anti-TPO Ab Research Articles

6581 Case of Conversion from Hashimoto’s Thyroiditis to Graves’ Disease: An Unusual Sequence

Abstract Disclosure: A. Atri: None. C. Anastasopoulou: None. Introduction: The two most common autoimmune thyroid diseases are Hashimoto’s thyroiditis (HT) and Graves’ disease (GD). HT is a destructive thyroiditis, via autoantibodies most commonly against the thyroid peroxidase enzyme (anti-TPO), while GD results in hyperthyroidism, due to TSH-receptor stimulating antibodies (TSAb) and Thyroid Stimulating Immunoglobulin (TSI). Case Report: A 23-year-old male presented to the clinic with complaints of weight gain, dry skin and excessive hair loss. His physical examination was non-contributory and laboratory evaluation revealed a TSH of 130 uIU/ml (ref: 0.45-4.5), free T4 (fT4) 0.4 ng/dl (ref: 0.82-1.77), and positive anti-TPO antibodies, for which he was started on levothyroxine (LT4) supplementation for newly diagnosed HT. Over the first five months on treatment, his TSH and T4 progressively improved to 31.8 uIU/ml and 1.48 ng/dl, respectively. Six months later, his TSH rapidly decreased to 0.01 uIU/ml, with an fT4 elevation to 2.45 ng/dl, alongside developing hyperthyroid symptoms like weight loss, insomnia and palpitations. Due to persistently positive anti-TPO antibody titers, his hyperthyroidism was considered iatrogenic, and LT4 dose was gradually reduced, but eventually required to be discontinued. A thyroid ultrasound depicted generalized increase in vascularity, consistent with active thyroiditis. He continued to have a significantly suppressed TSH <0.005 uIU/ml and elevated fT4, off all medications, and was also found to have multiple positive antibody titers [TSI of 1.02 IU/L (ref: < 0.55), thyroglobulin antibody of 351 IU/ml (< 0.9) and anti-TPO Ab >600 IU/ml (ref< 34)]. He was then diagnosed with new GD, and thyroid suppression therapy with 10mg/day of methimazole was initiated, to which he rapidly responded, with a TSH of 0.059 uIU/ml and reduced fT4 of 1.37 ng/dl. His diagnosis of GD was confirmed via an I-123 thyroid uptake scan which revealed a homogenous increased tracer uptake of 57% at 24 hours (ref 15-35%), following which he received definitive therapy for GD, with radio-active iodine (RAI) ablation with 20.6 mCi of I-131. Discussion: As HT and GD have a common autoimmunity-based pathophysiology, conversions between the two clinical states have been described, though HT to GD, as seen in our patient is much less common than the reverse conversion. Some described mechanisms include an antibody switch from thyrotropin receptor blocking to stimulating action, HT-induced thyrotroph destruction resulting in GD antibody formation, and treatment with LT4. Simultaneously elevated levels of both TSI and anti-TPO can occur, and therefore treatment and diagnosis should be based on thyroid function tests and clinical presentation. Patients with autoimmune thyroid disease require close monitoring, due to the potential risk of conversion from one clinical end of the spectrum to the other, and early recognition is important. Presentation: 6/1/2024

7435 Thyroid Abscess Post-FNA in an Immunocompetent Host

Abstract Disclosure: B. Gautam: None. M.S. Hossain: None. S. Hossain: None. S.C. Kumar: None. H. liao: None. B. Tiwari: None. D.S. Rosenthal: None. Background: Thyroid Fine Needle Aspiration (FNA) is a common diagnostic procedure for thyroid nodules. Most common post FNA complications are minor pain, bruises and small hematomas. Despite being generally safe, FNA can occasionally lead to rare complications, such as thyroid abscess, especially in immunocompromised individuals. This case highlights the development of a thyroid abscess post-FNA in a 42-year-old immunocompetent female. Case Report: A 42-year-old female presented to ED with painful right sided neck lump. She had undergone FNA of right sided thyroid cyst, 10 days ago without any immediate complications as confirmed on post procedural ultrasonogram. She started having right sided neck pain after FNA which progressively got worse overtime associated with fever, chills and difficulty swallowing without any dyspnea or dysphonia. She denied symptoms of hyperthyroidism or hypothyroidism. Family history was significant for thyroid cancer in her mother and thyroid nodule in a sister. On exam: Temp. 101 F, HR 105 beats/min, BP 113/69 mm Hg, RR 18 breaths/min. Neck exam revealed soft, warm, tender mass in right neck region which was mobile with swallowing without any skin discoloration or discharge. The physical exam was otherwise unremarkable. Laboratory investigations showed elevated WBC 18000 (4.5-11 k/mm3) with absolute neutrophil count 14.4 (1.8-7 k/mm3), normal CMP. Thyroid hormone levels were normal: TSH 0.32 Uiu/ml, FT4 1.0 ng/dl), as were anti-TG ab, TSI and anti-TPO ab. CT scan of Neck with IV contrast showed a 2.8 x 2.5 x 3.8 cm homogeneous right thyroid mass with mass effect on the trachea. US thyroid showed a 3.7 x 2.9 x 3.3 cm right thyroid hypoechoic lesion with increased internal echogenicity and peripheral hyperemia, consistent with a thyroid abscess. Patient underwent IR guided drainage of 30 cc thick, dark brown fluid and started on broad spectrum IV antibiotics which was then modified based on the bacteriology report showing presence of gram-variable rods, specifically Corynebacterium, with significant clinical improvement. Discussion: The thyroid gland is considered resistant to infections because of its characteristics such as encapsulation, high iodine content and rich blood supply. Nevertheless, rarely, patients may develop post FNA complications including bacterial thyroiditis, thyroid abscess and retropharyngeal cellulitis, presenting with acute life-threatening complaints. This case highlights the importance of monitoring for these rare complications along with early diagnosis and treatment which involves drainage and targeted antibiotic therapy. In the presence of suspicious findings on ultrasonogram and a strong family history of thyroid cancer, we also like to emphasize rare cases where a thyroid abscess could originate from necrotizing cancer cell, the likely etiology of thyroid abscess in our patient. Presentation: 6/3/2024

