Prevalence Of Autoimmune Thyroiditis Research Articles

Prevalence of Autoimmune Thyroiditis Among Children with Type 1 Diabetes

A single-stage cross-sectional study was conducted on the basis of the National Center for Maternal Health in the Kyrgyz Republic, children aged 0 to 18 years were examined. To study the prevalence of autoimmune thyroid disease with type 1 diabetes mellitus to improve the compensation of carbohydrate metabolism in children and adolescents with type 1 diabetes. Autoimmune thyroiditis often accompanies and interferes with type 1 diabetes mellitus in children and adolescents. Thyroid dysfunction in children with type 1 diabetes mellitus can negatively affect various areas of metabolic control. This study included 60 children with type 1 diabetes mellitus and autoimmune thyroiditis, 24 of them girls (40.0%), 36 boys (60%). The average value of ±SD for their age at the time of examination was 11.6±4.1 years, ranging from 1 to 17 years. Of the children with type 1 diabetes mellitus who tested positive for antibodies to thyroid peroxidase, 30 children (50%) had obvious hypothyroidism. Of the thirty children with normal TSH levels, 4 children (13.3%) showed signs of subclinical hypothyroidism, while 26 children (86.7%) had euthyroidism.

Chemotherapy for post-menopausal women with early breast cancer seems not to result in clinically significant changes in thyroid function.

Adjuvant chemotherapy is often indicated in patients diagnosed with early breast cancer (EBC). Among others, weight gain is one of the observed side effects of both chemotherapy and other cancer treatments; however, the mechanism is not well-described. In this study, we aimed to assess thyroid function before and shortly after the course of chemotherapy for EBC. This is a prospective cohort study of women diagnosed with EBC. The main outcome was the thyroid function and body weight before and after completing chemotherapy. Secondary outcomes were the presence of thyroid autoantibodies and treatment radiation dosage. We included 72 patients treated with adjuvant chemotherapy, whereas 59 patients also received supraclavicular locoregional radiotherapy. Triple-negative breast cancer (BC) patients receiving chemoimmunotherapy were excluded. After the chemotherapy, we observed an increase in thyroid-stimulating hormone (p = 0.03) and a decrease in free-thyroxine (p = 0.0006), with no significant weight change. The prevalence of autoimmune thyroiditis was low. On average 3 months post-chemo, we found no statistically significant difference in the thyroid function of women treated versus not treated with supraclavicular locoregional radiotherapy. Although statistically significant changes in thyroid hormones were observed, this study suggests no obvious clinically significant changes in thyroid function in women with early BC after the course of chemotherapy. The decrease in thyroid function was not related to autoimmunity, non-thyroidal illness, radiotherapy, or high-dose corticosteroids. Further studies with a longer follow-up of thyroid function after adjuvant chemotherapy and supraclavicular locoregional radiotherapy are needed.

Prevalence of autoimmune thyroiditis among children with autoimmune hepatitis.

Autoimmune hepatitis (AIH) is an organ specific autoimmune disease, which can manifest at any age of life. there is a high prevalence of extrahepatic autoimmune diseases in patients with AIH. Autoimmune thyroid diseases (ATDs) are the most frequent extrahepatic autoimmune disorders among patients with AIH. Aim of work is to detect the frequency of ATDs among Egyptian children with AIH. This research is a cross-sectional study conducted on 58 children with AIH aged ≤ 18years. All patients were tested for free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroid stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG). Thyroid ultrasound (US) and thyroid scan were performed for patients with abnormal thyroid profile, borderline values, positive anti-TPO or anti-TG. The mean ± standard deviation (SD) for the age of the patients was 11.3 ± 4.5years. Out of 58 patients of AIH, 28 patients (48.3%) had associated other autoimmune diseases. Autoimmune thyroiditis was the most common associated autoimmune disease being present in 10 patients (17.2%). The thyroid status of AIT patients showed that 6 patients (60%) were euthyroid, 3 patients (30%) had subclinical hypothyroidism and only one patient (10%) was hyperthyroid. Autoimmune hepatitis in Egyptian children is commonly associated with other autoimmune diseases. Autoimmune thyroiditis is the most common to be associated with AIH in pediatric patients. As it is not usually clinically manifesting, regular screening for AIT in children with AIH is mandatory.

