Presence Of Antithyroid Antibodies Research Articles

Immunological testing for female infertility: a modern view on the problem

Introduction. According to various estimates, in Russia 10 to 20 % of people of reproductive age are infertile. Changes in the immune system play a key role in the etiology and treatment of various infertility forms. The active introduction of immunological testing into clinical practice can potentially improve the results of infertility diagnostics and treatment.Aim: to analyze the current literature data on immunological testing in female infertility, as well as to assess its potential role in infertility diagnostics and treatment.Materials and Methods. There was conducted a search for publications in the electronic databases PubMed and eLibrary by using the following keywords and their combinations: "infertility", "immunology", "immune system", "immunological testing", "diagnostics", "treatment". The articles were evaluated in accordance with the PRISMA recommendations. Ultimately, 88 publications were included in the review.Results. Testing for antiphospholipid antibodies (APA) may be useful for women undergoing assisted reproductive technology (ART) therapy, as these antibodies increase the risk of pregnancy complications and thrombotic risks associated with ovarian stimulation, but studies assessing AFA effect on in vitro fertilization (IVF) outcomes have ambiguous results. The presence of antithyroid antibodies (ATA) may be associated with infertility, so their assessment is indeed important to determine treatment tactics. It has been suggested that antinuclear antibodies (ANA) may affect reproductive function by disrupting trophoblast cell development and interfering with RNA transcription, which may lead to lowered reproductive success. Studies have shown that patients with a positive ANA data have a lower incidence of pregnancy and a higher rate of miscarriages after IVF procedure. The human herpes virus type 6 (HHV-6) affects female fertility and is often the cause of spontaneous termination of pregnancy. B-cell lymphoma protein 6 (BCL-6) can serve as an important prognostic biomarker to identify individuals with endometriosis and related reproductive disorders, including idiopathic infertility. Evaluation of endometrial decidualization can be a useful tool to assess readiness for endometrial implantation and provide opportunities for targeted therapeutic interventions. The issue of testing for NK-cells in patients undergoing infertility screening remains controversial due to the difficulties of standardizing testing recommendations.Conclusion. To date, there is a limited number of reliable data on the role of various immunological tests in infertility diagnostics and treatment. With the exception of testing for AFA in patients with RPL, as well as for thyroid-stimulating hormone (TSH) and anti-thyroperoxidase antibodies (TPOAb) in patients undergoing therapy using various types of assisted reproductive technologies, the remaining immunological tests provide scant data to justify their routine use in clinical practice. The major limitations of existing studies are coupled to a small patient sample, as well as heterogeneity of inclusion criteria, patient groups and research methods.

Evans Syndrome in a Patient with Auto Immune Thyroiditis – A Rare Association

A 46-year-old woman, diagnosed with hypothyroidism, was on treatment with synthetic thyroxine 100 micrograms per day for one year. She complained of recent-onset exertional dyspnoea, and had malaise, lethargy, and pica. Investigations revealed significant anaemia and severe thrombocytopenia, necessitating blood transfusion. She had Coombs-positive autoimmune haemolytic anaemia and immune thrombocytopenic purpura, confirming a diagnosis of Evans syndrome. She also had a positive antinuclear antibody test but had no other notable findings of autoimmune disease, suggesting a diagnosis of primary Evans syndrome. The patient was treated with intravenous dexamethasone for four days, followed by oral prednisolone at 1mg/kg/ day, with supplemental calcium and vitamin D. Thyroperoxidase antibody was positive and there was reduced uptake in thyroid scintigraphy, confirming a diagnosis of autoimmune thyroiditis. Hashimoto’s thyroiditis frequently coexists with non-endocrine autoimmune disorders. Presence of antithyroid antibodies is sometimes observed in Evans syndrome, a condition where there is simultaneous occurrence of autoimmune Haemolytic Anaemia, Cytopoenia and immune thrombocytopenic purpura. However, the development of Evans syndrome in patients with overt hypothyroidism and Hashimoto’s thyroiditis is rare. This case implies the potential existence of a shared immunogenetic pathway among three distinct autoimmune diseases, namely autoimmune haemolytic anemia, immune thrombocytopenic purpura, and Hashimoto’s thyroiditis, in the pathogenesis.