Proportion and Covariates of Hypothyroidism Among Patients with Metabolic Syndrome Attending in Tertiary Care Hospital

Background: Hypothyroidism in patients with metabolic syndrome is associated with worse outcomes. However, this has not yet been adequately investigated in Bangladeshi people. Objective: To find out the proportion and covariates of hypothyroidism among patients with metabolic syndrome. Materials and methods: A hospital-based cross-sectional study was conducted with 323 patients from the Endocrinology and Allied Medicine Department at BIRDEM General Hospital. Patients with metabolic syndrome but no prior diagnosis of hypothyroidism were included. Detailed history, physical examinations, and thyroid function tests—Thyroid Stimulating Hormone (TSH), Free Thyroxine (FT4), and Anti-Thyroid Peroxidase Antibody (Anti-TPO Ab)—were performed. Subclinical hypothyroidism was defined as TSH >4.12 mIU/L and <10 mIU/L, while overt hypothyroidism was defined as TSH >10 mIU/L. Statistical analyses, including Chi-square tests, ANOVA, Pearson's correlation, and multiple linear regression, were conducted to explore associations between components of metabolic syndrome and thyroid dysfunction. Results: Out of the 323 participants, 62.8% were euthyroid, 28.5% had subclinical hypothyroidism, and 8.7% had overt hypothyroidism. Autoimmune hypothyroidism was confirmed in 31.6% of hypothyroid patients through elevated Anti-TPO Ab levels, a statistically significant finding. Hypothyroidism was significantly more prevalent in females and obese individuals. Significant positive correlations were observed between TSH and waist circumference (r=0.153), systolic blood pressure (r=0.271), and triglycerides (r=0.128), while FT4 showed negative correlations. Multiple linear regression indicated significant associations between waist circumference, fasting plasma glucose, and thyroid dysfunction. Conclusion: It was concluded that a higher proportion of metabolic syndrome cases were suffering from hypothyroidism. This necessitates that all MetS patients be screened for thyroid profile and autoimmune status and managed accordingly.

A Clinical Study of Thyroid Abnormalities and Autoantibodies in Patients Diagnosed With Anti-nuclear Antibody Positive Autoimmune Connective Tissue Disorders: An Observational Cross-Sectional Study.

Autoimmune connective tissue disorders (CTDs) are characterized by inflammation of the connective tissue structures and immune system aberrations, such as autoantibody production. This study investigates the prevalence and clinical significance of thyroid abnormalities in patients with anti-nuclear antibody (ANA)-positive autoimmune CTDs. This prospective cross-sectional observational study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, from September 2022 to June 2024. Eighty patients diagnosed with ANA-positive CTDs were included. Comprehensive histories were collected from them and clinical examinationsand routine investigations were performed. Blood samples were collected for thyroid function tests and autoantibody tests. Thyroid ultrasound investigations were also performed. Ethical approval and informed consent were obtained. The study revealed a significant prevalence of thyroid dysfunction among participants, with 39 (48.75%) exhibiting some form of thyroid abnormality. Subclinical hypothyroidism was the most common condition in 18 (22.50%) participants, predominantly affecting females. Thyroid autoantibodies were present in 32 (40%) participants, with thyroid peroxidase antibodies (anti-TPO Ab) being the most common seen in 17 (21.25%) participants. Systemic lupus erythematosus (SLE) was the most prevalent CTD among participants, seen in 44 (55%) participants, followed by Sjogren's syndrome (SS)seen in 19 (23.75%) participants. The study underscores the necessity of routine thyroid function screening in patients with ANA-positive CTDs to facilitate early detection and management of thyroid abnormalities, thereby preventing progression to overt hypothyroidism or hyperthyroidism. The findings highlight the significant association between thyroid dysfunction and autoimmune CTDs, advocating for a holistic approach to patient care.

