Incidence Of Autoimmune Thyroiditis Research Articles

Detection of autoimmune thyroiditis in children with goitre attending the pediatric department of a tertiary care hospital in Chennai.

Introduction: Goitre is a common problem among children. The incidence of autoimmune thyroiditis is on the rise. This study is intended to evaluate all goitrous children with Thyroid profile and to look for autoimmunity. AIM To detect autoimmune thyroiditis in children less than 15 years of age with goitre. Objectives: To screen for thyroid dysfunction. To detect autoimmunity by antithyroid antibodies and FNAC. Materials and methods: 107 Children with goitre attending the Paediatric Department of ESIC Medical College and PGIMSR were included. Relevant history and physical examination findings were documented in a preset proforma. Thyroid function tests, anti TPO antibody and FNAC of the thyroid gland were done. The results were analysed statistically. Observations and Results: Out of 107 children, 10 had evidence of hypothyroidism. Anti TPO antibodies were detected in 11, while 8 had FNAC evidence of autoimmune thyroiditis. While all the FNAC positive cases had hypothyroidism only 8/11 antibody positive cases had evidence of thyroid dysfunction. Three cases with neither evidence of hypothyroidism nor FNAC positivity had antibody positivity. On comparing antibody positivity with FNAC in the detection of autoimmunity, we inferred that antibody positivity can be used as a diagnostic tool. Conclusion: Prevalence of autoimmunity was 7.5% by FNAC and 10.3% by anti TPO antibodies. Hypothyroidism was detected in 9.34% of goitres. Few cases of AIT may not have hypothyroidism, may require serial TFT. Anti TPO antibody positivity is an effective, less invasive indicator for detecting AIT in children, compared to FNAC which is the gold standard.

Заболеваемость аутоиммунным тироидитом в республике Беларусь и радиационный фактор

Actuality: In the Belarus, the primary incidence of thyroid pathology is in the 2d rank among endocrine diseases after diabetes. Studying the trends in the primary incidence of autoimmune thyroiditis (AIT) in the Belarus is important for improving organizational decisions and further improving the quality of medical care for the population.
 Purpose: Is to conduct a comparative analysis of the incidence of AIT in the population and in the affected population based on an epidemiological study in the Belarus, taking into account the radiation and organizational components in the formation of pathology.
 Material and methods: The data of the republican statistical reports and the data of the Chernobyl Register from 1997 to 2017 were analyzed. Standard methods of descriptive epidemiology were used in the work.
 Results: According to Chernobyl Registry, during the observation period (1997–2017), the primary incidence of AIT decreased by 1.4 times (1997 – 135.1 ± 15.77 0/0000; 2017 – 98.4 ± 7.55 0/0000). The incidence was statistically significantly higher in women than men (ratios ranged from 2.39: 1 in 2004 to 4.0: 1 in 2000). Moreover, the incidence according to Chernobyl Registry was higher than in the adult population, but in children where was no difference with population data. This indicates a high-quality clinical examination of the children’s population. Two organizational and medical approaches have been formed in the republic. The first approach (Grodno, Brest, Minsk regions and Minsk) is characterized by periods of moderate growth, decline, and growth again. In the second approach (Vitebsk, Mogilev and Gomel regions), there are two periods when the increase in incidence sharply changes to decrease before the end of the study period. An analysis of the odds ratio allowed us to conclude that insignificant effect of radioactive iodine on the incidence of AIT in children at the time of the accident and its absence in the adult population.
 Conclusion: The study confirms the importance of the organizational component in the early diagnosis of AIT.

Effects of Environmental Chemicals on the Course of Autoimmune Thyroiditis

Introduction. The relevance of the research is attributed to the increased incidence of autoimmune thyroiditis in children, especially those dwelling in contaminated areas. Our objective was to study effects of environmental exposures to industrial chemicals on the course of autoimmune thyroiditis. Materials and methods. In order to establish the relationship between specific features of the course of autoimmune thyroiditis and adverse environmental exposures, we conducted a comparative study of incidence rates of thyroid diseases including thyroiditis, cytotoxicity testing, thyroid status assessment, antioxidant activity assays, and thyroid ultrasound. The observation group consisted of 98 children living the area with the developed metallurgical industry while the comparison group included 23 children living in a recreation area. The groups were matched by age and socio-economic characteristics. Results. We established that thyroiditis incidence rates in the industrially polluted area were almost thrice as high as those in the relatively clean area. The observation group was characterized by smoothed sexual differentiation, earlier development of the autoimmune thyroiditis, higher (up to 1.6 times) frequency of typical diffuse structural changes, and increased thyroid gland. Blood levels of metals having a direct cytotoxic effect on the thyroid gland were 2.0 to 6.7 times higher than normal in the cases compared to their matched controls. The correlation and regression analysis established contribution of chemicals to the increased incidence of autoimmune thyroiditis in children (zinc), antibodies to thyroid gland tissue (lead), thyroid-stimulating hormone (nickel), and decreased resistive indices (lead). Conclusion. High blood levels of lead, nickel and zinc were among the factors having an adverse effect on the course of AIT and thyroid function.

