Page 110 - GPD-2-1

Gene & Protein in Disease

CASE REPORT
Autoimmune thyroid disease in narcolepsy: A

case report

Chaofan Geng , Zhenzhen Yang , and Hongju Zhang *
1
1,3
2
1 Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou 450003, China
2 Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Zhengzhou
450003, China
3 Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou 450003,
China

Abstract

While the previous studies have discussed the association of narcolepsy with
autoimmune diseases, autoimmune thyroid disease (IATD) has rarely been described
in patients with narcolepsy. The association of narcolepsy with thyroid disease is
intriguing for speculating the causal or coexisting autoimmune disorder. We report
a case of narcolepsy Type 1 with IATD, presenting with excessive daytime sleepiness
(EDS), cataplexy attacks, and unexplainable weight gain. Oral modafinil and sodium
oxybate were used for treatment and prevention. During the 1-year follow-up, the
patient’s EDS and cataplexy attacks improved. However, the patient developed
hypothyroidism and was subsequently prescribed with thyroid replacement therapy.

Keywords: Autoimmune thyroid disease; Narcolepsy; Mechanism; Autoimmunity; Case
report

*Corresponding author:
Hongju Zhang
(hongjuz@sina.com) 1. Background
Citation: Geng C, Yang Z,
Zhang H, 2023, Autoimmune thyroid Narcolepsy is a chronic sleep disorder, primarily associated with excessive daytime
disease in narcolepsy: A case sleepiness (EDS), cataplexy attacks, sleep paralysis, and hypnagogic hallucinations [1,2] ,
report. Gene Protein Dis, 2(1):235. which affects one in every 2,000 individuals . Autoimmune-mediated destruction
[3]
https://doi.org/10.36922/gpd.v2i1.235
of hypocretin neurons is thought to be the main pathophysiological mechanism of
Received: October 25, 2022 narcolepsy [4,5] . More than 98% of narcolepsy patients with cataplexy are HLA-DQB1*06:02
Accepted: December 19, 2022 positive [6,7] . Although the previous studies have reported the association of narcolepsy
Published Online: January 11, 2023
with autoimmune diseases , no reports of autoimmune thyroid disease (AITD) have
[8]
Copyright: © 2023 Author(s). ever been described in patients with narcolepsy. Furthermore, the pathogenesis of
This is an Open Access article
distributed under the terms of the narcolepsy-associated autoimmune disorders has yet to be established. In this report, we
Creative Commons Attribution present a case of narcolepsy with AITD as comorbidity.
License, permitting distribution,
and reproduction in any medium, 2. Case presentation
provided the original work is
properly cited. A 14-year-old female patient presented to the hospital with a 5-year history of EDS,
Publisher’s Note: AccScience inexplicable weight gain, and cataplexy attacks. The patient reported that she often
Publishing remains neutral with falls asleep during class, while doing her homework, or using her cellphone without
regard to jurisdictional claims in
published maps and institutional any obvious cause, and then wakes up after 3 – 5 min; she also reported that whenever
affiliations. she was emotionally agitated, she would experience a transient weakness in both lower

Volume 2 Issue 1 (2023) 1 https://doi.org/10.36922/gpd.v2i1.235