The genetics of Hashimoto's disease.

Despite strong epidemiologic evidence in favor of a genetic component in the etiology of HT, few hereditary risk factors have been consistently identified. These factors include the HLA and CTLA-4 genes. The mechanisms by which these genes confer increased susceptibility to HT are unclear. The identification of these genes has failed to explain completely the large hereditary effect observed in families of patients. More substantial genetic determinants must be hidden in the folds of the human genome and will most likely be detected in the near future. The powerful approach of linkage analysis will be supported by advancements in the description of the human genome and by technologic improvements in the ability to process large amounts of biologic data. Knowledge of such determinants will provide predictive tools to be used on clinical grounds and invaluable insight into the pathogenesis of this puzzling disease.