Subacute thyroiditis and rapidly developing goiter in a 16-year-old female: a case report

Subacute thyroiditis (SAT) is an inflammatory disease of the thyroid gland with multiple etiologies and clinical features, often challenging to recognize. The classic presentation is the painful, granulomatous thyroiditis (DeQuervain’s) characterized by diffuse swelling of the gland, usually preceded by an upper respiratory tract infection. A painless variant, also referred to as autoimmune subacute thyroiditis, has been documented and is strongly linked to postpartum state, reported following ~10% of pregnancies. It can be differentiated from the former by the presence of anti-thyroid antibodies, which classifies it as an autoimmune thyroiditis. Any spontaneous development of painful swelling of the thyroid gland warrants a complete work up that includes thyroid hormones, thyroid autoimmune panel, acute phase reactant titers, and, if available, imaging that may lead to the diagnosis of an inflammatory or infectious cause of thyroiditis.

Steroid responsive encephalopathy associated with autoimmune thyroiditis as a cause of acuteencephalopathy.

Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), known as Hashimoto's encephalopathy (HE), represents a heterogeneous group of neurological and neuropsychiatric symptoms associated with a presence of antithyroid antibodies in case of other causes of encephalopathy were excluded. Clinical symptoms most commonly includes acute onset of encephalopathy, behaviour changes and cognitive dysfunction, epileptic seizures as well as cerebellar and extrapyramidal symptoms. Corticoids provides rapid and sustained therapeutic benefit in most patients and only a few patients require other immunosuppressive therapy such as plasmapheresis, intravenous immunoglobulins, or others. We present the cases of two patients with acute onset of encephalopathy, status epilepticus based on SREAT, with rapid improvement after steroid treatment.

Autoimmune thyroid disease disrupts immune homeostasis in the endometrium of unexplained infertility women-a single-cell RNA transcriptome study during the implantation window.

Autoimmune thyroid disease (AITD) is known to be associated with unexplained infertility in women. Although the presence of antithyroid antibodies have been speculated to be a marker of an immune imbalance that might lead to implantation failure, its underlying mechanism influencing the endometrial receptivity remains to be elucidated. In this study, we used single-cell RNA sequencing (scRNA-seq) to dissect immune microenvironment in endometrium of AITD patients during window of implantation (WOI). We collected CD45+ immune cell populations of endometrium samples of unexplained infertile women with AITD (n=3), as well as samples of AITD- controls (n=3). The cells were then processed with 10X Genomics Chromium for further analysis. We characterized 28 distinct immune cell subtypes totally, and uncovered differences in the composition and gene expression patterns between AITD patients and controls. The proportions of T CD4+, cNK, ILC3, T CD8+ GZMK+, T CD8+ Cytotoxic and ILC3 CD3E - cells were increased, and CD366+ uNK1 was decreased in AITD+ patients. And the abnormal expression of GNLY and chemokines was observed in AITD patients. In addition, uNK and T CD8+ Cytotoxic cells showed lower cytotoxicity but activation of immune response. Genes enriched in cell adhesion of ILC3 and Tregs were downregulated, while the number of ILC3 and Tregs were increased. Immune imbalance exists in endometrium during WOI, which may impact embryo implantation.

Correlation between Vitamin D Status and Antithyroid Antibody Levels in Patients with Newly Diagnosed Hashimoto Thyroiditis: Case-Control Study in Tlemcen (Algeria)

