Levels Of anti-TPO Antibodies Research Articles

T3, T4, TSH, Anti-TPO, and Anti-TG Autoantibodies Distribution in Autoimmune Thyroid Patients with Chlamydia Trachomatis Infection

Autoimmune thyroid disorders (AITDs) include a variety of inflammatory conditions affecting the thyroid gland, with Graves' disease (GD) and Hashimoto's thyroiditis (HT) being the most commonly seen types. Autoimmune thyroid illnesses often include the existence of antibodies against thyroid peroxidase (TPO), thyroglobulin (Tg), and thyroid stimulating hormone receptor (TSHR). We specifically targeted recently diagnosed adult patients with Graves' disease (GD), Hashimoto's thyroiditis (HT), and those with normal thyroid function as controls. The study looked at and compared different groups' levels of anti-TG antibodies, anti-TPO antibodies, and anti-chlamydia antibodies in the blood, as well as several clinical and biochemical markers, such as thyroid function tests. We analyzed data from a cohort of 60 patients diagnosed with Hashimoto's thyroiditis (HT), 60 patients diagnosed with Graves' disease (GD), and 60 healthy individuals serving as controls. The study found a strong link between having anti-TPO Abs and having Hashimoto's hypothyroidism (63.3%) and Graves' hyperthyroidism (86.7%). In the groups without anti-TPO Abs, Hashimoto's hypothyroidism was found in 36.7% of people and Graves' hyperthyroidism was found in 13.3% (P<0.03). Anti-thyroid peroxidase antibodies (anti-TPO Abs) are found in 86.7% of people with Graves' disease, which is more than the 63.3% of people with Hashimoto's disease who have these antibodies. There is no significant link between the percentage of people who have anti-TG antibodies and either Hashimoto's hypothyroidism (96.7%) or Graves hyperthyroidism (90%), according to the study. The significance level was set at P = 0.143. This is in comparison to the percentage of negativity in Hashimoto's hypothyroidism (3.3%) and Graves's hyperthyroidism (10.0%). The study showed how the groups were spread out based on the presence of Chlamydia trachomatis IgG antibodies. Chlamydia trachomatis IgG antibodies were much more common in people with Hashimoto's hypothyroidism (42) and Graves hyperthyroidism (26) than in the control group (0) (P<0.01).

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 < 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 < 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 < 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.

Biochemical evaluation of thyroid hormone level in infertile women: A case control study

Introduction: Infertility in women is an important health problem which imposes psychological stress and affects the wellbeing of couples. Thyroid disorders is the most frequently encountered endocrine problem among the women in the age reproductive and it can lead to infertility and miscarriage. The objective of the study was to evaluate the thyroid hormone level in infertile women and compared to the healthy controls. Materials and methods: The study was conducted on 50 infertile women (cases) and 50 fertile healthy women (controls). Thyroid stimulating hormones (TSH), free triiodothyronine (fT3), free thyroxine (fT4) and Anti-thyroid peroxidase (Anti-TPO) levels were estimated and compared between the cases and controls. Results: The mean TSH level was significantly higher in infertile women (cases) as compared controls (6.76±0.87 vs 2.54±0.12mIU/L; p=0.002).The prevalence of hypothyroidism among the infertile women in the present study was 28%. The anti-TPO antibody level was significantly higher was in infertile women as compared to controls (4.87±0.8 vs 2.32±0.05 IU/ml; p=0.000). In addition the number of positive Anti-TPO antibody cases was higher in infertile women as compared to controls (24% vs 4%; p=0.02). Conclusion: Therefore, women planning for pregnancy and infertile women must be evaluated for thyroid profile and if there are any abnormalities they should undergo proper treatment for better pregnancy outcome.

Effect of low and high doses of vitamin D3 therapy on vitamin D3, antithyroid antibody and thyroid hormone levels in thyroid autoimmunity