The relationship between autoimmune thyroiditis and pregnancy outcomes of patients with PCOS following in vitro fertilization and embryo transfer IVF-ET

Objective: To investigate the impact of autoimmune thyroiditis (AIT) on pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) following the in vitro fertilization and embryo transfer (IVF-ET) by analyzing their pregnancy outcomes. Methods: The patients undergoing IVF-ET treatment diagnosed with PCOS in Peking University Third Hospital from May 2010 to December 2014 were investigated. According to the anti-thyroid antibodies (TPOAb or TGAb), patients were divided into AIT group and non-AIT group. The pregnancy outcomes of two groups were analysed for investigate the effect of AIT on pregnancy outcomes. Results: Four hundred and ninety patients with PCOS were enrolled, 119 (24.3%) of AIT group and 371 (75.7%) of non-AIT group. Patients with PCOS had a higher incidence (24.3%) of AIT. There was no correlation between AIT and the different pregnancy outcomes.TSH was negatively correlated with pregnancy as a risk factor. Hyperandrogenemia was negatively correlated with clinical pregnancy as a risk factor. Hyperprolactinemia was negatively correlated with delivery as a risk factor, while TSH was positively correlated with delivery. Conclusions: The incidence of AIT was higher in patients with PCOS. AIT was not the risk factor of adverse pregnancy outcomes for PCOS women undergoing IVF. The metabolic disorders (including hyperinsulinemia, hyperandrogenemia and hyperprolactinemia) were the risk factors of adverse pregnancy outcomes. Patients in AIT group had the high TSH level. They should be received more care and monitoring to make it conducive to delivery.

Histologic pattern of thyroid disorders in Southern Kerala

Since the implementation of universal salt iodization in 1986, India is said to be in the transition phase from iodine deficiency to iodine sufficiency, and this is expected to change the spectrum of thyroid disorders in the country. Materials and Methods: A retrospective study of 246 biopsy specimens of subtotal/total/hemi thyroidectomy cases done during a period of 6 years from 2007 to 2012 at a tertiary hospital in Trivandrum, Kerala, is analyzed. Results: Thyroidectomy specimens accounted for 3.2% of the total surgical specimens received during the study period. Among the 246 thyroidectomy specimens, nodular colloid goiter (NCG) with or without other associated thyroid lesions outnumbered other disorders accounting for a total of 142 cases (58%) followed by 90 cases of autoimmune thyroiditis (AIT) with or without other thyroid lesions (37%). Dual lesions such as AIT with colloid goiter (7 cases, 3%), AIT with tumors (45 cases, 18%), and NCG with tumors (40 cases 16%) were also noted. The presence of tumors was found in 106 cases (43%). The overall incidence of malignancy was 36%. Forty-one cases of AIT and 36 cases of NCG were associated with papillary thyroid carcinoma (PTC) (46% and 25%, respectively); the difference was statistically significant ( P = 0.01). Conclusions: This study showed that the incidence of AIT and associated PTC is high, and the role of iodine or any other goitrogens in triggering or enhancing the onset and development of AIT in this area deserves further study.

Effect of iodine excess on Th1, Th2, Th17, and Treg cell subpopulations in the thyroid of NOD.H-2h4 mice.