Comparison of positive rates between glutamic acid decarboxylase antibodies and ElisaRSR™ 3 Screen ICA™ in recently obtained sera from patients who had been previously diagnosed with slowly progressive type 1 diabetes.

This study aimed to compare the positivity rates of glutamic acid decarboxylase autoantibodies (GADA) and ElisaRSR™ 3 Screen ICA™ (3 Screen ICA), a newly developed assay for the simultaneous measurement of GADA, insulinoma-associated antigen-2 autoantibodies (IA-2A), and zinc transporter 8 autoantibodies (ZnT8A), in recently obtained sera from patients who had been previously diagnosed with slowly progressive type 1 diabetes (SPIDDM). We enrolled 53 patients with SPIDDM who were positive for GADA at the diagnosis and 98 non-diabetic individuals, and investigated the diagnostic accuracy of the 3 Screen ICA (cutoff index ≥30 units) compared with that of GADA. In addition, we compared the clinical characteristics of patients with SPIDDM who were negative or positive on 3 Screen ICA. The positivity rates of 3 Screen ICA, GADA, IA-2A, and ZnT8A were 88.7, 86.8, 24.5, and 13.2%, respectively. The respective sensitivity, specificity, and positive and negative predictive values for SPIDDM were 88.7, 100, 100, and 94.2% by 3 Screen ICA and 86.8, 100, 100.0, and 93.3% by GADA. There were no significant differences in age at onset, duration of diabetes, body mass index, glycated hemoglobin and C-peptide levels, and the prevalence of autoimmune thyroiditis between patients with SPIDDM who were positive or negative on 3 Screen ICA. However, the prevalence of insulin users was significantly higher in those who were positive than in those who were negative on 3 Screen ICA. Similar to GADA, 3 Screen ICA may be a useful diagnostic tool for detecting patients with SPIDDM.

The substantiation of differentiated therapy of the combined disgormonal pathology of reproductive organs in women of reproductive age with comorbid conditions

The objective: substantiation of differentiated therapeutic approaches to the treatment of combined dyshormonal pathology of the reproductive organs, taking into account the comorbidity of patients.Materials and methods. 300 women of reproductive age (20–42 years, mean age – 29.9±5.6 years) with dyshormonal pathology of reproductive organs were examined: the main group included 180 patients who were prescribed complex differentiated pharmacotherapy for the treatment of combined dyshormonal pathology of the reproductive organs with correction of comorbid conditions, and the comparison group included 120 patients who received a standard set of measures. The control group included 50 healthy women without somatic and gynecological pathology. All women had ultrasound examination of the pelvic organs, mamma glands, thyroid gland, determination of the levels of pituitary tropic hormones and steroid ovary hormones, thyroid hormones, antibodies to thyroperoxidase, and the level of 25 (OH) D in blood serum. Results. Obesity of various degrees was observed in 31.0% of examined patients with dyshormonal pathology of the reproductive system, the prevalence of autoimmune thyroiditis in patients was 36.0%, and subclinical hypothyroidism was diagnosed in 21.3%. Among women with autoimmune thyroiditis, the frequency of subclinical hypothyroidism was 59.3% with 3.7% of manifest hypothyroidism. Vitamin D insufficiency was found in 34.0% of patients with dyshormonal pathology, vitamin D deficiency – in 44.3%, severe deficiency – in 21.7%. Treatment of patients in the main group led to the normalization of the menstrual cycle in 97.2% of cases, in the comparison group – in 73.3%, to a reduction of pain syndrome severity – in 94.7% and 60.6%, respectively, cyclic mastodynia – in 93.9% and 43.9%, manifestations of vegetative-vascular and non-specific symptoms – in 94.8±3.9% and 24.3±16.7% of cases, contributed to achieving the desired pregnancy – in 64.1% and 30.6% of patients, respectively, and also there was a reducing the frequency of relapses during 6 months of observation from 14.5% to 4.1%.Conclusions. The use of complex differentiated pharmacotherapy for the treatment of combined dyshormonal pathology of the reproductive organs with the correction of comorbid conditions makes possible to achieve higher efficiency, which is manifested in a greater reduction in the frequency of clinical symptoms and disease relapses compared to the usual practice.