Thyroid auto-antibodies in newly diagnosed multiple sclerosis patients: A cross sectional study.

Multiple sclerosis (MS) is a chronic inflammatory disease in which the immune system attacks the myelin sheath of the central nervous system (CNS). It has been proposed that autoimmune conditions may occur together and an individual's immune system may attack more than one system. Autoimmune thyroid disease is one of the most common comorbidities along with MS. Since thyroid hormones are crucial for normal brain function and remyelination, we aimed to determine the prevalence of thyroid dysfunction in a group of MS patients compared with healthy controls. This cross-sectional study was conducted in medical clinics affiliated to Shiraz University of Medical Sciences, South of Iran. To prevent the effects of MS modifying drugs on thyroid function, we examined 73 newly diagnosed MS patients, which had not been treated yet, compared to 72 healthy individuals. After measurement of the serum level of TSH, Anti TPO-Ab, and Anti TG-Ab, we found a significantly higher prevalence rate of abnormal TSH levels (high or low) in the MS group (p = 0.02). We also found a higher frequency of thyroid dysfunction in the female MS group (p = 0.01). However, there was no significant difference in the two other anti-thyroid antibodies among the groups. Our results demonstrate a significant and positive linear relationship between age and TSH levels (R = 0.402; p < 0.001) and also age and Anti TPO-Ab levels (R = 0.397; p < 0.001) among the MS population. We found a higher prevalence of TSH alteration among the MS population. Anti TPO-Ab and Anti TG-Ab levels did not differ among groups. These findings suggest that MS patients might be at an increased risk for thyroid dysfunction. However, further studies are required to determine the underlying cause. The linear relationship between age and TSH and Anti TPO-Ab levels in MS patients suggest that there is an association between TSH dysfunction and age.

Correlation between Interleukin-23, Autoantibodies and Thyroid Profile in a Sample of Iraqi Patients with Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis (HT) is the most common autoimmune condition characterized by hypothyroidism and thyroid cell death by leukocytes and antibody-mediated immunological mechanisms. The current paper set out to assess a number of inflammatory and metabolic potential indicators of Hashimoto’s thyroiditis. Fifty-one patients with Hashimoto’s thyroiditis took part in the current investigation. Ages ranged from 20 to 75 for them. Enzyme-linked immunosorbent tests were used to quantify the anti-thyroperoxidase antibody (anti-TPO Ab), anti-thyroglobulin antibody (anti-Tg Ab), T4, T3, and TSH at the beginning and conclusion of the trial. The result showed a significant relationship between the gender according to HT patient’s and healthy groups which showed that female effected more than male and there was no effected according to the age between these groups, In HT patients with greater TSH concentrations compared to healthy individuals, serum FT3 and FT4 concentrations were lower while IL-23 concentrations were higher. TSH levels were positively correlated with IL-23 levels. As a result, IL-23 can be useful for detecting disease activity in HT patients. However, more thorough, extensive, longitudinal investigations are required to evaluate whether IL-23 can be used in therapeutic settings. Our results showed that thyroid profile, serum IL-23, and autoantibodies were strong indicators of Hashimoto’s thyroiditis. To better understand these correlations and underlying pathogenic mechanisms, additional research is necessary.

Estimation of IL-8, IL-38, Vitamin D, TPO Ab, and CRP Levels in Iraqi Hashimoto Thyroiditis Patients

Abstract Background: Hashimoto’s disorder is an autoimmune disease affecting cells of the thyroid gland via the diffusion of the lymphocytes into thyroid cells. Calcitriol is the active form of Vit.D3; there were a strong correlation between low Vit-D levels and development of autoimmune diseases exists and calcitriol supplementation might play a protective role in the pathophysiology of autoimmune diseases. Objectives: This study aimed to estimate the levels of interlukin-8 (IL-8), interlukin-38 (IL-38), Vitamin D, thyroid peroxidase (TPO) Ab, and c-reactive protein (CRP) in Iraqi patients suffering from Hashimoto disease. Materials and Methods: In this study, 90 individuals (males and females) were enrolled, and divided into two groups: Hashimoto’s disorder group (60) patients and the healthy control group (30) persons were checked by the physician with the aid of medical history. The levels of TSH, Vit.D3, anti-TPO Ab, T4, IL-8, and IL-38 were measured for all the study groups. Results: A highly significant reduction (P &lt; 0.001) was shown in mean levels of Vit D, T4, and IL-38 among the patient’s group in comparison with the controls, whereas a significant reduction (P &lt; 0.05) was revealed in mean levels of CRP among patients in comparison with the controls. Also, the results showed a highly significant elevation (P &lt; 0.001) in mean levels of TSH, IL-8, and anti-TPO antibodies among the Hashimoto disease group in comparison with the controls. Conclusion: Hashimoto disease caused highly significant decreases in mean levels of Vit. D, T4, IL-38, and CRP, whereas there was a highly significant increase in the levels of TSH, IL-8, and anti-TPO antibodies.

