Positive Anti-thyroid Antibodies Research Articles

Hashimoto's encephalopathy in a 10-year-old girl

Hashimoto's encephalopathy (HE) is a rare but probably an unrecognized and underdiagnosed condition in children. Early diagnosis is critical since these patients respond dramatically to corticosteroid therapy. The diagnosis of HE requires a strong clinical suspicion along with a triad of positive antithyroid antibodies, encephalopathy not explained by another etiology, and a response to corticosteroids. We report the case of a 10-year-old female child with HE and review the literature.

Anemia and hematinic deficiencies in anti-gastric parietal cell antibody-positive and -negative recurrent aphthous stomatitis patients with anti-thyroid antibody positivity.

Serum anti-gastric parietal cell (GPCA), anti-thyroglobulin (TGA), and anti-thyroid microsomal antibodies (TMA) can be found in some recurrent aphthous stomatitis (RAS) patients. This study mainly assessed whether serum GPCA, TGA, TMA and RAS itself played significant roles in causing anemia and hematinic deficiencies in TGA/TMA-positive RAS patients with GPCA positivity (GPCA+/TGA/TMA/RAS patients) or negativity (GPCA-/TGA/TMA/RAS patients). The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of the four groups of 15 GPCA+/TGA/TMA/RAS patients, 69 GPCA-/TGA/TMA/RAS patients, 240 all autoantibodies-negative RAS patients (Abs-/RAS patients), and 342 healthy control subjects. GPCA+/TGA/TMA/RAS patients had significantly lower mean Hb (for men only) and vitamin B12 levels as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy control subjects. GPCA+/TGA/TMA/RAS patients had lower serum vitamin B12 level and higher MCV as well as a significantly greater frequency of vitamin B12 deficiency than GPCA-/TGA/TMA/RAS patients. Furthermore, both GPCA-/TGA/TMA/RAS and Abs-/RAS patients did have significantly lower mean Hb, MCV, and iron levels as well as significantly greater frequencies of Hb, iron and vitamin B12 deficiencies than healthy control subjects. There were no significant differences in blood data between GPCA-/TGA/TMA/RAS and Abs-/RAS patients CONCLUSION: Both serum GPCA positivity and RAS itself are the contributing factors causing anemia and hematinic deficiencies in GPCA+/TGA/TMA/RAS patients. RAS itself but not TGA/TMA positivity plays a significant role in causing anemia and hematinic deficiencies in GPCA-/TGA/TMA/RAS patients.

Presence of organ‑specific antibodies in patients with systemic sclerosis.

INTRODUCTION According to the literature, organ‑specific antibodies may be present in the course of systemic sclerosis (SSc). OBJECTIVES The aim of this study was to assess the prevalence of antithyroid antibodies (antithyroid peroxidase antibodies [anti‑TPO] and antithyroglobulin antibodies) and of antimitochondrial antibodies (AMAs), as well as to evaluate their clinical significance in patients with SSc. PATIENTS AND METHODS The study involved 86 consecutive in‑hospital patients with SSc (32 patients with diffuse cutaneous SSc [dcSSc] and 54 with limited cutaneous SSc [lcSSc]). Patients were observed for autoimmune thyroid diseases (ATDs) and primary biliary cirrhosis (PBC). Serum samples were obtained from each patient. RESULTS Positive antithyroid antibody titers were observed in 27 patients (31%) and positive AMA titers-in 11 patients (13%). ATD was diagnosed in 26 patients (30%) and PBC-in 10 patients (12%) with SSc. No significant differences in the prevalence of antithyroid antibodies were found between patients with dcSSc and those with lcSSc, but the prevalence of AMAs was significantly higher in patients with lcSSc compared with those with dcSSc. The prevalence of anti‑Ro‑52 antibodies was significantly higher in the SSc group with positive anti‑TPO antibody titers compared with the SSc group with negative anti‑TPO antibody titers. The prevalence of anticentromere antibodies (ACAs) was significantly higher in the SSc group with positive AMA titers compared with the SSc group with negative AMA titers. CONCLUSIONS The prevalence of organ‑specific antibodies in SSc patients is relatively high. The prevalence of AMAs is higher in patients with lcSSc than in those with dcSSc and is strongly associated with the presence of ACAs. Patients with SSc should be evaluated for coexisting ATDs and PBC.