Benign and malignant thyroid nodules with autoimmune thyroiditis.

The prevalence of autoimmune thyroiditis (AT) in papillary thyroid carcinoma (PTC) is still controversial. The aim of this study was to investigate the frequency of coexistence of PTC with AT versus that of the coexistence of benign nodules with AT. This was a cross-sectional retrospective study including patients operated on for thyroid nodules from January 2011, to April 2021. The frequency of papillary carcinomas cooccurring with AT was compared to that of benign nodules cooccurring with AT, which was assessed based on cytopathological diagnosis after thyroidectomy. The study included 668 cases of benign nodules and 420 cases with PTC. No statistically significant difference was observed between cases of benign and PTC nodules regarding the presence of AT (25% vs. 28%, respectively, p = 0.177). The size of the PTC compared to that of the benign predominant nodules was significantly smaller both in the absence (0.96 ± 1.09 cm vs. 2.19 ± 1.06 cm, p < 0.05) and in the presence (0.77 ± 0.76 cm vs. 1.67 ± 1.08 cm, p < 0.01) of AT. In the binary logistic regression analysis of the PTC, the only variable associated with AT was multifocality (odds ratio: 1.750, 95% confidence intervals: 1.131-2.706, p = 0.013). The incidences of lymph node involvement and advanced stage PTC were very low both in the presence and absence of AT. The nodules present with PTC were not more likely to coexist with AT than benign nodules were. The small incidence of advanced PTC indicates a significant improvement in early-stage diagnosis.

The prevalence of autoimmune thyroiditis in adolescent girls with polycystic ovary syndrome.

Both polycystic ovary syndrome (PCOS) and autoimmune thyroiditis (AT) are reported to be common endocrinopathies. In recent years the number of publications assessing the coexistence of these two disease entities in adult women has been growing. There are many suggestions regarding pathophysiological mechanisms that can cause the relationship between AT and PCOS. However, there is still a lack of research among adolescent girls. The aim of the study was to analyze the occurrence of autoimmune thyroiditis in adolescent girls with PCOS. The study group included 80 girls diagnosed with PCOS (chronological age: 16.54 ± 1.00 years, BMI: 22.80 ± 3.27 kg/m2), and the control group - 64 regularly menstruating girls (chronological age: 16.71 ± 0.63 years, BMI: 24.8 ± 5.2 kg/m2). The thyroid function and morphology were assessed based on the concentration of thyroid stimulating hormone (TSH), free thyroxine (fT4), anti thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG) antibodies and ultrasound scan of the thyroid gland. AT was diagnosed in 18 (22.5%) girls from the study group and nine (14.06%) from the control group (p > 0.05). Positive anti-TPO titer was observed more often in the study group [21 patients (26.25%)] than in the control group [9 girls (14.06%)] (p = 0.054). Moreover, an abnormal ultrasound scan of the thyroid gland characteristic for AT was found in 18 girls from the study group (22.50%) and 8 girls from the control group (12.50%) (p > 0.05). The results of the analyzed studies do not confirm a significant relationship between PCOS and AT in adolescent girls. However, in the group of girls with PCOS, autoimmune process exponents were more frequent (anti-TPO), reaching the borderline level of statistical significance.

The substantiation of differentiated therapy of the combined disgormonal pathology of reproductive organs in women of reproductive age with comorbid conditions