INVESTIGATION OF ANTI-THYROPEROXIDASE ANTIBODY (anti-TPO Ab) AND THYROID HORMONES IN HYPERTHYROIDISM

This study conducted at the Al Kindi Educational Hospital in Baghdad involved 100 participants, consisting of 50 healthy individuals and 50 patients diagnosed with hyperthyroidism. Both groups were evenly divided, with 25 men and 25 women in each. The baseline control data for the healthy individuals were collected between January 2022 and April 2023 within the same facility. All participants underwent testing for thyroid function markers, specifically TSH (Thyroid Stimulating Hormone), FT4 (Free Thyroxine), and Anti-TPO Ab (Antithyroid Peroxidase Antibodies). The study's findings revealed a significant gender-related disparity in hyperthyroidism. Females, whether in the patient or control group, exhibited the most pronounced increase in thyroid-related markers, with a highly significant increment (P ≤ 0.01) compared to their male counterparts. In contrast, no significant differences were observed between male patients and male controls, nor between female patients and female controls in the context of hyperthyroidism. Furthermore, the research highlighted specific biomarkers, Anti-TPO Ab and Free T4, which exhibited a highly significant increment (P ≤ 0.01) in hyperthyroid patients compared to the control group. However, TSH levels remained relatively consistent between the two groups, showing no significant differences. The aim of the study is to investigate the relationship between anti-thyroperoxidase antibody (anti-TPO Ab) levels and thyroid hormone concentrations in individuals with hyperthyroidism

Effect of Steroids on Patients With Fibromyalgia/Chromic Widespread Pain: An Observational Study.

Fibromyalgia causes widespread chronic pain. Pain management and treating underlying conditions are of utmost importance. Recent studies found an association of thyroid autoimmunity with fibromyalgia. Pain management of patients with anti-thyroid peroxidase antibody (anti-TPO Ab) positive was studied sparsely. To determine the effect of steroid (deflazacort) on pain management using numerical rating scale (NRS) pain score at baseline and at 3-month follow-up. A retrospective observational study was undertaken, recruiting patients diagnosed with fibromyalgia as per 2010 American College of Rheumatology guidelines and treated with the steroid, deflazacort 12 mg. Patients with missing details were excluded. Patients were categorized into negative, positive, and strongly positive anti-TPO Ab groups. Baseline and follow-up (3 months) pain score was compared across the groups. Reduction in pain was considered as a primary outcome variable. The study included 128 participants with 98 (76.6%) females and 30 (23.4%) males. The age of the study population was 48±13.29 years. The proportion of hyper, hypo, and euthyroidwas 10 (7.81%), 42 (32.81%), and 76 (59.38%), respectively. The proportion of participants with negative, positive, and strongly positive anti-TPO Ab levels was 41 (32.03)%, 50 (39.06%), and 37 (28.91%), respectively.Baseline pain score was 7.3±1.32 and 3-month follow-up was 4.7±2.46. Steroid response was found in 66 (51.6%). Negative andpositive anti-TPO Ab had a 1-point reduction in pain score from baseline, p-value <0.001. The strongly positive group had 5 points reduction, p-value<0.05. Fibromyalgia patients with thyroid autoimmunity responded well to short courses of steroids. Greater pain relief was observed among those who are strongly positive anti-TPO Ab group.

Pattern and Predictors of Thyroid Dysfunction among Pediatric Endocrine Referrals at the Tertiary Care Center of Northern India: A Longitudinal Study.

Postiodization era has experienced a change in pediatric thyroid disorders with autoimmune disorders and subclinical hypothyroidism (SCH) now more frequently diagnosed. The aims of this study were to evaluate the clinical spectrum of thyroid disorders among children referred to us, to ascertain characteristics that influence treatment, and to follow them for various outcome measures. An observational longitudinal study where all treatment-naïve children (<18 years) with suspected thyroid disorders were recruited. Data collected were anthropometry, serum TSH, TT4, TT3, antithyroid autoantibodies, family history, and clinical symptoms. The management was based on the clinical judgment of the endocrinologist with the first follow-up at six weeks and subsequent visits three monthly for one year. A total of 241 subjects aged 28 days to 17 years were included. Overall, SCH was the most common abnormality (39%) detected among subjects, followed by overt hypothyroidism (OH) (33%), congenital hypothyroidism (CH) (18%), and overt thyrotoxicosis (5%). A total of 85.5% (n = 204) of subjects were treated and in follow-up, 81% of them were found to be adequately managed. Comparative analysis of OH and SCH revealed pubertal age, female predominance, and the presence of autoimmunity (positive anti-TPO and anti-TG Ab) statically significant variables in the OH group. A major independent predictor of treatment in treated SCH (72/96) in comparison with nontreated SCH (24/96) was anti-TPO positivity (P = 0.029). Eight of 24 nontreated SCH were eventually treated in follow-up and positive family history was observed as a significant variable among them (P < 0.05). Subjects with CH presented at a mean age of 6 months (28 days to 2 years). However, guidelines for the management of SCH are still evolving, autoimmunity and positive family history should be considered as decisive factors while initializing treatment. Delayed presentation of CH in our study warrants active surveillance of children at birth for thyroid disorders for their mental well-being.