Increased frequency of positive antithyroid antibody in nodular goiter

Background: Nodular goiter is mostly a benign thyroid tumor. A change of frequency of nodular goiter in areas with sufficient iodine intake has been documented in several reports. However, contrary to common belief it may also be associated with autoimmunity is being observed recently by many investigators.Objectives: To observe association between thyroid autoimmunity and nodular goiter. Methods: This cross sectional study included two hundred cases and one hundred controls. Clinically suspected nodular thyroid patients were confirmed by USG. Selection of healthy control was done after exclusion of nodule clinically and by USG. Data were collected through a structured questionnaire.Results: Frequency of positive anti-thyroid antibodies was significantly higher in nodular goiter cases, when anti-TPO and anti-TG considered together (42.5% vs. 25.0%; ?2=8.792, p=0.003) as well as individually (anti-TPO: 37.0% vs. 20.0%; ?2=8.955, p=0.004 and anti-TG: 31.0% vs. 9.0%; ?2=17.861, p<0.001) in the patients with nodular goiter than that of control. Conversely, there was no statistical difference between STN and MNG for antibody status when considered together (41.lvs. 42.5%; ?2=0.093; p=0.769) or separately (for anti-TPO: 34.2% vs. 38.6%; ?2=0.374, p=0.648 and anti TG: 27.4% vs. 33.1%; ?2=0.698, p=0.431). Also there was no statistical disparity for frequency of positivity of the two antibodies in STN (p=0.359) and MNG (p=0.167).Conclusion: Significant number of nodular goiter cases was positive for anti-thyroid antibodies.

Celiac disease in children and adolescents with Hashimoto Thyroiditis.

The aim of this study was to evaluate clinical and laboratory findings and determine the prevalence of celiac disease (CD) in children with Hashimoto thyroiditis (HT). The data of a total of 80 patients with positive anti-thyroid antibodies who were aged between 6 and 17.9 years were retrospectively studied. Age, gender, complaints at the time of presentation, family history of thyroid disorders, clinical and laboratory findings were recorded. The levels of thyrotropin, free thyroxin, thyroid autoantibodies (thyroid peroxidase and thyroglobulin antibodies), immunoglobulin A (IgA), anti-tissue transglutaminase antibodies (IgA-tTG), and thyroid ultrasonography findings were enrolled. Eighty patients (65 females (81.2%) and 15 males (18,8%)) were included in the study. Family history of thyroid disease was present in 38 (47.5%) patients. The most common complaints at the time of presentation were goiter (%30) and weight gain (%25). Forty three (53.8%), 23 (28.7%), and 14 (17.5%) patients presented with euthyroidism, subclinical hypothyroidism and obvious hypothyroidism. Thirty seven (46.2%) patients had goiter. IgA-tTG was found to be positive after a diagnosis of HT was made in only one patient (1.25%) and the diagnosis of CD was confirmed when intestinal biopsy of this patient revealed villus atrophy, crypt hyperplasia and increase in the intraepithelial lymphocyte count. In our study, it was found that the most common complaints at presentation in patients with a diagnosis of hashimoto thyroiditis included goiter, weakness and weight gain and the prevalence of celiac diseases was found to be 1.25% (1/80). This study shows that the prevalence of CD in patients with a diagnosis of HT is higher compared to the prevalence in the healthy pediatric population.

The Effect of Subclinical Maternal Thyroid Dysfunction and Autoimmunity on Intrauterine Growth Restriction: A Systematic Review and Meta-Analysis.

