocrinol. 2000;52:565–73.CrossRef

17.

International Schizophrenia Consortium, Purcell SM, Wray NR, Stone JL, Visscher PM, O’Donovan MC, et al. Common polygenic variation contributes to risk of schizophrenia and bipolar disorder. Nature. 2009;460:748–52.PubMedCentral

18.

Kadasah S, Arfin M, Tariq M. HLA-DRB1 association with schizophrenia in Saudi Arabian patients. Int J Psychiatry Clin Pract. 2011;15:112–7.CrossRefPubMed

19.

Sayeh A, Cheikh CB, Mrad M, Lakhal N, Gritli N, Galelli S, et al. Association of HLA-DR/DQ polymorphisms with schizophrenia in Tunisian patients. Ann Saudi Med. 2014;34:503–7.PubMed

20.

McDevitt HO. The role of MHC class II molecules in susceptibility and resistance to autoimmunity. Curr Opin Immunol. 1998;10:677–81.CrossRefPubMed

21.

Knight JG. Dopamine-receptor-stimulating autoantibodies: a possible cause of schizophrenia. Lancet. 1982;2:1073–6.CrossRefPubMed

22.

von Kirchbach A, Fischer EG, Kornhuber HH. Failure to detect dopamine receptor IgG autoantibodies in sera of schizophrenic patients. Short note. J Neural Transm. 1987;70:175–9.CrossRef

23.

Müller UJ, Teegen B, Probst C, Bernstein HG, Busse S, Bogerts B, et al. Absence of dopamine receptor serum autoantibodies in schizophrenia patients with an acute disease episode. Schizophr Res. 2014;158:272–4.CrossRefPubMed

24.

Miller BJ, Buckley P, Seabolt W, Mellor A, Kirkpatrick B. Meta-analysis of cytokine alterations in schizophrenia: clinical status and antipsychotic effects. Biol Psychiatry. 2011;70:663–71.CrossRefPubMedPubMedCentral

25.

Ezeoke A, Mellor A, Buckley P, Miller B. A systematic, quantitative, review of blood autoantibodies in schizophrenia. Schizophr Res. 2013;150:245–51.CrossRefPubMed

26.

Jacobson EM, Huber A, Tomer Y. The HLA gene complex in thyroid autoimmunity: from epidemiology to etiology. J Autoimmun. 2008;30:58–62.CrossRefPubMedPubMedCentral

27.

Rodriguez-Venturaa AL, Yamamoto-Furushob JK, Coyotea N, Dorantesa LM, Ruiz-Moralesb JA, Vargas-Alarconc G, et al. HLA-DRB1*08 allele may help to distinguish between type 1 diabetes mellitus and type 2 diabetes mellitus in Mexican children. Pediatr Diabetes. 2007;8:5–10.CrossRef

28.

Williams RC, Muller YL, Hanson RL, Knowler WC, Mason CC, Bian L, et al. HLA-DRB1 reduces the risk of type 2 diabetes mellitus by increased insulin secretion. Diabetologia. 2011;54:1684–92.CrossRefPubMed

29.

Schoepf D, Potluri R, Uppal H, Natalwala A, Narendran P, Heun R. Type-2 diabetes mellitus in schizophrenia: increased prevalence and major risk factor of excess mortality in a naturalistic 7-year follow-up. Eur Psychiatry. 2012;27:33–42.CrossRefPubMed

30.

Perry BI, McIntosh G, Weich S, Singh S, Rees K. The association between first-episode psychosis and abnormal glycaemic control: systematic review and meta-analysis. Lancet Psychiatry. 2016;3:1049–58.CrossRefPubMed

31.

Ban Y, Davies TF, Greenberg DA, Concepcion ES, Osman R, Oashi T, et al. Arginine at position 74 of the HLA-DRb1 chain is associated with Graves’ disease. Genes Immun. 2004;5:203–8.CrossRefPubMed

32.

Simmonds MJ, Howson JM, Heward JM, Cordell HJ, Foxall H, Carr-Smith J, et al. Regression mapping of association between the human leukocyte antigen REGION and Graves disease. Am J Hum Genet. 2005;76:157–63.CrossRefPubMed

Title: HLA DRB1*03 as a possible common etiology of schizophrenia, Graves’ disease, and type 2 diabetes
Authors: Aicha Sayeh
Cheker Ben Cheikh
Ali Mardessi
Meriem Mrad
Brahim Nsiri
Abdelaziz Oumaya
Najiba Fekih-Mrissa
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Annals of General Psychiatry / Issue 1/2017
Electronic ISSN: 1744-859X
DOI: https://doi.org/10.1186/s12991-017-0128-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

HLA DRB1*03 as a possible common etiology of schizophrenia, Graves’ disease, and type 2 diabetes

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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