Introduction: Hashimoto thyroiditis (HT) is characterized by the presence of antithyroid antibodies with lymphocyte infiltration of the thyroid gland. Its etiology results from the interaction between environmental factors and genetic susceptibility traits. One of the factors most recently involved in autoimmunity is vitamin D. The principal aim of our study was to investigate a possible relationship between vitamin D status and antithyroid antibody levels in patients with newly diagnosed Hashimoto diseases, from Tlemcen. Materials and methods: Cross-sectional case-control study, including 310 subjects, divided into two groups: a group of cases (n = 155) with newly diagnosed HT and a group of apparently healthy controls (n = 155). The 02 groups were matched by sex, age ± 02 years, body mass index (BMI) and the same season (blood collection period). All subjects benefited from hormonal assays, anti-thyroid antibodies and biochemical parameters (Thyroid Stimulating Hormone (TSH), Free Thyroxine (FT4), anti-peroxydase antibody (anti-TPO), anti-thyroglobulin antibody (anti-Tg), 25 hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), calcemia, phosphoremia, albuminemia and alkaline phosphatases). Results: High prevalence of hypovitaminosis D in our study population: 98% at the threshold of 25(OH)D < 30 ng/mL, 89% at the threshold < 20 ng/mL. The most significant risk factors associated with low levels of 25(OH)D are lack of sun exposure, season, skin color and lack of physical activity. The 25(OH)D deficit is more pronounced in the HT group than in the control group with a significant difference (11.45 ± 5.16 vs 13.02 ± 7.45; p = 0.03). In the HT group, the correlation between the status of 25(OH)D and the anti-TPO is inverse and significant (r = - 0.185; p = 0.02), relationship confirmed by multivariate analysis by linear regression where the 02 variables statistically related to anti-TPO are Vit D and TSH. Moreover, no correlation between 25(OH)D and anti-Tg and not between 25(OH)D and the degree of depth of biological hypothyroidism. Conclusion: There is an inverse and significant statistical relationship between serum levels of 25(OH)D and anti-TPO in the case group, however the exact involvement of vitamin D in the immunopathogenesis of Hashimoto’s diseases remains to be substantiated.

THE ASSOCIATION BETWEEN SERUM THYROID HORMONE, VITAMIN D, VITAMIN B12, FOLATE, FERRITIN, AND ZINC LEVELS AND FEMALE INFERTILITY. A COMPASSION WITH HEALTHY PREGNANT SUBJECTS

Alterations in thyroid hormone levels and presence of antithyroid antibodies were implicated in the etiology of infertility or recurrent pregnancy loss. High concentration of homocysteine that occurs in folic acid and vitamin B12 deficiencies may cause cytotoxicity and oxidative stress, and may lead to impaired oocyte maturation and embryo development. Zinc, vitamin D and iron deficiencies were also demonstrated to hamper oocyte quality. The aim of the present study was to assess the association between serum thyroid hormone, vitamin D, vitamin B12, folate, ferritin and zinc levels and female infertility.

Prevalence of autoantibodies in patients with juvenile idiopathic arthritis: results from the German inception cohort ICON-JIA

BackgroundAn association of different autoimmune diseases is suspected. In juvenile idiopathic arthritis (JIA), only few and partially conflicting data on the co-existence of other autoimmune disorders are available. The prevalence of autoantibodies in patients with JIA in Germany is not known.MethodsSamples from 499 patients (median age at time of blood collection 11 years, median disease duration 4.4 years) in the prospective, multicenter inception cohort of children newly diagnosed with JIA (ICON-JIA) were analysed for the presence of anti-thyroid antibodies, celiac disease-specific antibodies (anti-tTG IgA, anti-tTG IgG), and connective tissue disease-associated antibodies (CTD-screen).ResultsA total of 76 (15.2%) patients had either clinically diagnosed autoimmune comorbidity or elevated autoantibodies. Of 21 patients with clinical autoimmune comorbidity, only 8 were also serologically positive at the time of testing, while 55 patients had autoantibodies without clinical diagnosis. Thus, 63 patients (12.6%) had at least one elevated autoantibody. Antibodies against thyroglobulin were found in 3% and against thyreoperoxidase in 4% of the samples. TSH receptor antibodies could not be detected in any of the 499 patients. Tissue transglutaminase antibodies were elevated in 0.4% of the patients. A positive screen for CTD-specific antinuclear antibodies was found in 7%, but only rarely specific antibodies (anti-dsDNA 1.4%, anti-SS-A and -SS-B 0.2% each, anti-CENP-B 0.4%) were confirmed.ConclusionsIn our study, a specific correlation between JIA and other autoimmune phenomena could not be confirmed. The lack of well-matched control groups makes interpretation challenging. Further data need to corroborate the suspected increased risk of developing other autoimmune phenomena in JIA patients.