Autoimmune thyroid disease in patients with type 1 diabetes mellites: A cross-sectional study from Syria.

The present study aimed to investigate the occurrence of autoimmune thyroid disease (AITD) in patients with type 1 diabetes mellitus (T1DM) by the presence of antithyroid peroxidase (anti-TPO Ab). Furthermore, we studied the relationship of clinical and thyroid ultrasound (US) characteristics with anti-TPO Ab. This cross-sectional study was performed in Al- Mowasat and Al-Assad University Hospitals from 2021 to 2023. Clinical, laboratories, and US features were collected and analyzed between positive compared to negative anti-TPO Ab. Of 76 patients, anti-TPO Ab was positive in 12 patients (15.7%) with female predominance [n = 10 (83.3%)]. Gender showed a difference between anti-TPO Ab groups (P = .026). DM duration showed a difference (P = .034), which was dominant for a group of positive anti-TPO Ab (median = 9). The age at DM diagnosis also showed a difference (P = .048), where most patients were under 10- years old at diagnosis [n = 39 (51.3%)] and the highest number of anti-TPO Ab positive patients [n = 7 (58.3%)] were in this age category. US findings showed a significant difference (P = .001). Regarding positive anti-TPO Ab patients, the most frequent US finding was immune pattern [7 (58.3%)], which was more common than in the negative group (12.5%). Age, hemoglobin A1c (HBA1c), and body mass index (BMI) did not present differences (P = .391, 0.692, and 0.453, respectively), however, all anti-TPO Ab positive patients were older than ten years and had HBA1c more than 8. Thyroid-stimulating hormone (TSH) was abnormal in 2 patients (16.6%) and both in anti-TPO Ab positive group. This study suggests that anti-TPO Ab appears in older patients and with longer MD duration. Also, data support using US and anti-TPO Ab as earlier markers for AITDs, and further recommending regular annual monitoring by US and anti-TPO Ab in all patients with T1DM for AITDs diagnosis, especially in females.

Dietary Iodine Intake and Pattern of Thyroid Disorders among the Ethnic Population of Eastern Himalayan Ranges of India

Background and Aim: In the present study, dietary iodine intake and thyroid functioning were assessed among the ethnic adolescent group of Eastern Himalayan range with the hypothesis that insufficient iodine intake negatively affects normal thyroid functions. The aim of the study was to see the prevalence and relation between iodine deficiency and thyroid functioning. Materials and Methods: It is a hospital-based study conducted in the health care facilities of Dima Hasao district, Assam, from April 2021 to March 2022. The study included 821 subjects including both male and female of adolescent age group (10–19 years). The thyroid profiling, anti-Thyroid peroxidase antibody (anti-TPO Ab), and urinary iodine content (UIC) were carried out. Thyroid hormone analysis was carried out by chemiluminescence assay. The anti-TPO Ab was determined using the electrochemiluminescence immunoassay analyzer. The dietary iodine intake was measured on the basis of UIC and was determined by arsenic cerium catalytic spectrophotometry method by the Sandell-Kolthoff reaction. Results: The prevalence of thyroid disorder among the studied population was found to be 13.8%. Among different conditions of thyroid disorders, hypothyroidism was present in 10.6% and hyperthyroidism in 3.13%. 4.18% had elevated anti-TPO Ab. Among the euthyroid subjects with different thyroid disorders, 1.48% and 21% had anti-TPO Ab positivity, respectively. The median UIC was 99.97 µg/l. 25.78% of the population had iodine deficiency. Thyroid disorders were common in subjects with iodine deficiency (61.34%) than iodine sufficient subjects (20%). Conclusion: The work was an attempt to demonstrate how the dietary iodine intake influences thyroid functioning among the adolescent ethnic population of Eastern Himalayas which is manifested as high prevalence of subclinical hypothyroidism with iodine deficiency. The work underscores region specific recommendation on iodine supplementation for populations living in geographically remote locations.

Autoimmune Thyroid Disease in Psoriasis Patients: A Case-Control Study.