Aims: Vitamin D3 deficiency is more common in autoimmune thyroid diseases (AITD). Vitamin D3 supplementation in AITD is not questioned, but the required doses have been offered differently in several reports. This study attempts to provide a clinical answer as to what doses of vitamin D3 may be effective in AITD. Methods: Ninety-seven patients were included in the study: 44 with Hashimoto’s thyroiditis (HT), 26 with Graves ’disease (GD) and 27 controls. Serum vitamin D3, thyroid hormone and autoantibody levels against thyroid peroxidase (TPO) and TSH receptor were measured before and after treatment. Biochemical data were measured by a fully automated competitive chemiluminescence assay and presented as geometric mean(95% confidence interval). Results: Baseline vitamin D3 deficiency was detected in 22 out of 44 HT, 13 out of 26 GD and 19 out of 27 controls, and improved after vitamin D3 therapy. Vitamin D3 therapy significantly increased serum vitamin D3 levels in all patient groups [46.07(16.55-128.29) vs. 71.05(40.61-124.3) nmol/l, p<0.0001 for HT, 44.27(8.98-218.25) vs. 64.22(38.85-106.16) nmol/l, p<0.0207 for GD, and 39(15.57-97.73) vs. 59.32(27.27-129.03) nmol/l, p<0.0003 for controls]. The increass in vitamin D3 levels was found after low-dose vitamin D3 therapy (<7000 NE/week) in HT (p<0.0001) and controls (p<0.0002), but not in GD. The success of vitamin D3 therapy was dependent on high doses of vitamin D3 (>7000 NE/week) in GD, but levels were lower in Graves’ ophthalmopathy (p<0.0302). Anti-TPO antibody and TSH levels were decreased by low doses of vitamin D3 in HT, but FT4 and FT3 decreased, and TSH levels increased only by high doses in GD. Conclusion: The efficacy of vitamin D3 therapy was demonstrated in all patient groups. The greatest improvement in vitamin D3 status was seen in HT. A dose-dependency of vitamin D3 therapy was rather related to the improvement in GD.

In infertile women with subclinical hypothyroidism, with or without thyroid peroxidase antibodies, serum TSH during pregnancy follows preconception values and thyroid hormones remain stable.

How does subclinical hypothyroidism, defined in infertile women during preconception by thyroid-stimulating hormone (TSH) >2.5 or >4.5 mIU/l, with or without thyroid peroxidase antibodies (anti-TPO) >100 IU/ml, impact thyroid hormone levels during pregnancy and after birth? During pregnancy, TSH levels remain similar to those in preconception, even with supplementary thyroxine, whereas the serum levels of anti-TPO progressively decline. Overt hypothyroidism impacts both pregnancy and offspring but randomized clinical trials and cohort studies failed to detect the benefit of treatment with thyroxine in cases with low-threshold TSH or with anti-TPO during pregnancy. First, the prevalence and reproducibility of two candidate cut-off levels of subclinical hypothyroidism in a cohort of 177 infertile women was compared with 171 women not aiming for pregnancy. Second, the impact of distinct setpoints of TSH in preconception (with or without anti-TPO) was monitored during pregnancy in 87 previously infertile women by high-frequency monitoring of thyroid function. Both studies were carried out from 2007 to 2019. Reproducibility and prevalence of subclinical hypothyroidism were examined in infertile women presenting in the fertility care unit of an academic institution. Women not aiming for pregnancy participated as controls. In both groups, TSH and anti-TPO were measured two times on different occasions. In addition, a group of previously infertile women with known preconception setpoints of TSH (with or without anti-TPO) were followed up prospectively throughout pregnancy and after birth. During pregnancy, serum was sampled weekly until Week 12, then monthly until delivery, and once after birth. Only cases with preconception TSH >4.5 mIU/l were supplemented with thyroxine. After collection of all samples, the serum levels of anti-TPO and the major thyroid hormones were measured. Prolactin with known fluctuations during pregnancy was used as reference. Measures of both TSH and anti-TPO at two different time points were accurate and reproducible. The odds of subclinical hypothyroidism in infertile women and controls were similar. During pregnancy, TSH closely followed preconception TSH levels, whereas serum levels of the thyroid hormones predominantly remained within or above (not below) the reference. Treatment of infertile women with preconception TSH >4.5 mIU/l with thyroxine resulted in higher free thyroxine (fT4) serum levels. The serum levels of anti-TPO declined as pregnancies evolved. The numbers of participants both in the prevalence study and in pregnancy did not reach the a priori estimated numbers. For ethical reasons, the patients with preconception TSH >4.5 mIU/l were treated with thyroxine. The findings apply to infertile women only. We propose to use >4.5 mIU/l as the serum TSH threshold for supplementing women with thyroxine before pregnancy. During pregnancy, fT4 may be the better marker to monitor thyroid function. The consistent decrease of anti-TPO antibody levels during ongoing pregnancies must be considered a protective element. The prevalence part of this study was supported by Merck-Serono, Geneva (TH006/EMR200007-603). The hormone measurements of the serum samples collected during the follow-up pregnancies were made possible by financial support of Roche Diagnostica (November 1721, 2017, Rotkreuz, Switzerland). I.D.G. was supported by a grant of the Repronatal Foundation, Basel, Switzerland. All authors declare no conflict of interest. Research Database of UniBasel, project no. 576691 (2007).