The objective: substantiation of the differentiated therapeutic approaches to the treatment of the combined dyshormonal pathology of the reproductive organs, taking into account the comorbidity of the patients.Materials and methods. The study involved 300 women of reproductive age (20 - 42 years, an average of 29.9±5.6 years). The examination included ultrasonographic examination of the pelvic organs, mammary glands, thyroid gland, determination of the levels of pituitary tropic hormones and ovarian steroid hormones, thyroid hormones, antibodies to thyroperoxidase, serum levels 25 (OH) D. Results. Obesity of varying degrees was observed in 31.0% of the patients examined. The prevalence of autoimmune thyroiditis in patients with a dyshormonal pathology of the reproductive system was 36.0%, and subclinical hypothyroidism was diagnosed in 21.3% of women, but among patients with autoimmune thyroiditis, the incidence of subclinical hypothyroidism was 59.3% with 3.7% of manifest hypothyroidism. Insufficiency of vitamin D was detected in 34.0% of patients with dyshormonal pathology, vitamin D deficiency in 44.3%, severe deficit in 21.7%. Сonclusions. The use of complex differentiated pharmacotherapy for treatment of combin dyshormonal pathology of reproductive organs with correction of comorbid states allows to achieve a higher efficacy in comparison with usual practice (normalization of MCs 97.2% at 73.3%, reduction of pain syndrome 94.7% at 60.6% and cyclic mastodynia – 93,9% at 43,9%, reduction of vegetative-vascular and non-specific symptoms – 94,8±3,9% at 24,3±16,7%), to reduce the frequency of relapses during 6 months of observation from 14, 5% to 4.1% (p=0.0128), to achieve the desired pregnancy without stimulants and the ART and ovulation in 64.1% of patients compared with 30.6% (p=0.0079) in case of usual practice.

РАСПРОСТРАНЕННОСТЬ ПОРАЖЕНИЯ ЩИТОВИДНОЙ ЖЕЛЕЗЫ У БОЛЬНЫХ РЕВМАТОИДНЫМ АРТРИТОМ, ПРОЖИВАЮЩИХ НА ЮГЕ КЫРГЫЗСТАНА

Rheumatoid arthritis (RA) is one of the most relevant but less studied medical and social problem of Kyrgyzstan. According to latest research of WHO, published in 2017, Kyrgyzstan is ranked second among world countries by rheumatoid arthritis-caused death rate. It is estimated, that autoimmune thyroiditis, hypothyroidism and thyrotoxicosis are associated comorbidities of rheumatoid arthritis. In Kyrgyzstan the autoimmune thyroiditis is ranked as second (8.9%) among the all thyroid diseases rate and considered to be the most frequent cause of hypothyroidism (7.2%). Meanwhile the thyrotoxicosis has been found in 6% of population, being on the fourth rank. The article shows the prevalence of thyroid pathology and its common nosological forms in patients with RA living in south of Kyrgyzstan, evaluates its association to rheumatoid arthritis’ activity. In RA patients the prevalence of autoimmune thyroiditis was found 12,6%, hypothyroidism (14,2)% (subclinical 13,0%, manifested in 1,2%), thyrotoxicosis in 1,2% cases.

Predictivity of Autoimmune Stigmata for Gluten Sensitivity in Subjects with Microscopic Enteritis: A Retrospective Study

Non-celiac gluten sensitivity (NCGS) is an emerging gluten-related condition. We investigated whether the presence of autoimmune stigmata in a group of patients with clinical suspicion of NCGS and a histological picture of microscopic enteritis (ME) could be a predictive factor of NCGS. Patients with ME were followed up by periodical examinations. At baseline, we collected data about previous clinical history, including autoimmune diseases. NCGS was diagnosed according to Salerno criteria; other causes of ME were diagnosed according to well-established protocols. Patients with celiac disease were excluded. Student’s and chi-square tests were used in univariate analysis. Kaplan-Meier curves and Cox regression were used to estimate hazard ratios (HR). Sixty-three patients were included. Twenty-two had a final diagnosis of NCGS; the remaining 41 had non-gluten-related causes of ME. Prevalence of autoimmune thyroiditis was higher among NCGS patients (40.1%) than in other ME (14.6%; p = 0.03). NCGS showed higher positivity rate for anti-gliadin (27.3% versus 2.5%; p = 0.006) and anti-nucleus (45.4% versus 12.2%; p = 0.005). Autoimmune thyroiditis had a non-significant trend (p = 0.06) for NCGS diagnosis, (HR = 2.4). Both anti-gliadin (HR = 2.4; p = 0.04) and anti-nucleus (HR = 2.7; p = 0.04) were directly associated with NCGS diagnosis. In conclusion, NCGS may have a cohort of autoimmune stigmata that can precede its diagnosis.