Psoriasis is a common immunologically mediated inflammatory disease characterized by skin inflammation, epidermal hyperplasia, an increased risk of painful and destructive arthritis, cardiovascular morbidity, and psychosocial challenges. Some autoimmune diseases are mediated by stimulating or blocking auto-antibodies. Auto-antibodies may act as antagonists and bind to hormone receptors, blocking receptor function. It may result in impaired secretion of mediators and gradual dysfunction of the affected organ, e.g., Graves disease and myasthenia gravis. This study was planned to evaluate the association between anti-thyroid peroxidase antibody (anti-TPO Ab) and anti-thyroglobulin antibody (anti-TG Ab) as biochemical markers in 30 clinically diagnosed psoriasis patients. This hospital-based, epidemiological case-control study was conducted in the Department of Biochemistry in collaboration with the Department of Dermatology, Venereology, and Leprology at Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India. Thirty subjects diagnosed clinically with psoriasis and an equal number of age-matched controls with no known autoimmune disease from the outpatient department were also enrolled. The following hormonal tests, i.e., thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and antibodies, anti-TPOAb and anti-TG Ab, were performed. The study period was one year. The data thus obtained was analyzed using SPSS Statistics version 26.0 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp). The significance level (p-value) was taken as <0.05. The mean age of psoriasis subjects was 37.83±12.89 years compared to 36.91±12.32 years in the control group and was found to be non-significant (p=0.432), reflecting a similar age distribution. A male preponderance was observed in the present study, where the psoriasis group consisted of 80% males and 20% females, while the control group had 60% males and 40% females. All six psoriasis patients diagnosed with autoimmune thyroid disease (AITD) were euthyroid at the time of enrollment, compared to only one control subject in a subclinical hypothyroid state. The mean values of anti-TPO Ab were 30.93±41.26 IU/mL in psoriasis patients and 11.39±28.42 IU/mL in the control group (p=0.001), while the mean values of anti-TG Ab were 11.21±27.69 IU/mL in psoriatic subjects and 2.49±9.05 IU/mL in the control group (p=0.004). No significant correlation between AITD and psoriasis was found when both parameters were analyzed statistically for correlation; even when one marker was considered, no significant correlation was found. The odds ratio was calculated to find an association between the disease and thyroid autoimmunity. The odds ratio was estimated to be 2.25 for psoriasis and the control group, with a confidence interval of 95% (0.77-6.59) and a p-value of 0.139, which was not statistically significant. Psoriasis, a dermatological disorder, has been seen as related to AITD. The role of early detection of anti-thyroid antibodies, i.e., anti-TPO Ab and anti-TG Ab, can be of prognostic value in AITD and psoriasis.

Thyroid dysfunction and autoantibodies among patients infected with Covid 19 in Erbil city /IRAQ

Background and objectives: Autoimmune thyroid diseases or specifically Anti-thyroid peroxidase antibodies increasing after corona virus infection pandemic. This study investigating Anti-thyroperoxidase, anti-thyroid stimulating receptor antibodies in conjunction with traditional thyroid markers after corona virus infection hoping that this would aid in reduction of enduring morbidity and associated health concerns. Methods: This cross-sectional study was conducted in Rizgary Teaching Hospital and Erbil Teaching Hospital in Erbil, Iraq, within the period of February to September 2022. The study comprised hundred patients; 80 females and 20 males, these patients had clinical symptoms suspecting thyroid abnormalities and were suspected for having a sort of thyroid disease. They had abnormal thyroid function tests, with investigating thyroid autoantibodies and corona virus infection. Investigations include thyroid function test and antithyroid antibodies. Results: The level of Anti-thyroid peroxidase antibodies was positive among 75 hypothyroidism patients than among hyperthyroidism cases 2, p-value 0.012. Positive Anti-thyroperoxidase antibodies and hypothyroidism were significantly more common among corona virus infected cases, p-value 0.012 and 0.0109 respectively. However; anti-thyroid stimulating hormone receptor antibody was positive only among hyperthyroidism group (18%); p-value was significant 0.019. Conclusions: This study confirmed the correlation between thyroid function test, Anti-thyroperoxidase antibodies values and corona virus infection. Autoimmune thyroid diseases are more common among female cases, in addition; antithyroid antibodies especially Anti-thyroperoxidase antibodies were more common among female patients. There was high prevalence of both hypothyroidism and positive anti-TPO Ab in COVID-19 cases.