Association of HLA-DRB1*04 gene with Hashimoto’s thyroiditis among Iraqi-Kurdish population in Erbil province

Background and objective: Hashimoto’s thyroiditis is one of the common autoimmune thyroid diseases with increasing incidence in the general population. It has been suggested that a combination of genetic and environmental factors increase the risk of developing the disease. The current study aimed to find the association between HLA-DRB1*04 gene with Hashimoto's Thyroiditis among the Iraqi-Kurdish population in Erbil Province. Methods: The case-control study was conducted on 45 untreated patients with Hashimoto’s thyroiditis who have already been diagnosed and 45 control subjects. Blood specimens were taken from the subjects for gene detection purposes via conventional polymerase chain reaction. Sera specimens were used to run enzyme linked immunosorbent assay to measure the level of IFNγ. Results: The age of subjects ranged from 32 to 63 years with no significant difference between mean ±SE of cases (46.822±1.087 years) with the mean ±SE (47.044 ±1.162 years) of the control subjects (P = 0.999). The mean ±SE of free T3 and T4 levels was lower in cases in comparison to those of controls, while the mean ±SE of TSH level in cases was significantly higher compared to those of controls. Statistically there was a highly significant difference in the mean ±SE of free T3, free T4 and TSH levels between cases and controls (P <0.001). Furthermore, the mean ±SE of anti-TPO, anti-Tg and IFNγ levels was higher in cases compared to those of control subjects. Statistical analysis shows a highly significant difference between mean ±SE of anti-TPO and anti-Tg antibody levels of cases compared to those of controls (P <0.001). As for IFNγ level, there was a significant difference between mean±SE of IFNγ levels in cases and controls (P = 0.021). The conventional polymerase chain reaction results showed that 39/45 (86.7%) of cases were tested positive for HLA-DRB1*04, while only 20/45 (44.04 %) of the control subjects tested positive for the gene, statistical analysis revealed a highly significant association between the existence of the gene with HT disease (P <0.001). Conclusion: The study revealed a highly significant association between the existence of HLA-DRB1*04 gene and Hashimoto's thyroiditis disease among the Iraqi-Kurdish population in Erbil Province.

Assessment of autoantibodies in paediatric population with primary immunodeficiencies: a pilot study

BackgroundThe correlation between primary immunodeficiencies (PIDs) and autoimmunity shows ethnic and geographical diversity. The aim of our study was to accumulate more data in paediatric PID population.Methods58 children aged 1–17 and with PID (study group) and 14 age-matched immunocompetent individuals (control group) were included in the study. Serum levels of 17 different specific IgG antibodies against autoantigens were measured by means of a quantitative enzyme immunoassay. Immunoglobulin levels were analysed in relation to a detailed medical examination.ResultsAutoantibodies against one or more antigens were detected in the sera of 24.14% (n = 14) subjects in the study group. The most frequent were anti-thyroid peroxidase (anti-TPO) antibodies (n = 8; 13.8%). Anti-TPO antibody levels were elevated more often in PID patients with a positive family history of autoimmune diseases (p = 0.04). The screening for anti-deamidated gliadin peptide (DGP) and anti-tissue transglutaminase (tTG) antibodies in our series allowed identifying two previously undiagnosed cases of coeliac disease in PID patients. There was no statistically significant difference between the study and the control group in terms of the autoantibodies prevalence.ConclusionsThis study provides data on the prevalence of autoantibodies in paediatric population diagnosed with PID. Selected autoantibodies (i.e. anti-tTG, anti-DGP) might be useful for the screening of PID to avoid the delay of diagnosis of an autoimmune disease.

