Preoperative Serum Macrophage Migration Inhibitory Factor Level Correlates with Surgical Difficulty and Outcome in Patients with Autoimmune Thyroiditis.

Kian-Hwee Chong,Chuang-Wei Chen,Ming-Hsun Wu,Tsung-Han Hsieh,Chieh-Wen Lai

doi:10.3390/jcm10184034

Abstract

Surgical treatment for autoimmune thyroid disease is theoretically risky due to its chronic inflammatory status. This study aimed to investigate the correlation between preoperative serum migration inhibitory factor (MIF) levels and the difficulty of thyroidectomy in patients with autoimmune thyroiditis. Forty-four patients (average age: 54 years) were prospectively recruited: 30 with autoimmune thyroiditis and 14 with nodular goiter. Preoperative serum samples were collected to measure MIF levels. The difficulty of thyroidectomy was evaluated using a 20-point thyroidectomy difficulty scale (TDS) scoring system. The potential correlations between MIF levels and clinicopathological features as well as postoperative complications were analyzed. Preoperative serum thyroid-stimulating hormone (TSH), TSH receptor antibody, thyroid peroxidase antibodies levels, TDS score, and serum MIF levels were significantly higher in the autoimmune thyroiditis group than those in the goiter group. MIF levels were significantly associated with postoperative transient recurrent laryngeal nerve injury and hypoparathyroidism. MIF levels were positively correlated with TDS score, operation time, and blood loss in the autoimmune thyroiditis group. Increased preoperative serum MIF levels are associated with higher TDS scores, operation time, blood loss, and postoperative complications. Preoperative serum MIF level may be a useful predictor of difficult thyroidectomy and help surgeons provide better preoperative management.

Highlights

Thyroidectomy has a high mortality rate and was prohibited by the French MedicalSociety during the late 19th century
This study aimed to evaluate whether preoperative serum migration inhibitory factor (MIF) levels correlated with thyroidectomy difficulty scale (TDS) and could be predictive of surgical difficulty in thyroidectomy
The results of the current study demonstrated that preoperative serum MIF levels were significantly elevated in patients with autoimmune thyroiditis

Summary

Introduction

Thyroidectomy has a high mortality rate and was prohibited by the French MedicalSociety during the late 19th century. Thyroidectomy has a high mortality rate and was prohibited by the French Medical. Theodor Kocher attained a low mortality rate for thyroid surgery and won a Nobel Prize in 1909 [1]. Thyroidectomy is one of the most common surgical procedures performed worldwide. Autoimmune disease of the thyroid is a frequent cause of thyroiditis and inflammatory thyroid disorders. The most common pathohistological findings in Hashimoto’s thyroiditis are lymphocytic infiltration, follicular destruction, and apoptosis of thyroid epithelial cells. Hashimoto’s thyroiditis often induces a chronic inflammatory status to the thyroid tissue with or without goiter formation, and the thyroid gland may become diffusely enlarged or shrunken. The common pathohistological findings in Graves’ disease include follicular hyperplasia, intracellular colloid droplets, and non-homogenous lymphocytic infiltration, which is predominantly T-lymphocytes. The surgical indications for Graves’ disease and

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