Abstract
Introduction. Plasma antithyroid peroxidase (anti-TPO) and anti-thyroglobulin antibodies (anti-Tg) are widely used in the diagnosis of autoimmune thyroiditis. No research has compared anti-TPO and anti-Tg both in plasma and cerebrospinal fluid (CSF) of healthy individuals vis-à-vis patients with thyroid disease. Methods. We measured anti-TPO and anti-Tg antibodies in plasma and CSF in nine subjects (mean age ± SD: 73 ± 6 years) with hypothyroidism and nine subjects (mean age ± SD: 73 ± 8 years) without thyroid disease. Results. The concentration of anti-TPO autoantibodies in CSF was very low compared to plasma in both subjects with thyroid and without thyroid disease (P = 0.007). CSF anti-Tg autoantibodies titers were very low compared to the plasma in subjects with thyroid disease (P = 0.004), whereas, in subjects without thyroid disease, this difference did not reach statistical significance (P = 0.063). Conclusions. Thyroid autoantibodies levels were low in plasma and CSF; we did not observe any transfer of thyroid autoantibodies from the peripheral blood to the CSF. Therefore, regarding Hashimoto's encephalopathy, where elevated antithyroid autoantibodies are often measured in blood, it is more likely that thyroiditis and encephalopathy represent nonspecific, but distinct, events of an aggressive immune system.
Highlights
Plasma antithyroid peroxidase and anti-thyroglobulin antibodies are widely used in the diagnosis of autoimmune thyroiditis
The concentration of anti-Tg autoantibodies in cerebrospinal fluid (CSF) was very low compared to plasma in subjects with thyroid disease (P = 0.004 sign test), whereas in subjects without thyroid
We found very low CSF antithyroid autoantibodies compared to plasma in both subjects with and without thyroid disease
Summary
Plasma antithyroid peroxidase (anti-TPO) and anti-thyroglobulin antibodies (anti-Tg) are widely used in the diagnosis of autoimmune thyroiditis. No research has compared anti-TPO and anti-Tg both in plasma and cerebrospinal fluid (CSF) of healthy individuals vis-a-vis patients with thyroid disease. The appearance of thyroid autoantibodies (in particular, antithyroid peroxidase; anti-TPO) in plasma and cerebrospinal fluid (CSF) is a necessary condition for the diagnosis of Hashimoto’s encephalopathy (HE), a rare disease associated with autoimmune thyroiditis [1, 2]. Thyroid autoantibodies in plasma are very common in the general population (10%–25% have them, women) [3, 4] and one could speculate the transfer of autoantibodies from blood to the CSF Corroborating the latter, anti-thyroglobulin (anti-Tg) antibodies were described in the CSF of patients with hypothyroidism in the past [5]. The aim of this study was to search for anti-TPO and antiTg antibodies in CSF and assess them vis-a-vis their plasma concentrations in subjects with and without thyroid disease
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