Correlation Analysis of HHV-6A Viral Load and Anti-TPO Antibody Levels in Patients with Hashimoto’s Thyroiditis

Aim: This study investigated the correlation between anti-thyroid peroxidase (anti-TPO) antibody levels and human herpesvirus 6 (HHV-6) viral load as triggers for Hashimoto's thyroiditis (HT). Materials & methods: The study included 60 HT patients, 60 patients with non-autoimmune thyroid disease, and 60 subjects with normal thyroid function. HHV-6 viral loads in serum samples were detected using real-time PCR. Results: A significant correlation was found between the increase in viral load and increased levels of anti-TPO antibodies in serum samples from HT patients (p = 0.001). Conclusion: The aim of this study was to explore the potential involvement of HHV-6A in the onset of HT, with the goal of identifying improved treatment options for affected individuals.

Is there a relationship between the urinary iodine of pregnant and diabetic patients?

We investigated the iodine status in this study in pregnant women, diabetic women-men, and nondiabetic men-women living in our region. A total of 385 cases who applied to the endocrine clinic between 2015 and 2020 were reviewed retrospectively. The gender, age, free T3 (pg/ml), free T4 (ng/dl), TSH (μIU/mL), anti-TPO antibody (IU/ml), anti-thyroglobulin antibody (IU/ml), and random urine iodine concentration (μg/L) levels of cases were recorded. The cases were grouped as pregnant, female, male, diabetic female, and diabetic male. Cases with overt thyroid disease, heart failure, liver failure, and kidney failure were excluded. There were 6.75% (n = 26) pregnant, 54.8% (n = 211) nondiabetic female patients, 18.9% (n = 73) diabetic female patients, 12.7% (n = 49) nondiabetic male, and 4.15% (n = 16) diabetic male patients. The random urinary iodine level was significantly higher in nondiabetic women (112.9 ± 77.21) and diabetic women (140.7 ± 97.8) than in pregnant women (77.8 ± 31.8) (P = 0.00 and P = 0.03). There was no significant relationship between random urine levels of pregnant women and nondiabetic men (104.1 ± 82.6) (P = 0.16). The random urinary iodine level was significantly higher in diabetic men (170.0 ± 112.1) than in pregnant women (P = 0.00). In our region (xxx Region), pregnant women had iodine deficiency. The iodine level in men and women was very close to the lower limit. The urinary iodine level was higher in diabetic women and diabetic men than in both pregnant women and nondiabetic women and nondiabetic men. The results brought us the question: Could the high spot urinary iodine level in diabetic patients be a clue to nephropathy?

Study on Autoimmune Thyroid Disorders in Chronic Spontaneous Urticaria at a Tertiary Care Central Rural Hospital in India.

Background Chronic spontaneous urticaria (CSU) is a medical condition characterized by the persistence of urticaria for more than six weeks, primarily caused by mast cell activation. Autoimmune thyroid diseases (AITDs) are the most common cause of dysfunction of the thyroid gland, and they are influenced by both genetic and environmental factors. Mast cell mediators have a significant role in the pathogenesis of CSU through two main pathways: the derangement of intracellular signaling pathways in mast cells and basophils and the production of autoantibodies against these cells. This study aimed to explore the association between AITDs and CSU by examining clinical features and measuring thyroid hormones and anti-thyroid peroxidase (anti-TPO) antibodies in patients. Aim and objectives The primary aims of this study are to investigate the prevalence and clinical characteristics of autoimmune thyroid disorders in patients with chronic spontaneous urticaria. The specific objectives are to evaluate the triiodothyronine (T3), tetraiodothyronine (T4), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (anti-TPO) antibody levels in patients and controls and to explore the correlations between these parameters and the development and severity of chronic spontaneous urticaria. Material and method The present study was an observational investigation that enrolled 40 patients, consisting of 20 cases and 20 controls. The inclusion criteria involved patients of both sexes, aged above 18 years, who had chronic spontaneous urticaria and agreed to participate in the study with informed consent. Patients with other skin conditions lacking abnormal thyroid etiopathogenesis were also included. Exclusion criteria included patients with major systemic disease, uncontrolled medical or surgical illness, renal or hepatic disorders, and pregnant or lactating females. Patients with chronic spontaneous urticaria underwent a comprehensive clinical evaluation, and their urticaria severity was scored using an established scoring system. Blood samples were collected from both cases and controls for measuring T3, T4, TSH, and anti-TPO antibody levels. The anti-TPO antibody was processed using the enzyme-linked immunosorbent assay (ELISA) method. The autoimmune thyroid disease was screened by monitoring T3, T4, TSH, and anti-TPO antibody levels. Results There were significant variations observed in thyroid-stimulating hormone and anti-thyroperoxidase antibody levels. Among the cases analyzed, 40% demonstrated an urticaria severity score of one, while 25% reported a duration exceeding eight weeks. Additionally, 25% of patients experienced severe pruritus and intense wheals. Conclusions This research has discovered a robust association between serum anti-TPOantibodies and the occurrence of chronic spontaneous urticaria. To mitigate the potential for chronic spontaneous urticaria to lead to long-term morbidity, it is imperative to consider testing for serum anti-TPO antibodies in conjunction with primary thyroid markers, including T3, T4, and TSH.