Estimating the Correlation between Autoimmune Thyroid Disorders and Chronic Spontaneous Urticaria: A Study Protocol

Background: Chronic spontaneous urticaria is thought to occur due to the patient's predilection to produce self-reactions. Urticaria contributes to loss of sleep, anxiety, depression, lack of motivation and social isolation, which may contribute to a substantial decrease in the patient's quality of life. Chronic spontaneous urticaria is unpredictable and can impair the patient's usual everyday activities. Autoimmune thyroid disorders are as a consequence of immune system dysregulation, that results in a thyroid invasion. A relationship between Chronic Spontaneous Urticaria and Autoimmune Thyroid Disorders is related to the duration and severity of the disease. Chronic Spontaneous Urticaria is associated with the presence of antithyroid antibodies. This study aims to analyze the changes in Patients detected with T3, T4, TSH and anti-TPO of chronic spontaneous urticaria, in contrast to normal healthy individuals and patients with other skin diseases which do not have abnormal thyroid etiopathogenesis.
 Materials and Methods: This will be a Case Control study conducted at Department of Dermatology, AVBRH, Sawangi, Wardha. Patients with chronic spontaneous urticaria will be subjected to a thorough clinical review and will be scored based on urticaria severity scoring. To test for autoimmune thyroid disease, the levels of T3, T4, TSH and anti-TPO antibodies will be traced. Data will be collected and analysed with appropriate statistical tests.
 Expected Results: Statistical correlation between chronic spontaneous urticaria and autoimmune thyroid disorders which can aid in the early detection and arrest of progression of autoimmune thyroid disorders in chronic spontaneous urticaria.
 Conclusion: Preventive steps toward patient management can be taken with this analysis in chronic spontaneous urticaria, in patients with deranged parameters for the T3, T4, TSH and ANTI – TPO.

Case report of Hashimoto encephalopathy in a 21-year-old female patient

Hashimoto encephalopathy is a rarely diagnosed autoimmune neurological disorder, associated with the presence of antithyroid antibodies. The variability of clinical presentation, rarity of the disease, and absence of specific diagnostic markers make timely diagnosis very complicated. This article describes a clinical case of a female patient with Hashimoto encephalopathy and discusses diagnosis, differential diagnosis and treatment approaches. We emphasize the importance of establishing a timely diagnosis, considering high efficacy of targeted treatment.

Recurrence of benign paroxysmal positional vertigo: experience in 3042 patients.

SUMMARYObjectivesBenign paroxysmal positional vertigo (BPPV) is a disorder of the inner ear with a high rate of recurrence. Vascular disorders, migraine and autoimmune disorders have been considered facilitating factors for relapsing episodes. Our aim was to assess the role of vascular disorders, migraine and anti-thyroid antibodies in patients with recurrences.MethodsWe retrospectively analysed records of 3042 patients treated for BPPV without other lifetime vertigo. Clinical data included previous vascular disorders of the central nervous system, heart disorders, migraine and recent head trauma. The presence of anti-thyroid autoantibodies was assessed in all patients.ResultsMean age of the first BPPV was 52.8 ± 14.5 years; there were 2339 females (76.9%), while 2048 (67.3%) of patients presented recurrences within two years of follow-up. Previous disorders of the central nervous system, presence of anti-thyroid antibodies, head trauma and migraine showed an association with recurrences. Above all, in subjects having the first BPPV while aged between 40 and 60 years, anti-thyroid antibodies were predictive for recurrences.ConclusionsOur data are consistent with the hypothesis that anti-thyroid autoantibodies may play a role in recurrences in subjects with initial manifestations between 40 and 60 years.

Presence of Anti-Thyroid Antibodies Correlate to Worse Outcome of Anti-NMDAR Encephalitis.

