Study on the Correlation Between ANCA and Thyroid-related Ophthalmopathy

Yuping Xiong,Changfu Peng

doi:10.11648/j.ijovs.20200501.14

Abstract

Background The pathogenesis of thyroid associated ophthalmopathy (TAO) is still unclear. Studies have proved that there are several autoantibodies in TAO patients, and ANCA, as one of the autoantibodies, is positive in some TAO patients, but its correlation with the occurrence, development and outcome of TAO is still unclear. Objective To study the correlation between ANCA and Thyroid Associated Ophthalmopathy. Methods Prospective observational cohort study was designed. This study was approved by the Ethic Commission of Hunan Provincial People’s Hospital/the First Affiliated Hospital of Hunan Normal University, and written informed consent was obtained from each Subject before entering this trial. 120 patients diagnosed as TAO and visited our hospital from January 2016 to June 2018 were enrolled in the study, including 30 cases in inactive group and 90 cases in active group [According to the criteria of clinical activity score (CAS)], 42 cases in Mild group and 78 cases in Moderate-to-severe and Sight-threatening group (According to the criteria of EUGOGO). The differences in ANCA positive rate among above groups and Active group after transferred to Inactive were compared. Results The overall positive rate of ANCA in TAO patients was 16.7%. The positive rates in the Inactive group and Active group were respectively 3.33% and 21.11%, and the difference was statistically significant (P 0.05). The positive rates of Active group reduced to 5.5%, and the difference was statistically significant (P<0.05). Conclusion ANCA can reflects the activity of TAO to some extent, which is helpful to guide clinical treatment and prognosis judgment.

Highlights

Thyroid-related ophthalmopathy (TAO), known as Graves ophthalmopathy (GO), is a common orbital autoimmune disease associated with Graves disease (GD) [1]
The study subjects were divided into the static period and active period group according to the clinical activity score (CAS) scoring method, and the ANCA test results (Table 1) passed the corrected χ2 test, and the difference between the two groups was significant (χ2 = 3.92, P
The study subjects were divided into mild group, moderate to severe group, and threatened vision group according to the EUGOTAO grouping

Summary

Introduction

Thyroid-related ophthalmopathy (TAO), known as Graves ophthalmopathy (GO), is a common orbital autoimmune disease associated with Graves disease (GD) [1]. TAO is characterized by the inflammatory response of the post-bulbar tissue resulting in the excessive deposition of highly hydrophilic glycosaminoglycan (GAG) and / or the increase of post-bulb adipose tissue, which in turn leads to an increase in orbital connective tissue and extraocular muscle volume. The pathogenesis of TAO is currently unknown, and may be related to immunity, genetics and the environment. During the onset of TAO, inflammatory factors of orbital fibroblasts are highly secreted, such as TNF-α, IL-6, IL-10, etc. The secretion of these inflammatory factors participates and affects the progress of TAO [2]. The pathogenesis of thyroid associated ophthalmopathy (TAO) is still unclear. Studies have proved that there are several autoantibodies in TAO patients, and ANCA, as one of the autoantibodies, is positive in some TAO patients, but its correlation with the occurrence, development and outcome of TAO is still unclear

Methods

Results

Conclusion