Abstract #1406613: Recurrent Thyroiditis in a Patient with Multiple sclerosis on Natalizumab

Thyroiditis, or self-limiting inflammation of the thyroid gland consists of 3 phases: hyperthyroidism, from release of hormone from damaged cells; hypothyroidism, when thyroid stores are depleted and euthyroidism with restoration of thyroid function. Etiology can include infectious, drug-induced or autoimmune causes such as multiple sclerosis (MS). In fact, 20-25% of untreated MS patients have autoimmune thyroiditis [1]. Moreover, drugs used to treat MS such as alemtuzumab and interferon have been reported to cause thyroid disease [2]. A 42-year-old female with MS on natalizumab for 10 years presented with right sided neck pain radiating to her jaw for 3 months and difficulty swallowing. Family history was pertinent for hypothyroidism in her father, and MS in her brother. She was exposed to nuclear radiation at age 3 from the Chernobyl disaster. On presentation, vital signs and physical exam were unremarkable. Thyroid ultrasound noted an ill-defined 4.2X1.3X1.9 cm hypoechoic nodule in the right mid-pole. Fine needle aspiration of the nodule showed subacute granulomatous thyroiditis (SAH). Labs showed TSH 0.02mIU/L [0.4-4.5], FT4 1.5ng/dL [0.8-1.8] and elevated total T3 204ng/dL [76-181]. TSI< 89 [140%]. Naproxen was given for pain control. Repeat labs 1 month later showed TSH 0.83mIU/L, FT4 1.1 ng/dL and total T3 196ng/dL, consistent with resolution of thyroiditis and clinically correlated with resolution of her pain. However, a month later she presented with worsening left sided neck pain and left thyromegaly associated with speech difficulty, diaphoresis, and constipation. Repeat thyroid ultrasound showed decreased size of right thyroid nodule 1.1X1.1X0.9cm and findings consistent with thyroiditis. She was treated with prednisone with complete resolution of symptoms. Labs post treatment showed elevated TSH 6.01mIU/L, total T3 106ng/dL, and FT4 0.8ng/dL consistent with the recovery phase of thyroiditis. Anti-TPO antibody level was < 1 [< 9 IU/mL]. Labs 1 month later showed normal TSH and FT4 levels. Natalizumab, a humanized monoclonal antibody commonly used to treat MS, has rarely been associated with thyroid disease. Alterations in thyroid function are thought to be due to direct toxicity on the thyroid, its blood supply or indirectly mediated by the immune system [2]. Although MS can be associated with thyroiditis, our patient did not present with the typical pattern of thyroiditis. Instead, she reported symptoms consistent with inflammation of one lobe of thyroid followed by resolution, and thereafter developed inflammation and pain of the other lobe, raising suspicion of potential involvement of natalizumab due to her atypical presentation.

Anti-TPO antibody and thyroid hormone levels in Iranian female breast cancer patients and their association with prognostic factors: a case-control study

The aim of this study was to assess prevalence of anti-thyroid peroxidase (anti-TPO) antibody and thyroid hormones in Iranian female breast cancer patients, compare them to a control population, and investigate their association with prognostic factors. In this case-control study, breast cancer patients were selected from a surgery clinic in a tertiary hospital and control group participants were enrolled from those who had visited for mammography screening. Participants with any history of thyroid disease, or thyroid related medication were excluded from both groups. Groups were assessed for levels of thyroid stimulating hormone (TSH), T3, T4, and anti-TPO. In addition, the status of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) was determined for cancer patients. Overall 69 participants (39 cancer patients and 30 controls) were included. Difference in serum anti-TPO levels between the two groups was not statistically significant (p-value: 0.184). While a significant difference was observed for T4 and TSH levels between groups (p-value: 0.034 and <0.001, respectively), T3 levels did not reveal any significant difference (p-value: 0.177). In addition, ER, PR, and HER2 status were not correlated with anti-TPO levels. This results can serve as preliminary evidence that thyroid autoimmunity is not correlated with breast cancer incidence in Iranian female population. However, additional studies with larger sample sizes are required for more conclusive evidence.

