Association between Helicobacter Pylori infection and autoimmune hypothyroidism in Egyptian population

Abstract

Autoimmune hypothyroidism commonly affecting females is one of the commonest causes of thyroid disease in adults. Among the various autoantibody tests applied in research and clinical practice, the determination of thyroid microsomal antibodies (TPO) and thyroglobulin antibodies (TG Ab) still retains its strong value in the screening for thyroid autoimmunity. Helicobacter pylori (H. pylori) infection plays an important role in the pathogenesis of chronic gastritis, peptic ulcer disease, MALT (Mucosa Associated lymphocyte T) Lymphoma and gastric cancer. Aim of the work: The aim of this work was to study the relationship between H.pylori infection and autoimmune hypothyroidism in Egyptian population. Subjects and Methods: This study was carried out on 147 Egyptian persons divided into 3 groups: Hypothyroid Group: Included 49 patients with autoimmune hypothyroidsm and positive antithyroid antibodies with no history of dyspeptic symptoms or peptic ulcer. H.pylori positive Group: Included 50 patients with dyspeptic symptoms or peptic ulcer with H.pylori positive antibodies with no history of any thyroid disease. Control Group: Included 48 apparently healthy persons serving as control. Serum Free T3, Free T4 and TSH were done for all subjects together with Antimicrosomal antibodies (TPO-Ab), Antithyroglobulin antibodies (TG-Ab) and Helicobacter Pylori antibodies (H. pylori Ab). Result There was no significant difference between all groups as regards age. Also there was significant difference between Hypothyroid and H.pylori positive groups as regarding TSH and Free T3, TG-Ab, TPO-Ab and H. pylori Ab. There is also significant difference between Hypothyroid and control groups regarding TSH, free T3, TG-Ab, TPO-Ab, and H. pylori Ab. There is significant difference between H.pylori positive and control groups regarding FT3 and H. pylori AB. Hypothyroid Group was divided according to the presence of H. pylori Ab into –ve &+ve H. pylori Ab subgroups. There was significant difference between the –ve and +ve subgroups as regard TSH, free T4 and TG-Ab. H.pylori positive Group was divided according to the presence of TG Ab & TPO Ab into–ve and +ve subgroups. There was significant difference between the –ve and +ve cases in TSH, free T4, Free T3, and H.Pylori Antibody. Positive correlation was found between H pylori Ab titer and age, TSH, TG-Ab and TPO-Ab titers. There was also negative correlation between H. pylori Ab titer and free T4. There is no correlation between H. pylori Ab titer and free T3. (Correlation is referred to all subjects of the study = 147). Conclusion This study revealed that patients with positive TG & TPO antibodies, showed (+ve) H. pylori Ab, with significant high titer in their sera. The patients with positive H. Pylori Ab showed high serum titer of TG-Ab. In our study H. pylori-Ab correlates to thyroid function tests and thyroid antibodies.