ObjectiveTo investigate the characteristics and prognosis of anti-NMDAR encephalitis with the prevalence of anti-thyroid antibodies (ATAbs).MethodsThe clinical data of anti-NMDAR encephalitis patients admitted to Xuanwu Hospital from January 2012 to August 2018 was prospectively analyzed, and the patients were followed up for 24 months.ResultsA total of 120 patients were enrolled, of which 34.2% (41/120) were positive for ATAbs. The antibodies were more frequent in patients with severe disease compared to the non-severe group (51.4% vs. 25.6%, P=0.008). In addition, prevalence of ATAbs correlated with a higher incidence of disturbed consciousness, autonomic dysfunction, central hypoventilation and mechanical ventilation. The ATAbs-positive patients were also more likely to receive intravenous gamma immunoglobulin and immunosuppressor compared to the ATAbs-negative cases (P=0.006; P=0.035). Although the presence of ATAbs was associated with longer hospital stays and worse prognosis at 6 months (P=0.006; P=0.038), it had no impact on long-term patient prognosis. Positive status of anti-thyroglobulin antibody was an independent risk factor for worse prognosis at 6 months [odds ratio (OR)= 3.907, 95% CI: 1.178-12.958, P=0.026].ConclusionATAbs are prevalent in patients with anti-NMDAR encephalitis, especially in severe cases, and correlate with poor prognosis and impaired short-term neurological recovery.

The Role of TPOAb in Thyroid-Associated Orbitopathy: A Systematic Review

ABSTRACT Introduction Thyroid-associated orbitopathy (TAO) is one of the most common autoimmune inflammatory disorders of the orbit. The presence of anti-thyroid antibodies is believed to play a role in the pathogenesis and clinical status of the TAO patients. Herein, we review the usefulness of TPOAb as a biomarker for TAO. Methods A systematic search in MEDLINE library was conducted. Results: Twenty studies were included. TPO is expressed in orbital tissues, and the polymorphism rs11675434 SNP has proven to be associated with clinically evident TAO. Studies in pediatric patients have shown a positive correlation between high TPOAb levels and TAO. In contrast, results in adults are inconsistent. Some studies imply a protective role of TPOAb, yet the majority did not find any association. Some authors have suggested an implication of TPOAb in the pathophysiology of TAO in TRAb-negative patients. Conclusions The role of TPOAb in TAO remains unclear and controversial.

Association between anti-thyroid antibodies and quality of life in patients with Hashimoto thyroiditis: a systematic review and meta-analysis.

The aim of this review was to evaluate the association between anti-thyroid antibodies and quality of life in people with euthyroid Hashimoto thyroiditis. Patients with Hashimoto thyroiditis report symptom distress more often than those with non-autoimmune thyroid disorders. Therefore, anti-thyroid antibodies may be related to decreased quality of life in persons with Hashimoto thyroiditis. The etiology of lingering symptoms, even in euthyroidism, remains unknown. The relationship between anti-thyroid antibodies and quality of life for people with Hashimoto thyroiditis has not been evaluated in a systematic review. The participants were males and females at least 12 years of age, in any country, with Hashimoto thyroiditis. Participants not in a euthyroid state were excluded from this review. In this review, the exposure was the presence of anti-thyroid antibodies and the primary outcome was quality of life as measured by a validated scale. A three-step search strategy was implemented with an initial search of PubMed and CINAHL. A comprehensive database search using all identified keywords and index terms was undertaken in March 2019 for relevant published literature, gray literature, and clinical trial registries. The final updates to the search strategies were conducted in December 2019. The search was limited to studies published in English after 1956. Two independent reviewers completed screening for inclusion and utilized the recommended JBI approach to critical appraisal, study selection, data extraction, and data synthesis. The findings are presented in a meta-analysis and in a narrative synthesis, which includes tables and figures. All 13 studies had high methodological quality. Four studies found a significant correlation (P < 0.05) between the presence of anti-thyroid antibodies and quality of life. A fifth study found a significant correlation (P < 0.001) between higher antibody levels and quality of life. A meta-analysis was conducted using two cross-sectional studies, which revealed that the summative small effect size was statistically significant and suggested a lower quality of life in antibody-positive patients. Due to the heterogeneity of the studies, a narrative synthesis was conducted for the three secondary outcomes: symptom distress, executive function, and mental health. Three studies found a statistically significant (P < 0.05) correlation between symptom distress and antibodies, two studies found a statistically significant (P < 0.05) association between executive function and antibodies, and all but one study found a statistically significant (P < 0.05) relationship between mental health and antibodies. The findings in this review did not reveal a definitive relationship between antibodies and quality of life. However, our meta-analysis suggested a link between anti-thyroid antibodies and decreased quality of life in euthyroid children and adults. Though not conclusive, poor mental health and symptom distress may be associated with anti-thyroid antibodies. Therefore, it may be beneficial to periodically evaluate the quality of life and mental health in euthyroid patients with positive antibodies. It is unlikely that antibodies and executive functions are related. The studies and our review's limitations require replication of findings to confirm a connection between antibodies, quality of life, and the secondary outcomes. Future research should continue to evaluate the relationship between anti-thyroid antibodies and the quality of life in individuals with euthyroid Hashimoto thyroiditis. PROSPERO CRD42018084663.