A Cross-Sectional Study to Determine the Prevalence of Thyroid Autoimmunity in Patients with Chronic Spontaneous Urticaria

Abstract Background: Chronic spontaneous urticaria (CSU) can be a distressing condition for both the patient and the treating doctor due to the lack of a definite underlying etiology. The condition has been found to be associated with autoimmune (AI) conditions, which brings to light possible pathogenesis being shared by AI conditions and chronic urticaria. This can help us understand the condition better as well as have a bearing on the treatment. Thyroid autoimmunity is one such condition which has commonly been associated with chronic urticaria. Objectives: To determine the prevalence of thyroid autoimmunity in patients with CSU. To determine the correlation between thyroid autoantibodies level and the severity and duration of CSU. Materials and Methods: Forty-eight adult patients of CSU were enrolled, in whom thyroid autoimmunity was determined by detecting the levels of anti-thyroid peroxidase (anti-TPO) antibody. Urticaria Activity Score was used to determine the activity of the disease. Results: Nine out of 48 (18.75%) patients showed raised anti-TPO antibody levels. Eight out of those 9 (88.89%) patients were female. No correlation was found between the duration of disease and the antibody levels. A significant association was found between the disease activity and anti-TPO antibody levels. Conclusion: The prevalence of thyroid autoimmunity is higher in patients of CSU compared to the general population. The condition occurs more frequently and with greater severity in the female population.

Endocrine system involvement in patients with RASopathies: A case series.

Endocrine complications have been described in patients affected by RASopathies but no systematic assessment has been reported. In this study, we investigate the prevalence of endocrine disorders in a consecutive unselected cohort of patients with RASopathies. 72 patients with a genetically confirmed RASopathy (Noonan syndrome [NS], N=53; 29 LEOPARD syndrome [LS], N=2; cardiofaciocutaneous syndrome [CFCS], N=14; subjects showing co-occurring pathogenic variants in PTPN11 and NF1, N=3) and an age- and sex-matched healthy controls were included in the study. Endocrine system involvement was investigated by assessing the thyroid function, pubertal development, auxological parameters, adrenal function and bone metabolism. Short stature was detected in 40% and 64% of the NS and CFCS subcohorts, respectively. Patients showed lower Z-scores at DXA than controls (p<0.05) when considering the entire case load and both NS and CFCS groups. Vitamin D and Calcitonin levels were significantly lower (p< 0.01), Parathormone levels significantly higher (p<0.05) in patients compared to the control group (p<0.05). Patients with lower BMD showed reduced physical activity and joint pain. Finally, anti-TPO antibody levels were significantly higher in patients than in controls when considering the entire case load and both NS and CFCS groups. The collected data demonstrate a high prevalence of thyroid autoimmunity, confirming an increased risk to develop autoimmune disorders both in NS and CFCS. Reduced BMD, probably associated to reduced physical activity and inflammatory cytokines, also occurs. These findings are expected to have implications for the follow-up and prevention of osteopenia/osteoporosis in both NS and CFCS.

To study the prevalence of thyroid autoimmune antibody in chronic kidney disease patients with hypothyroidism in Eastern Uttar Pradesh

Chronic kidney disease (CKD) is defined as the presence of kidney damage. Hypothyroidism is prevalent in patients with CKD, including those on dialysis. The present observational cross-sectional study included 120 patients (70 subjects and 50 controls) who had previously been diagnosed with chronic kidney disease and primary hypothyroidism, as well as those who presented with primary hypothyroidism alone. Serological Estimation of Anti-TPO Antibody, T3, T4 and TSH levels were done as per standard protocol. We enrolled 120 patients, 70 of whom had hypothyroidism in addition to CKD and 50 of whom had hypothyroidism without CKD. Twenty percent of the cases tested positive for anti-TPO antibodies, while 80 % tested negative for anti-TPO antibodies. 71.5 % of positive cases were female, while 28.5 % were male. Among the controls, 74% were positive for anti-TPO antibodies, and 26% were negative. 64.9 % of the positive controls were female, while 35.1 % were male.Our findings indicate that primary hypothyroidism is prevalent in a subgroup of patients with chronic kidney disease. The non-autoimmune mechanism appears to be more prevalent. However, additional multi-centric studies will be necessary to improve the reliability and generalizability of the current study's observations.