The objective of this study was to evaluate the association between maternal subclinical thyroid dysfunction and autoimmunity with the risk for intrauterine growth restriction (IUGR).Design is a systematic review and meta-analysis.A literature search was conducted using PubMed, Embase, and Cochrane database. A combination of 2 key words was used to search for the eligible studies: one indexed thyroid dysfunction or antithyroid antibodies; and the other one indexed the adverse neonatal outcomes of pregnancy, such as IUGR, small for gestational age, fetal growth restriction, or low birth weight.Two reviewers selected the studies, and eligible studies met the following criteria: prospective cohort studies or case control studies, studies of maternal thyroid dysfunction and positive antithyroid antibodies as the exposure of interest, and studies of IUGR or small for gestational age as the outcome of interest.Data were recorded, including data from maternal thyroid disorders and IUGR, and compared with a reference group.There were 22 individual data from the 13 cohort articles. Among these, 7 were focused on subclinical hypothyroidism (SCH), 4 on subclinical hyperthyroidism, 7 on positivity for thyroid peroxidase antibody (TPOAb), and 4 on isolated hypothyroxinemia. Meta-analysis showed that there was no effect of subclinical hyperthyroidism (odds ratio (OR) = 0.98; 95% confidence interval (CI), 0.40–2.41), TPOAb positivity (OR = 1.57; 95% CI, 0.77–3.18), or isolated hypothyroxinemia (OR = 1.05, 95% CI: 0.37–2.92) on IUGR. However, SCH is associated with IUGR (OR = 1.54; 95% CI, 1.06–2.25).SCH is associated with IUGR; however, subclinical hyperthyroidism, TPOAb positivity, or isolated hypothyroxinemia do not affect the risk of IUGR.

Effect of thyroid autoimmunity per se on assisted reproduction treatment outcomes: A meta-analysis

ObjectiveThyroid autoimmunity (TA) is the most prevalent autoimmune disease in women of reproductive age and is often accompanied by subclinical hypothyroidism (SCH). Both TA and SCH have been associated with adverse pregnancy outcomes, but their relative influence is unclear. Therefore, we carried out a meta-analysis to evaluate the sole effect of TA on pregnancy outcomes in euthyroid women undergoing assisted reproductive technology. Materials and MethodsLiterature searches were conducted on Pubmed, EMBASE, and the Cochrane Controlled Trials Register Database from inception to May 2014. ResultsIn euthyroid women whose SCH status is unknown, those with positive antithyroid antibodies (ATA) had a higher miscarriage rate [pooled relative risk (RR) = 1.638; 95% confidence interval (CI), 1.228–2.185] and a lower delivery rate (pooled RR = 0.856; 95% CI, 0.759–0.965) than those with negative ATA. Clinical pregnancy rates were similar between groups. However, clinical pregnancy rate, miscarriage rate, and delivery rate were all comparable between ATA-positive and ATA-negative euthyroid women without SCH. ConclusionTA per se does not impair assisted reproductive treatment outcomes in women without SCH.

Cytomorphologic spectrum of lymphocytic thyroiditis and correlation between cytological grading and biochemical parameters.