Association between Thyroid autoimmunity and Fibromyalgia: Single center retrospective study (P9-6.004)

<h3>Objective:</h3> The objective of this study was to describe the prevalence of anti TPO ab among FM patients, their thyroid status and to evaluate clinical response to corticosteroids. <h3>Background:</h3> Fibromyalgia (FM) is a disorder characterized by widespread musculoskeletal pain and other somatic symptoms. Studies have shown that there is a high prevalence of anti TPO ab (Thyroid peroxidase antibody) positivity among FM patients. It is unknown if thyroid autoimmunity is a predisposing factor for FM. <h3>Design/Methods:</h3> We included 107 patients who were diagnosed with FM based on 2010 American College of Rheumatology Criteria who attended our neurology clinic at Appusami Hospital, India between July 2019 and 2022. We recorded data including age, gender, thyroid profile, anti TPO titer [Negative (&lt;15), positive (15 to 500), strongly positive(&gt;500)] and calculated age adjusted odds ratio for steroid responsiveness. <h3>Results:</h3> Mean age of the study group was 48.29 and 78.5% were females. In our series, 75.7% of FM patients had positive anti TPO ab (Positive- 41.12%;strongly positive-35.51%). 51.40% were euthyroid, 38.32% were hypothyroid and 10.28% were hyperthyroid. Overall 56.8% responded well to steroids. (80.85% of strongly positive;19.15% of positive patients). Age-adjusted odds of steroid response in patients with higher anti TPO ab is 5.2 times that of the one with low ab (p&lt;0.001) (95%CI 3.03;9.04) <h3>Conclusions:</h3> Thyroid autoimmunity is frequently associated with middle aged women with FM. Higher anti TPO ab titers strongly correlated with steroid responsiveness in our study and we recommend a short course of steroids for this subset of patients. These findings need to be confirmed with a larger prospective study. Further research should focus on understanding the pathophysiology of FM and it9s the causal relationship with thyroid autoimmunity. <b>Disclosure:</b> Dr. Eswaradass has nothing to disclose. C Eswaradass, 303 has nothing to disclose. Dr. Thermalingem has nothing to disclose. Dr. Thirunavukkarasu has nothing to disclose. Dr. Gurunathan has nothing to disclose.

Thyroid Dysfunction in Adults with Newly Detected Type 2 Diabetes Mellitus: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh

Background: Thyroid disorders and diabetes mellitus are common endocrine disorders that often coexist and can significantly impact each other’s management. The American Diabetes Association recommends that people with diabetes be periodically screened for thyroid dysfunction due to the strong link between the two conditions. It is important for individuals to be aware of the risk factors for both conditions and to seek appropriate medical care if necessary, and for healthcare providers to consider testing for thyroid dysfunction in adults with newly detected type 2 diabetes mellitus. The aim of the study was to find out thyroid dysfunction in adults with newly detected type 2 diabetes mellitus. Material Methods: This cross-sectional, descriptive study was conducted at the Departments of Medicine and Endocrinology at Sir Salimullah Medical College and Mitford Hospital in Dhaka. The study period lasted six months, from May to October 2019. A total of 102 adult patients (above 20 years old) with newly diagnosed type 2 diabetes mellitus who were attending the Endocrinology and Medicine Outpatient Department participated in the study. Results: Out of 102 adults with newly detected type 2 diabetes mellitus, the majority (86.3%) had normal thyroid function (euthyroid), while a smaller number (13.7%) had thyroid dysfunction. The most common subgroup of thyroid dysfunction was subclinical hypothyroidism (7.8%), followed by hypothyroidism (3.9%), subclinical thyrotoxicosis (1.0%), and hyperthyroidism (1.0%). The majority of the study population was male (66%) and from urban areas (88%), with a mean age of 45.1 years, a mean BMI of 25.0 kg/m2, and a mean waist circumference of 98.4 cm. About 45% had a family history of diabetes mellitus and 37% were smokers. The blood pressure of the study population was within normal limits. A minority (30%) had co-morbidities such as hypertension, dyslipidemia, and ischemic heart disease. The predictors of thyroid dysfunction were observed Age (OR=0.785), F/H of thyroid disorder (OR=0.495) BMI (OR=1.059), Anti-TPO Ab(OR= 0.021). Conclusion: Thyroid dysfunction and diabetes are commonly associated with each other and can impact clinical presentation and laboratory results. It is important to routinely screen for thyroid function in all patients with type 2 diabetes mellitus to detect, treat, and prevent complications of both these conditions.

Prevalence of thyroid disorder in patients with systemic lupus erythematosus and patients with lupus nephritis