Association of anti thyroid peroxidase antibody with thyroid profile in the patients of subclinical hypothyroidism

Background: Thyroid is an endocrine gland which is ductless and plays very important roles such as metabolism of body along with maturation and growth. Subclinical Hypothyroidism is a mild form of Hypothyroidism which due to the abnormal level of TSH. Objectives: The aim of the study was to find out the correlation of anti-TPO antibody with thyroid profile in subclinical hypothyroidism. Materials and Methods: The present study was conducted on 200 cases and 200 controls who attended the OPD of Shri Guru Ram rai Institute of Medical and Health Sciences, Dehradun. The various Biochemical investigation (TSH, FT3, FT4 &amp; Anti- TPO) of these patients were analyzed by ELISA Method with standard protocol. Data analyzed statistically by SPSS software. Results: The study observed TSH and Anti-TPO antibody level was statistically higher (p-value= &lt;0.05) in cases as compared to control. Free T3 and Free T4 value was in normal range in both subjects. Anti-TPO antibody has positive correlation with THS. Conclusion: Out of all the investigations and observations only record of TSH is the definite prognostic marker to ensure that the patients have subclinical hypothyroidism.

Association of Psoriasis With Thyroid Disorders: A Hospital-Based, Cross-Sectional Study.

BackgroundAlthough numerous studies have been conducted to determine the relationship between psoriasis and thyroid dysfunction, contrasting results have been reported. The link between psoriasis and thyroid disease has not been elucidated well. This study aimed to determine the frequency of thyroid dysfunction and its relationship with gender, age, duration, and severity of psoriasis among patients with psoriasis.MethodologyPsoriasis was diagnosed clinically, and the severity of the disease was assessed by the Psoriasis Area Severity Index (PASI) score and the body surface area (BSA) involved, as measured by Wallace’s rule of nine. A total of 111 patients with psoriasis were analyzed for thyroid dysfunction, which included thyroid-stimulating hormone, free T3, free T4, and anti-thyroid peroxidase (anti-TPO) antibody levels. SPSS version 23.0 (IBM Corp., Armonk, NY, USA) was used for analysis.ResultsOut of the 111 analyzed psoriasis patients, deranged thyroid status was observed in 22 patients. Anti-TPO was increased in 19 patients. Patients with thyroid dysfunction had a more severe form of psoriasis (both by PASI score and BSA involvement) than those with mild psoriasis (61.9% vs. 38.1%), whereas patients with increased anti-TPO had a milder disease.ConclusionsThis study illustrated deranged thyroid status and thyroid autoimmunity in 19.8% and 17.1% of psoriasis patients, respectively, suggesting thyroid dysfunction and autoimmunity. However, further studies are required to expand our knowledge of psoriasis and its association with thyroid dysfunction and thyroid autoimmunity, as well as with age, gender, disease duration, and severity of psoriasis.

The Association Between Anti-Thyroid Peroxidase Antibody and Dyslipidemia in Subclinical Hypothyroidism Among the Rural Population of Central India.

ObjectiveIn this study, we aimed to determine the association between anti-thyroid peroxidase (anti-TPO) antibody and dyslipidemia in subclinical hypothyroidism (SCH).Materials and methodsWe conducted a cross-sectional case-control study in the department of medicine at a tertiary care teaching hospital in central India. The study consisted of 150 patients (75 cases and 75 controls) who fulfilled the inclusion and exclusion criteria.ResultsThe study showed that serum cholesterol was high in 23.1% of cases in the negative anti-TPO antibody SCH sub-group and 88.7% of cases in the positive anti-TPO antibody SCH sub-group (p<0.001). Serum triglyceride (TG) levels were high in 61.5% of cases in the negative anti-TPO antibody SCH sub-group and 90.3% of cases in the positive anti-TPO antibody SCH sub-group (p=0.008). Serum high-density lipoproteins (HDL) were low in 15.4% of cases in the negative anti-TPO antibody SCH sub-group and 24.2% of cases in the positive anti-TPO antibody SCH sub-group (p=0.490). Serum low-density lipoproteins (LDL) were high in 61.5% of cases in the negative anti-TPO antibody SCH sub-group and 90.3% of cases in the positive anti-TPO antibody SCH sub-group (p=0.008). Serum very-low-density lipoproteins (VLDL) were high in 84.6% of cases in the negative anti-TPO antibody SCH sub-group and 83.9% of cases in the positive anti-TPO antibody SCH sub-group (p=0.947). Based on our findings, 82.8% of participants with negative anti-TPO antibodies had normal serum LDL levels, while 11.1% of participants with positive anti-TPO antibodies had normal LDL levels (p<0.001). The study also showed that elevated serum LDL was present in 17.2% of participants with negative anti-TPO antibody levels and 88.9% of participants with positive anti-TPO antibodies (p<0.001). The study showed a correlation coefficient of 0.0432 between serum TG and anti-TPO antibody levels (p<0.001).ConclusionOur findings showed an increased incidence of dyslipidemia in SCH patients with positive anti-TPO antibodies. SCH with positive anti-TPO antibody is significantly associated with elevated serum total cholesterol (TC) levels, serum TG levels, and serum LDL levels. Hence, early screening and diagnosis of dyslipidemia are crucial to prevent cardiovascular morbidity and mortality in SCH patients with positive anti-TPO antibodies.