Introduction:Chronic lymphocytic thyroiditis [Hashimoto thyroiditis (HT)] is a common thyroid lesion diagnosed on fine-needle aspiration cytology (FNAC). Apart from FNAC, various other parameters, such as clinical features, ultrasonographic findings, antithyroid antibody levels, hormone profiles, and radionuclide thyroid scan, are also taken into consideration in making a diagnosis of HT.Aims:To grade lymphocytic thyroiditis based on the cytomorphology and to correlate the cytological grades with the levels of antithyroid peroxidase antibody (ATPO), antithyroglobulin antibody (ATG), and thyroid stimulating hormone (TSH).Materials and Methods:During a period of one and half years, 1,667 cases underwent FNAC of thyroid at our tertiary care center. Of these, 128 cases had cytological evidence of lymphocytic thyroiditis. Out of these, in 60 cases the levels of ATPO, ATG, and TSH were known. The cytological grades of lymphocytic thyroiditis in these cases were correlated with these parameters.Results:Out of the 60 cases, 55 were females. Age ranged from 5 years to 70 years, with majority of patients in third decade. Diffuse enlargement of thyroid was the commonest presentation. However, 14 cases presented with nodular disease. Majority of the patients had grade 1 thyroiditis (27 cases), followed by grade 2 thyroiditis (22 cases). Cytomorphology was diagnostic of thyroiditis in all 60 cases. ATPO was elevated in 57 cases and ATG was elevated in 40 cases. Elevated level of TSH was seen in only 18 cases. In 39 cases, TSH value was normal. There was no correlation between the cytological grades of thyroiditis and the levels of antithyroid antibodies and TSH.Conclusion:Lymphocytic infiltration of thyroid follicles is pathognomonic of lymphocytic thyroiditis. Positivity for antithyroid antibodies is strongly associated with HT but no correlation was observed between the grades of thyroiditis and the levels of ATPO, ATG, and TSH.

Clinical features of chronic urticaria in aging population.

Different clinical features of skin diseases have been addressed between aging patients and non-aging patients. However, data focusing on the clinical features of chronic urticaria (CU) in aging patients especially in the Asian population are still limited. This study aimed to investigate the clinical characteristics of CU in aging and non-aging patients in the Asian population. Case records of 1622 CU patients attending the Urticaria Clinic, Department of Dermatology, Siriraj Hospital, Mahidol University, Thailand between 2000 and 2013 were retrospectively reviewed. All CU patients older than 60 years were recruited. Twice the number of CU patients who were non-aging were enrolled using a systematic sampling method. Of the 1622 CU patients, 67 (4.1%) were aging patients. From these, 134 non-aging patients with CU were recruited. The majority of patients for both groups were female, with 67.2% and 77.6% of the aging and non-aging groups, respectively. In both groups, the most common cause of CU was chronic spontaneous urticaria. In the aging group, positive autologous serum skin test, anti-thyroid antibodies and antinuclear antibodies were found more commonly than in the non-aging group, without a statistically significant difference. The mean duration of the disease tended to be shorter in the aging group. Our study showed that CU in aging patients was uncommon (4.1%). Aging patients with CU seemed to have shorter disease duration and higher percentages of autoantibodies than non-aging patients with CU without a statistically significant difference.

Evaluation of Xerostomia and salivary flow rate in Hashimoto's Thyroiditis.

BackgroundOne of the most common causes of hypothyroidism is Hashimoto´s Thyroiditis (HT). Early detection of dry mouth is critical in preserving and promoting systemic and oral health. In this study we have assessed, for the first time, salivary function and xerostomia in HT patients who have not been involved with Sjögren´s syndrome.Material and MethodsHT was diagnosed in 40 patients based on clinical findings and positive anti-thyroid peroxidase antibodies (anti-TPO). Controls, matched by sex, age and body mass index (BMI), and with no history of thyroid disease, were selected. A questionnaire was used for diagnosis of xerostomia. Saliva samples were taken between 8 a.m. and 9 a.m., and at least 2 hours after the last intake of food or drink. The flow rate was calculated in milliliters per minute.ResultsXerostomia was significantly higher in patients with HT. Unstimulated salivary flow rate was significantly lower in the HT group. Stimulated salivary flow rate was lower in HT group, but the difference was not significant.ConclusionsThe patients with HT experienced xerostomia, and their salivary flow rate was diminished. Spitting the saliva then assessing salivary flow rate based on milliliter per minute is non-invasive, fast, and simple for chair-side diagnosis of dry mouth. Autoimmune diseases can be accompanied by salivary gland dysfunction. This may be due to the effect of cytokines in the autoimmune process or because of thyroid hormone dysfunctions. Key words:Thyroid, salivary gland, xerostomia.