Utilidad de los estudios en busca de autoinmunidad en pacientes con urticaria crónica espontánea

Chronic spontaneous urticaria (CSU) is a common condition in adults, especially among women; this entity is frequently associated with autoimmune diseases. Our goal is to assess through laboratory studies whether patients with autoimmune CSU presented data. A cross-sectional study of 35 patients was done in the area of Allergy and Immunology at Hospital Juarez de Mexico diagnosed with CSU. We performed the following tests: complete blood count, thyroid antibodies (antiperoxidase and thyroglobulin), antinuclear antibodies, rheumatoid factor, lupus anticoagulant, LE cells Autologous Serum Skin Test (ASST), add (C3 and C4). In addition, we made Helicobacter pylori test, thyroid hormones (T3, T4, TSH) and D-dimer. We evaluated 35 adult patients, 27 female; ASST was positive in 4 patients, negative antinuclear antibodies in all cases, but positive anti thyroid (AAT) antibodies in 4. The LE cell, lupus anticoagulant, complement, dimer D, thyroid and Helicobacter pylori profile were normal or negative and rheumatoid factor was positive in one patient. All AAT-positive patients were women, but 26 of them had negative ASST. The correlation between ASST and AAT was not significant. Most patients were women UCE and only 4 had positive ASST, but this does not correlate with the presence of anti-thyroid antibodies. Most studies were normal, so we suggest not making unnecessary laboratory studies in this disease.

Clinical and Biochemical Characteristics of Severe Hypothyroidism Due to Autoimmune Thyroiditis in Children.

Introduction: In the majority of countries, autoimmune thyroiditis is the main cause of acquired hypothyroidism in children. Typically, the natural course of the disease is initially insidious and the diagnosis is incidental. There are some children who develop severe hypothyroidism without a proper diagnosis. The aim of the study was to analyze the clinical and biochemical profiles of children with severe primary hypothyroidism due to autoimmune thyroiditis.Materials and Methods: We analyzed the records of 354 patients diagnosed between 2009 and 2019 with autoimmune thyroiditis. Only patients with TSH above 100 μIU/mL, associated with decreased free thyroxine and the presence of antithyroid antibodies, were enrolled in the study. The analysis encompassed clinical symptoms, thyroid and biochemical status, bone age, and imaging.Results: Twenty-six children were enrolled in the study. The mean age at diagnosis was 10.26 ± 3.3 years, with a female preponderance of 1.8:1. The most frequent symptom was growth impairment (77%) and weight gain (58%). Goiters were present in 42% of patients. Less common findings were pituitary hypertrophy (four patients) and hypertrichosis (three patients). Median values at the time of diagnosis were TSH 454.3 uIU/ml (295.0–879.4), anti-TPO antibodies 1,090 IU/ml, and anti-Tg antibodies 195 IU/ml. Anti-TSHR ab were evaluated only in six out of the 26 patients. The characteristic biochemical profile was correlated with the grade of hypothyroidism, and the strongest correlations were found with CBC parameters, lipid profile, aminotransferases, and creatine.Conclusion: In children with severe hypothyroidism, the most sensitive symptoms are growth arrest and weight gain despite the fact that, in some children, the auxological parameters at presentation could be within normal values for the population. The specific biochemical profile closely correlates to the severity of thyroid hormone deficiency and involves mostly erythropoiesis, liver function, and kidney function. Pituitary enlargement should be considered in each child with severe hypothyroidism. It is necessary to conduct prospective studies evaluating the actual frequency of anti-TSHR antibodies and pituitary enlargement in children with extremely high TSH, especially those presenting without goiters.