Protection and safety of a repeated dosage of KI for iodine thyroid blocking during pregnancy

In case of nuclear power plant accidents resulting in the release of radioactive iodine (131I) in large amounts, a single intake of stable iodine is recommended in order to prevent 131I fixation to the thyroid gland. However, in situations of prolonged exposure to 131I (e.g. Fukushima-Daiichi natural and nuclear disaster), repetitive administration of iodine may be necessary to ensure adequate protection, with acceptable safety in vulnerable populations including pregnant women. Here we conducted toxicological studies on adult rats progeny following prolonged exposure to potassium iodide (KI) in utero. Pregnant Wistar rats were treated with 1 mg kg d−1 KI or saline water for 2 or 4 d either between gestation days gestational day (GD) GD 9–12, or GD13–16. Plasma samples from the progeny were tested 30 d post-weaning for clinical biochemistry, thyroid hormones, and anti-thyroid antibody levels. Thyroid and brain were collected for gene expression analysis. The hormonal status was similar for the mothers in all experimental conditions. In the offspring, while thyroid-stimulating hormone and anti-thyroid peroxidase (anti-TPO) antibody levels were similar in all groups, a significant increase of FT3 and FT4 levels was observed in GD9–GD10 and in GD13–GD14 animals treated for 2 d, respectively. In addition, FT4 levels were mildly decreased in 4 d treated GD13–16 individuals. Moreover, a significant decrease in the expression level of thyroid genes involved in iodide metabolism, TPO and apical iodide transporter, was observed in GD13–GD14 animals treated for 2 d. We conclude that repeated KI administration for 2–4 d during gestation did not induce strong thyroid toxicity.

Gestational Diabetes Mellitus with autoimmune subclinical hypothyroidism in pregnancy in relation to gravida.

ABSTRACTIntroduction:Gestational diabetes mellitus (GDM) and hypothyroidism are the most common endocrinological abnormalities associated with pregnancy. The association of gravida with incidence of autoimmune subclinical hypothyroidism (SCH) and GDM in pregnancy has not been studied extensively with availability of very limited data in this context. So, this study was done to find out the association between GDM and autoimmune SCH in pregnancy as per gravida status of the study population.Materials and Methods:382 antenatal cases, both primi and multigravida, were screened for thyroid dysfunction and GDM in their first ANC coming to a tertiary level health care institution. 75 gm GCT was used for diagnosis of GDM and serum TSH, fT4, and anti-TPO antibody were measured for assessment of thyroid dysfunction. Prevalence of SCH was evaluated taking the ATA 2011 guidelines. Data obtained was also compared with ATA 2017 recommendations. Anti-TPO antibody level more than 60 U/L was considered to be raised value.Observation:The percentage of GDM was higher in autoimmune SCH participants compared to euthyroid cases with raised anti-TPO Ab Titer. GDM, SCH, and raised anti-TPO Ab titer were overall more prevalent in multigravida cases compared to primigravida participants.Conclusion:GDM and SCH with high anti-TPO Ab titer were more prevalent in multigravida participants compared to primigravida cases though not statistically significant. As occurrence of SCH varies with nutritional and geographical factors, hence internal trimester specific range should be calculated and used in practice as recommended by ATA 2017 guidelines.