Patients with diabetes type 1 and thyroid autoimmunity have low prevalence of microangiopathic complications.

The prevalence of thyroid dysfunction in T1DM is higher than in general population [1–3]. Unrecognized thyroid dysfunction may impair metabolic control of diabetes [2, 4, 5]. Substantial proportion of patients with T1DM develop microangiopathic complications [6]. The significance of the coexisting comorbidity of AITD and T1DM in assessment of the risk of development of diabetic microangiopathy is unknown. The aim of the present study was to determine the association between anti-thyroid antibody positivity and the presence of microangiopathy in adults with T1DM without prior evidence of the thyroid disease.

Induction of painless thyroiditis in patients receiving programmed death 1 receptor immunotherapy for metastatic malignancies.

Immunotherapies against immune checkpoints that inhibit T cell activation [cytotoxic T lymphocyte antigen 4 (CTLA-4) and programmed cell death 1 (PD-1)] are emerging and promising treatments for several metastatic malignancies. However, the precise adverse effects of these therapies on thyroid gland function have not been well described. We report on 10 cases of painless thyroiditis syndrome (PTS) from a novel etiology, following immunotherapy with anti-PD-1 monoclonal antibodies (mAb) during treatment for metastatic malignancies. Six patients presented with transient thyrotoxicosis in which thyrotropin binding inhibitory immunoglobulins (TBII) were absent for all, whereas four patients had evidence of positive antithyroid antibodies. All thyrotoxic patients required temporary beta-blocker therapy and had spontaneous resolution of thyrotoxicosis with subsequent hypothyroidism. Four patients presented with hypothyroidism without a detected preceding thyrotoxic phase, occurring 6-8 weeks after initial drug exposure. All of these patients had positive antithyroid antibodies and required thyroid hormone replacement therapy for a minimum of 6 months. Patients receiving anti-PD-1 mAb therapy should be monitored for signs and symptoms of PTS which may require supportive treatment with beta-blockers or thyroid hormone replacement. The anti-PD-1 mAb is a novel exogenous cause of PTS and provides new insight into the possible perturbations of the immune network that may modulate the development of endogenous PTS, including cases of sporadic and postpartum thyroiditis.

Anti-thyroid Antibodies in Bipolar Disorder

Dysfunction of the hypothalamus-pituitary-thyroid axis has been shown to play a role in the pathophysiology of bipolar disorder. Autoimmune thyroiditis is the most common cause of thyroid function alteration. Thus, auto-immune thyroiditis is likely associated with bipolar disorder. It might influence its course, prognosis and/or management. To study the prevalence of positive anti-thyroid antibodies in patients with bipolar disorder and to examine the prognostic and the therapeutic implications of their presence. Literature was reviewed using the Medline database and the following keywords: ‘bipolar disorder” ‘antithyroid antibodies” ‘thyroiditis”. PubMed research returned 12 results. After manual inspection, 10 articles were retained and examined. The prevalence of positive antithyroperoxydase antibodies (anti-TPO Abs) is higher in bipolar patients than in healthy controls, reaching 27%. The presence of positive anti-TPO Abs has been associated with rapid-cycling, with a higher risk of lithium-induced hypothyroidism as well as with poor prognosis. Auto-immune thyroiditis appears to be related not only to bipolar disorder itself but also to the genetic vulnerability to develop the disorder. The presence of anti-TPO Abs is a possible endophenotype for bipolar disorder. Anti-TPO Abs should be obtained in many patients with bipolar disorder, especially in those on lithium.

Antithyroid antibodies and thyroid function in pediatric patients with celiac disease.