2274-PUB: Prevalence and Risk Factors of Sexual Dysfunction in Romanian Women with Type 2 Diabetes Mellitus and Chronic Autoimmune Thyroiditis

Background: Female sexual dysfunction (FSD) represents one of the chronic complications of diabetes, as the male sexual dysfunction, but less studied. Objective: Assessment of the prevalence and risk factors associated with sexual dysfunction in Romanian women with type 2 diabetes mellitus (T2DM) and chronic autoimmune thyroiditis (CAT). Material and Methods: The study sample included 132 Romanian women with T2DM and CAT. The presence of sexual disfunction was established using two validated questionnaires: Female Sexual Function Index, and Female Sexual Distress Scale-revised. CAT diagnosis was confirmed by the presence of antithyroid antibodies (antiperoxidase and antithyroglobulin antibodies). Results: We found that 47% of women presented sexual dysfunctions: 25.8% loss of libido, 21.2% orgasm, 17.4% lubrication, 18.9% arousal, 8.3% pain, and 17.4% satisfaction problems. The analysis revealed that age was a significant risk factor for FSD, along with DM duration and CAT duration. The presence of dyslipidemia as well as a ponderal status of overweight or obese, and also the glycemic control parameters such as average glycemic level and HbA1c were significant risk factors for FSD. Conclusions: Women with T2DM and CAT are more likely to present FSD and should be aware of additional risk factors. Disclosure A. Gherbon: None. M. Frandes: None. R. Timar: None.

Тактика ведення хворих після гемітиреоїдектомії з приводу доброякісного однобічного еутиреоїдного зоба

Мета даного аналізу — оцінити на підставі результатів світових досліджень ризик розвитку поопераційного гіпотиреозу (як субклінічного, так і маніфестного), час виникнення гіпотиреозу після гемітиреоїдектомії та частоту рецидивів вузлоутворення в частці ЩЗ, що залишилася. Матеріал і методи. Для пошуку відповідних досліджень використовували електронні бази PubMed. Результати. Для аналізу характеристик поопераційного гіпотиреозу відібрано 13 досліджень, із них у 8 представлено кількісні дані щодо структури гіпотиреозу, який розділили на два підтипи: субклінічний і маніфестний. В огляді представлено дані про найбільш поширене ускладнення після гемітиреоїдектомії — гіпотиреоз, його структуру, частоту розвитку, час настання після операції та чинники, що впливають на розвиток поопераційного гіпотиреозу. Серед основних розглянуто передопераційний рівень ТТГ, вік пацієнта та наявність антитиреоїдних антитіл. Також описано ризики вузлоутворення в залишеній частці щитоподібної залози після гемітиреоїдектомії. У цілому в короткостроковій перспективі не відзначалося розвитку вузликів у частці, що залишилася. Висновки. Основним ускладненням у віддалений період після гемітиреоїдектомії з приводу однобічного доброякісного еутиреоїдного захворювання ЩЗ є гіпотиреоз, який розвивається в 10,9-48,8% випадків. Частота розвитку поопераційного гіпотиреозу та перехід його з транзиторної в перманентну форму залежить насамперед від передопераційних показників тиреотропного гормону та рівнів антитиреоїдних антитіл. Поопераційну замісну терапію тиреоїдними гормонами не слід призначати рутинно, а лише у випадках переходу гіпотиреозу із субклінічної в маніфестну форму (ТТГ понад 10 мОд/мл).