Background Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that can affect many organs. Lupus nephritis (LN) is a major cause of morbidity and mortality in patients with SLE. The interaction between kidney and the thyroid-gland functions has been known for a long time. Thyroid hormones (TH) are necessary for growth and development of the kidney, and for the maintenance of water and electrolyte homeostasis. On the other hand, kidney is involved in the metabolism and elimination of TH. Thyroid disease appears to be more frequent in SLE patients than in the general population. Therefore, screening of thyroid dysfunction in patients with SLE, especially in those with evidence of LN, is recommended. The aim of this work is to study morphological (thyromegaly and thyroid nodules) and functional (hypothyroidism or hyperthyroidism) thyroid disorders in patients with SLE with or without renal affection, and whether LN acts as an independent risk factor of thyroid abnormalities. Patients and methods In total, 60 participants were divided into three groups: group I: 20 patients diagnosed with SLE without evidence of renal affection, group II: 20 patients diagnosed with SLE with evidence of LN, and group III: 20 healthy participants. All were subjected to full history taking, thorough physical examination, laboratory investigations (urea and creatinine), thyroid function, and serological marker serum [antithyroid peroxidase antibody (anti-TPO Ab)]. Ultrasound examination of the thyroid gland was done. Results There was a direct significant relationship between renal function tests, namely urea and creatinine and anti-TPO among cases with SLE, both without and with LN, and an inverse significant relationship between estimated glomerular filtration rate and anti-TPO among both the SLE group and the LN group. Conclusion Screening of thyroid dysfunction in patients with SLE, especially in those with evidence of LN by estimation of thyroid function tests, thyroid autoantibodies, and by ultrasonography, is recommended.

The assessment of immunological parameters (Anti- Thyroid peroxidase antibody and Anti-Thyroglobin antibody) in premenopausal thyroid women patients

Background: Thyroid diseases may be complicated by anti-thyroglobin and anti-thyroid peroxidase antibodies. Objective: This research examined thyroid diseases and serum Anti-TPO Ab and Anti-Tg Ab levels. Methods: Al-Fadel foundation for training and development (research foundation) in Babylon province conducted this cross-sectional study. The research comprised 90 patients aged 15–45, separated into three groups: 60 patients with thyriodism, 30 healthy participants as a control group, and all patients (n=60) into two groups: hypothyroidism and hyperthyroidism. Results: Hyperthyroidism and hypothyroidism patients and healthy controls had similar mean Anti TPO levels. Compared to healthy controls, hypothyroidism and hyperthyroidism patient groups increased significantly. Hypothyroidism and hyperthyroidism patients had higher Anti Tg levels than the health control group. Conclusion: Anti-TOP Ab and Anti-Tg Ab vary significantly between Hyperthyroidism, Hypothyroidism, and control. Clinical labs should evaluate thyroidism patients for potential consequences using these biomarkers.

A case-control study to assess the association of Alopecia areata with thyroid dysfunction and thyroid Autoimmunity.

Several previous studies have suggested a positive association between Alopecia Areata and thyroid disorders. However, there is a paucity of such studies in our country. Our study aimed to know the frequency of thyroid dysfunction and thyroid autoimmunity in patients reporting to Dermatology Outdoors with Alopecia Areata (AA) and to compare it with normal controls. This was a Case-Control study conducted at the Dermatology outpatient of a tertiary care hospital in Pakistan. 102 patients with AA and 102 age and sex-matched controls were enrolled. The age of onset of the disease, the involved sites and the presence of other associated diseases were noted. Venous blood samples were taken from patients and controls for Thyroid function tests and Anti- Thyroid peroxidase antibodies (Anti-TPO Ab). The data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. The mean age of onset of the disease was 30.37±12.53. 91.2% of patients had the classic patch type of AA. The most commonly involved site was Scalp. Associated diseases were found in eight (7.8%) patients. Thyroid dysfunction was found in two patients and none of the Controls. Both the patients had Subclinical thyroid disease. The p-value was 0.157, which was not statistically significant. Thyroid autoimmunity (raised Anti-TPO Ab titre) was detected in five (4.90%) patients and none of the Controls. The p-value was 0.024, which was statistically significant. AA is significantly associated with Thyroid autoimmunity but there is no significant association between AA and clinical or subclinical thyroid disease.

Comparison of thyroid hormone profile (T3, T4, TSH, ANTI TPOAB, &amp; TBG) among fertile and infertile females.

Objective: To compare thyroid hormone profile (T3, T4, TSH, Anti TPOAb, &amp; TBG) among fertile and infertile females. Study Design: Case-control study. Setting: Department of Physiology and Department of Gynecology and Obstetrics, JPMC Karachi, BMSI. Period: Jan 2018 to Jan 2019. Material &amp; Methods: There were 88 participants in the sample, who were split into two groups. Infertile group (group A) and control group (group B). Non-probability purposive sampling was employed because each group's subjects were chosen based on specified standards. In the current investigation, all subjects who met the eligibility requirements were registered. Each subject who took part gave their written consent. Information obtained was held in strict confidence. Data was analyzed using IBM SPSS version 23. Results: Serum T3, T4, TSH, anti TPOAb, and TBG levels differed significantly between the two study groups. There was significant mean difference obtained for TSH and anti TPO antibodies between fertile and infertile samples with p-value less than 0.05. Conclusion: In this study, all the subjects had T3, T4, TSH &amp; TBG levels within the normal pre-pregnancy reference range. A trend towards subclinical hypothyroidism and the incidence of anti-thyroid antibodies was observed within females who had UE infertility, when their thyroid hormone profile was compared with fertile females.