Objective. Aim of the study was to determine the prevalence of autoimmune thyroid disease, persistence of antithyroid antibodies, effect of gluten-free diet, and long-term outcome of thyroid function in pediatric patients with celiac disease (CD). Methods. 67 patients with CD aged from 1 year to 16 years were screened for thyroid antithyroperoxidase, antithyroglobulin and anti-TSH receptor antibodies, serum free triiodothyronine, free thyroxine, and thyroid-stimulating hormone (TSH) at diagnosis and during follow-up. Results. None of the patients had antithyroid antibodies at diagnosis. Antithyroid antibodies became positive in 16.4% of the patients (11/67) 2 to 3 years after the diagnosis of CD. Clinical hypothyroidism was observed only in 3 of 11 CD patients with positive antithyroid antibodies (27.2%). The antithyroid antibodies positive and negative patients did not differ significantly according to compliance to GFD (P > 0.05). A statistically significant difference was observed only in age, in which the patients with positive antithyroid antibodies were younger than the patients with negative antithyroid antibodies (P = 0.004). None of the patients had any change in their thyroid function and antibody profile during their follow-up. Conclusion. Antithyroid antibodies were detected in younger pediatric patients with CD and the prevalence of antithyroid antibodies did not correlate with the duration of gluten intake.

The development of guidelines for management of thyroid diseases in pregnancy – current status

The development of guidelines for management of thyroid diseases in pregnancy – current status

Diagnostic profile among patients with chronicurticaria/angioedema attending a reference clinic in Brazil: the role of auto-immunity

Methods Two hundred and fifty four patients aged 13-80 years (202 females,79.5%), with chronic urticaria/angioedema who receive care at the Allergy Clinic of the Clinical Hospital of Ribeirao Preto Medical School in Brazil, were evaluated prospectively. Patients were inquired about triggering of symptoms by medications and/or physical agents and presence of anaphylaxis. In addition, they were investigated by skin testing and tests for eosinophilia, IgE, and hepatitis B and C. Autoimmune basis was characterized by presence of positive autologous test, anti-thyroid or antinuclear antibodies (ANA). When indicated, a skin biopsy was performed. Use of medications for urticaria was analyzed.

PO-0060 Anti-thyroid Antibodies As A Marker Of Thyroid Disease In Paediatric Patients With Diabetes Mellitus

Background and aims In a study carried out in adults with diabetes mellitus has been shown that monitoring thyroid function is cost effective in patients with positive anti-thyroid antibodies from the start of the illness; but the incidence of hypothyroidism is low in those patients who did not have antibodies from the begging. Although autoimmune thyroiditis is rare in prepuberal age, the aim of our study was to determinate if the data obtained in adults correlates with the paediatric population diagnosed of diabetes mellitus and also to find out how many patients have thyroid antibodies during their follow up and when that positivization occurs. Methods Retrospective descriptive study of 76 paediatric patients diagnosed of diabetes (between 1988 and 2013) at our hospital with available data of anti-thyroid antibodies (anti-thyroglobulin and anti-thyroperoxidase). Characteristics of age at the begging, Tunner stage, thyroglobulin antibodies, anti-thyroperoxidase, thyroid function, glycosylated haemoglobin and other antibodies were analysed. Results 76 patients were included, 51% were men and 48% women. The mean age of the study population at diagnosis was 8.15 years (1–16), Tunner stage 1 in 61% of cases, with mean baseline TSH of 2.9 mUI/L. In an isolated case positive anti-thyroid antibodies were detected at the begging before puberty. Among all the patients with no anti-thyroid antibodies at the diagnosed of the illness, 3 patients had thyroid antibodies at prebuberal age and 6 after puberty, with a mean age 12.1 years at the time of the positivization (8–16 years). Conclusions Most of the patients have negative anti-thyroid antibody titles at diagnosis, positivization often occurs after puberty or in adulthood, that suggests monitoring thyroid function is not cost effective in paediatric patients.