Iodine is an indispensable micronutrient for thyroid hormone synthesis and metabolism. Iodine excess may trigger and exacerbate autoimmune thyroiditis (AIT). The pathogenetic mechanism of iodine excess-induced AIT is partly regarded as T helper type 1 (Th1) cell and/or T helper type 17 (Th17) cell dominant autoimmune disease. It is still unknown whether other cluster of differentiation 4+ T (CD4+T) cell subpopulations are involved. Therefore, we studied the profile of all the CD4+T cell subpopulations of the thyroid in iodine excess-induced nonobese diabetic-H2h4 (NOD.H-2h4) mice to explore the potential immunologic mechanism of iodine excess-induced AIT. A total of 40 healthy 8-week-old NOD.H-2h4 mice were randomly allocated into the normal group (NG, n=20) and the test group (TG, n=20), which were fed with double-distilled water and 0.05% sodium iodine (NaI) for 8 weeks, respectively. Compared to the NG, in the TG, the incidence of AIT was significantly higher, the expressions of interleukin-17 (IL-17), interleukin-23 (IL-23), interleukin-6 (IL-6), and transforming growth factor-β (TGF-β) remarkably increased by immunohistochemistry, which were further verified by reverse transcription polymerase chain reaction (RT-PCR), while the protein and mRNA expressions of interleukin-4 (IL-4) and interferon-γ (INF-γ) decreased markedly. In the AIT mice, the expressions of retinoic acid-related orphan receptor gamma t (RORγt), retinoic acid-related orphan receptor alpha (RORα), and signal transducer and activator of transcription 3 (STAT3) were much higher, the expression of forkhead/winged helix transcription factor p3 (Foxp3) significantly lower by western blot, and the proportion of Th17 cells by flow cytometry method (FCM) much larger compared to those of the NG group. In conclusion, Th17 cells may promote an inflammatory reaction in the development of iodine-excess-induced AIT, which is negatively regulated by Th1, T helper type 2 (Th2), and regulatory T (Treg) cells.

Hashimoto Thyroiditis in Childhood – Review of the Epidemiology, Genetic Susceptibility and Clinical Aspects of the Disease

Chronic autoimmune thyroiditis or Hashimoto’s thyroiditis (HT) is the most common cause of thyroid diseases in children and adolescents. It is also the most common cause of acquired hypothyroidism with or without goiter. The incidence of autoimmune thyroiditis has increased dramatically over the past few decades, affecting up to 5% of the general population in iodine sufficient areas. HT is caused by the complex interplay of genetic, environmental, and endogenous factors. Significant progress has been made in identifying and characterizing the genes involved in pathogenesis of the disease. The aim of this review is to analyze current opinions and options regarding the etiology, genetic contribution to the pathogenesis, evaluation, diagnosis, treatment, and prognosis of the HT in children.

Diagnostic value of antithyroid peroxidase antibody for incidental autoimmune thyroiditis based on histopathologic results

Detection of antithyroid peroxidase antibody (TPOAb) is widely used in the diagnosis of autoimmune thyroiditis (AIT), but no research has evaluated the diagnostic accuracy of TPOAb detection using histopathologic reference standards. To fill this research gap, this study assessed the diagnostic accuracy of detection of TPOAb and that of other serological markers in asymptomatic patients who had been diagnosed with AIT by histopathologic analysis after thyroid surgery. After review of patient records, 598 patients who had undergone thyroid nodule surgery were enrolled for examination for thyroid parenchyma by a pathologist and classification into no co-existing lymphocytic thyroiditis, Hashimoto thyroiditis, or non-Hashimoto type of lymphocytic thyroiditis (NHLT). The correlation between patient serological data and thyroid parenchyma pathology was analyzed. Statistically significant differences (P < 0.05) were found between co-existing lymphocytic thyroiditis and no co-existing lymphocytic thyroiditis groups regarding thyroid-stimulating hormone (TSH) and TPOAb levels. And, TPOAb titer was significantly associated with the degree of inflammation. An abnormal TPOAb titer was found in 86 of the 598 patients (14.4 %) and the specificity of TPOAb detection for AIT diagnosis was found to be 96.9 %. The prevalence of Hashimoto thyroiditis and NHLT in the 560 papillary thyroid cancer (PTC) patients was found to be 7.9 and 17.9 %, respectively. The results indicate that TPOAb titer is associated with the degree of thyroid inflammation and that detection of TPOAb is a very specific means of diagnosing AIT. The results also indicate that the incidence of AIT and PTC coexistence is relatively high.

Natural course of autoimmune thyroiditis in type 1 diabetes: association with gender, age, diabetes duration, and puberty

Aims: To investigate the natural history and incidence of autoimmune thyroiditis (AIT) in paediatric patients with type 1 diabetes (T1D). Methods: Since 1990, annual screening for thyroid disease has been...

