The genetics of Hashimotos thyroiditis

Patient

Q: I have Chronic Nephrotic Syndrome and Hasimoto Thyroid which was diagnosed when I was a child. I am now 36 and would like to know what is the possibility of having children? Current medication: 2 mg Perindopril 80 mg Frusemide 100 mcg Thyroxin Please advise likelihood of having a healthy baby, Thanks.

Doctor

A:   There is a genetic susceptibility to Hashimotos thyroiditis and autoimmune thyroid disease. The disease typically clusters in families, sometimes alone and sometimes in combination with Graves disease. The sibling recurrence risk may be as high as 14% as shown in one study. The concordance rate in identical twins is 30 to 60%. There is increased frequency in patients with genetic syndromes such as Downs syndrome, Turners syndrome and with certain HLA alleles such as DR3. A specific gene has not been identified and therefore it is difficult to calculate the risk of an affected child. I would advise discussing risk with your endocrinologist, and it is also important to note that ACE inhibitors (Perindopril) are contraindicated in pregnancy and the use of diuretics (Furosemide) during pregnancy is generally avoided due to risk of decreased placental blood supply.

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