Thyroid disorders, hyperprolactinemia and systemic lupus erythematosus activity

Aim: The aim of this study was to determine the relationship between thyroid disorders and prolactin in patients with and without lupus activity. Patients & methods: Women with systemic lupus erythematosus (SLE) were evaluated for lupus activity. Serum tri-iodothyronine (T3), serum thyroxine (T4) and thyroid-stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO) anti-thyroglobulin (anti-TG) and prolactin were measured. Results: 50 women with SLE with lupus activity and 50 women with SLE without activity with mean age of 34.5 ± 14.8 years and mean disease duration of 15.0 ± 2.8 years. Patients with disease activity, subclinical hypothyroidism, anti-TG and anti-TPO were more prevalent and had higher prolactin levels compared with those without disease activity. There was no difference in prolactin levels according to the presence of hypothyroidism, and antithyroid antibody positivity did not differ in patients with and without hyperprolactinemia. Conclusion: There was no relationship between thyroid ...

Is an isolated TSH elevation in chronic nonthyroidal illness "subclinical hypothyroidism"?

Elevated TSH with normal T4 frequently occurs with chronic kidney, liver, and heart diseases. Whether isolated TSH elevations represent mild thyroid gland failure has not been established. PubMed was searched for longitudinal studies in chronic heart, liver, or kidney disease documenting persistent isolated TSH elevations or progression to overt hypothyroidism. Four articles met inclusion criteria. In 16 end-stage renal failure patients, four had isolated TSH elevations. All normalized within 14 months. In 452 systolic heart failure patients, 20 had isolated TSH elevations, five of 20 were persistent, and none progressed to overt hypothyroidism within 6 months. In 207 untreated chronic hepatitis C patients, 12 had isolated TSH elevations and four had increased TSH with reduced free T4; all were female, and 14 had positive antithyroid antibodies. After 1 year, two of 12 developed "clinical hypothyroidism." In 72 chronic hepatitis C patients, nine females had positive antithyroid antibodies. Two antibody-negative patients had TSH 5-6 mU/L with reduced free T4. After 1 year, three of four with positive antithyroid antibodies and baseline TSH < 4 mU/L had elevated TSH with reduced free T4. In chronically ill patients, there is inadequate evidence to determine: 1) that isolated TSH elevations usually persist or progress to overt hypothyroidism; 2) the etiology and clinical significance of isolated TSH elevations; and 3) whether levothyroxine therapy is indicated for persistent isolated TSH elevations. Thus, isolated TSH elevations in chronic renal, cardiac, or liver diseases have not been documented to indicate mild thyroid gland failure.

Is autoimmune thyroid dysfunction a risk factor for gestational diabetes?

Abstract Objective Some recent studies have related autoimmune thyroid dysfunction and gestational diabetes (GD). The common factor for both conditions could be the existence of pro-inflammatory homeostasis. The study objective was therefore to assess whether the presence of antithyroid antibodies is related to the occurrence of GD. Material and methods Fifty-six pregnant women with serum TSH levels ≥ 2.5 mU/mL during the first trimester were retrospectively studied. Antithyroid antibodies were measured, and an O'Sullivan test was performed. GD was diagnosed based on the criteria of the Spanish Group on Diabetes and Pregnancy. Results Positive antithyroid antibodies were found in 21 (37.50%) women. GD was diagnosed in 15 patients, 6 of whom (10.71%) had positive antibodies, while 9 (16.07%) had negative antibodies. Data were analyzed using exact logistic regression by LogXact-8 Cytel; no statistically significant differences were found between GD patients with positive and negative autoimmunity (OR = 1.15 [95%CI = 0.28–4.51]; P = 1.00). Conclusions The presence of thyroid autoimmunity in women with TSH above the recommended values at the beginning of pregnancy is not associated to development of GD. However, GD prevalence was higher in these patients as compared to the Spanish general population, suggesting the need for closer monitoring in pregnant women with TSH levels ≥ 2.5 mU/mL.