High Glucose Levels Increase Major Histocompatibility Complex Class I Gene Expression in Thyroid Cells and Amplify Interferon-γ Action

Increased major histocompatibility complex (MHC) class I gene expression in target tissues may be relevant to the pathogenesis of autoimmune diseases. In this study, we questioned whether high glucose levels might increase MHC class I levels and thereby contribute to autoimmune complications. We used thyrocytes in continuous culture, because there is an increased incidence of autoimmune thyroiditis in type 2 diabetics and because transcriptional regulation of MHC class I is well studied in these cells. Northern analysis and flow cytometry showed that 20 and 30 mM D-glucose up-regulated MHC class I expression and that the glucose effect was additive to and independent of interferon-gamma. The effect was specific, because L-glucose did not modify class I expression. The glucose acted transcriptionally, requiring both enhancer A and a cAMP-response element-like element located in the hormone-sensitive region of the MHC class I 5'flanking region. These elements are different from those activated by interferon-gamma. High glucose levels increase formation of the MOD-1 complex with enhancer A; MOD-1 is a heterodimer of fra-2 and the p50 subunit of NF-kappaB. Both TSH and insulin are required for full expression of the glucose activity in thyrocytes. The glucose effect is partially blocked by wortmannin, suggesting involvement of the PI3K signal system. The data support the possibility that high serum glucose levels in type 2 diabetic patients may increase MHC class I levels in target tissues and contribute to autoimmune complications of the disease.

EFFECT OF MURINE RECOMBINANT IL-2 ON THE COURSE OF LUPUS-LIKE DISEASE IN (NZB×NZW) F1 Female Mice

ABSTRACTThe exacerbation of pre-existing autoimmune diseases is a potential toxic effect of immunoactive drugs. An increase in the incidence of autoimmune thyroiditis has been noted in patients treated with human recombinant interleukin-2 (rIL-2). In contrast, human rIL-2 tends to protect mice from autoimmunity. As the effects of murine rIL-2 on autoimmunity have not been reported in mice, lupus-prone female (NZB×NZW) F1 mice were treated with 20,000 IU murine rIL-2 intraperitoneally, twice weekly for 13 weeks, beginning at 15 weeks of age. No evidence of an exacerbating effect of murine IL-2 on the lupus disease of (NZB×NZW) F1 mice was observed as no change in the following parameters were seen, namely mean survival time, mean body weight, anti-DNA and antinuclear antibody production. These results show that: 1) like human rIL-2, murine rIL-2 does not exacerbate autoimmunity in mice; 2) the biological effects of human as well as murine rIL-2 in mice differ from those seen with human rIL-2 in man. These latter findings suggest that the selection of the relevant animal species for immunotoxicity studies with recombinant cytokines and derivatives may be less straightforward than previously thought.

Autoimmune thyroiditis: current understanding of the etiology, pathogenesis, diagnosis and treatment (lecture)

A significant place in the practical activities of endocrinologists is occupied by the diagnosis and treatment of thyroid diseases. Among them, one of the most common is autoimmune thyroiditis (AIT). The prevalence of AIT among the population of different countries ranges from 0.1-1.2% in children to 6-11% in women over 60 years of age (Matsuura et al., 1990). According to A. Weetman (1992), the incidence of AIT in a population (clinically explicit forms) is 1%. At the same time, subclinical thyroiditis and circulating antithyroid antibodies can be found in 10-15% of practically healthy individuals in an euthyroid state. The ratio of sick men and women is 1: 4-1: 8 (R. Langer, 1996).

A differential nuclear uptake and retention of 3H-androgens in the thyroids of baboons.

Women have a greater incidence of autoimmune thyroiditis, thyroid cancer and radiation-induced carcinogenesis than men. Over the past several years we have examined for the presence of steroid receptors in both humans and non-human primates. In this study we examined the nuclear uptake and retention of 3H-testosterone, the main circulating androgen in mammals, in different cells of the thyroid gland of baboons, our non-human primate model. Castrated-adrenalectomized male baboons were injected with 3H-testosterone (1 microgram/kg bw) and killed 1 1/2 h later. The thyroid glands and other tissues were removed and processed for autoradiography. Nuclear localization of 3H-testosterone or one of its metabolites was found in a small fraction of the follicular cells (approximately 10-20%). The discrepancy between these findings and those previously obtained with 3H-dihydrotestosterone (virtually 100% of the follicular cells concentrated the 3H-steroid) are discussed. The results from this study and those of the past strongly support a direct action of androgen on the thyroid. Whether a direct action of androgen on the thyroid is related to smaller incidence in autoimmune thyroiditis, thyroid cancer and radiation-induced carcinogenesis in men than women remains an unanswered question at the present time.