Thyroid disorders in spontaneous chronic urticaria

Chronic spontaneous urticaria (CSU) is linked to thyroid disease in up to 54%, with predominance of hypothyroidism. To describe the impairments of the thyroid function in patients with CSU in a third level of care. A cross-sectional, observational, and descriptive study in which we have included men and women over 18-year-old with CSU; in which TSH and free T4 were quantified. According to the results, they were classified as euthyroid, hyperthyroid, and hypothyroid; in the latter ones, the presence of antithyroid antibodies was intentionally sought. The demographic and biochemical characteristics of the results were assessed. The clinical characteristics of 127 patients with CSU were analyzed. Women accounted for 78%. The average age was 44.5 ± 15.1 years. Impairments of the thyroid function were identified in 50 patients (39%), and subclinical hypothyroidism (SH) occurred in 41 (82%) of them; patients with hyperthyroidism were not found. Of the patients with hypothyroidism, 14 (28%) presented positive antibodies; all of them were women. More than a third of the analyzed patients with CSU presented impairments of the thyroid function; subclinical hypothyroidism (SH) was more common. The importance of identifying this entity lies in the possibility of a multidisciplinary treatment with endocrinology. Subsequent studies may establish whether the presence of hypothyroidism influences the activity of CSU.

SAT-276 Vitamin D Deficiency In Hashimoto's Thyroiditis

Background: Vitamin D (25OHD) deficiency is associated with the presence of antithyroid antibodies and abnormal thyroid function tests, suggesting that vitamin D may be involved in the pathogenesis of autoimmune thyroid disease (1). Some have described an inverse association between 25OHD levels and thyroid antibody titers as well as thyroid stimulating hormone (TSH) in patients with Hashimoto’s Thyroiditis (HT) (2). Objective: To study vitamin D deficiency in children and young adults with Hashimoto’s thyroiditis and to assess the relationship between 25OHD levels and thyroid antibody titers (thyroid peroxidase/TPO Ab and thyroglobulin/Tg Ab) in our center. Methodology: An IRB-approved study consisting of 20 patients, ages 1- 21 years with HT was conducted in endocrinology clinic and vitamin D status was assessed. Fifteen had 25OHD deficiency defined as <20 ng/ml (group 1) and 5 had levels ≥20 ng/ml (group 2). T-tests and Spearman’s correlation were performed. Results: Among the whole group, mean age was 16 ± 2.6 (S.D.) years, 80% female, and 45% African American, 25% Asian, 15% Caucasian and 10% Hispanic. Mean 25OHD level was 11.91 ± 4.23 ng/ml in group 1 vs 29.98 ± 4.03 ng/ml in group 2 (p <0.05). Mean TSH was 5.06 ± 3.80 mIU/ml in group 1 vs 2.07 ± 1.61 mIU/ml in group 2 (p=0.02), while mean FT4 was 1.14 ± 0.30 ng/dl in group 1 vs 1.07 ± 0.22 ng/dl in group 2 (p=0.62). TPO antibody titers were 1907 ± 3497 IU/ml in group 1 vs 305 ± 264 IU/ml in group 2 (p=0.09). Thyroglobulin antibody titers were 263 ± 508 IU/ml in group 1 vs 87 ± 157 IU/ml in group 2 (p=0.29). Spearman’s correlation analysis was performed to assess the association between the variables TSH, FT4, TPO Ab titers, Tg Ab titers against 25OHD levels. A significant negative correlation was found between TSH and 25OHD (r= -0.51, p=0.013) as well as between TPO Ab titers and 25OHD (r= -0.47, p=0.035). Conclusion: Small sample size was a limitation in our study. However, this is the first study as far as we know in a minority group of children and adolescents in the United States. Seventy-five percent of our group had 25OHD deficiency. We found a significant negative correlation between TSH and 25OHD as well as TPO Ab and 25OHD. This suggests that there may be a significant role of vitamin D in the pathogenesis of Hashimoto thyroiditis. Further studies will be needed to evaluate the role of treatment of vitamin D deficiency and its effects on Hashimoto’s thyroiditis.