Репродуктивне здоров’я і дисфункція щитоподібної залози

Diseases of thyroid gland, according to world statistics, are found in almost 30% of the world’s population. Thyroid dysfunctions, according to many epidemiological studies, are quite widespread in the population. Normal development of the reproductive system occurs under the influence of gonadotropic hormones of the pituitary gland and during normal functioning of the thyroid gland. In turn, the state of the reproductive system has a pronounced effect on the function of the thyroid gland, as evidenced by changes in its function during pregnancy and lactation, in patients with abnormal uterine bleeding, in girls during puberty and women during the menstrual cycle. The objective: is to evaluate the prevalence and effectiveness of diagnosis of dysfunction of thyroid dysfunction in women with reproductive health disorders to improve treatment and rehabilitation activities and quality of life. Materials and methods. In the first stage of a prospective study, 989 women of reproductive age were put through the method of continuous sampling. Based on the results of verifying the gynecological pathology, 350 patients who gave informed consent for participation in the second stage of the study, were divided into clinical groups for further comparative analysis of the prevalence of dysfunction of thyroid gland: I group – 159 (51.3%) patients with combined non-hormonal non-inflammatory pathology of reproductive organs and dyshormonal pathology of the mammary glands (genital endometriosis, adenomyosis / uterine leiomyoma in combination with endometrial hyperplasia), II group – 31 (8.9%) female with PCOS, III – 53 (15.1%) with endometriotic disease, IV group – 57 (16.3%) women with uterine leiomyoma. Absence of gynecological pathology and pathology of mammary glands at the time of the survey was found in 50 (14.3%) of women, which amounted to V group. Results. Structural and functional changes of the thyroid gland were found in 53.4% of women, while the frequency of detection of diffuse goiter I–II st. did not differ between clinical groups (p&gt;0.05). The prevalence of autoimmune thyroiditis was higher in patients with dyshormonal pathology of the reproductive system than in healthy women (p=0.0001). The euthyroid state with combined dyshormonal and proliferative pathology occurred 1.5 to 1.9 times less frequently than in patients of other groups (p≤0.0005). Subclinical hypothyroidism was diagnosed in 39,6% of the I group of women at 12.9%, 15.1% and 14.0% in the II, III and IV groups, respectively. At the same time, the incidence of subclinical hypothyroidism was 60.6% for the I group in women who had diffuse goiter and / or autoimmune thyroiditis, with 8.6% of the manifest hypothyroidism that was absent in women with PCOS, and the prevalence of endometriosis disease and uterine leiomyomies were 1.9% and 3.5%, respectively. Conclusion. Thus, the results of a two-stage study of thyroid gland thyroid dysfunction in women with dyshormonal pathology of reproductive organs of non-inflammatory genesis confirm that dysfunction of the thyroid gland, especially hypothyroidism, is a serious problem for reproductive health, requiring changes in diagnostic and therapeutic approaches. Key words: thyroid gland, autoimmune thyroiditis, hypothyroidism, reproductive health, non-inflammatory dyshormonal diseases of reproductive organs.

ASSESSMENT OF COMORBIDITY IN THE MANAGEMENT OF PATIENTS WITH A DISGORMONAL COMBINED PROLIFERATIVE PATHOLOGY OF REPRODUCTIVE ORGANS

The influence of comorbid pathology on the clinical manifestations, diagnosis, treatment and prognosis of many diseases is individual, but it is generally recognized that the interaction of diseases, age and pathomorphosis predetermines the pathogenetic features of the pathology of the reproductive system, troubles diagnosis, the choice of optimal medical technologies, negatively affects the quality of life of women.The aim of the study was to evaluate the prevalence of comorbid conditions in women with reproductive health disorders against the background of a dyshormonal combined pathology of the reproductive system.Materials and methods. The study involved 350 women aged 20 to 42 years. The examination included the study of complaints, personal and family history, anthropometric, physical, ultrasonographic, instrumental, clinical and laboratory examination with the definition of the hormonal profile, the function of thyroid gland, level 25 (OH) D. A combined dyshormonal benign proliferative pathology of the reproductive organs (genital endometriosis, adenomyosis / leiomyoma of the uterus in combination with endometrial hyperplasia and diffuse mastopathy) was diagnosed in 51.3% of the patient, 8.9% had PCOS, 15.1% had endometriosis disease, 16,3% - to the uterus leiomyoma. Absence of pathology at the time of examination was found in 14.3% of women.Results of the study and their discussion. Diffuse mastopathy (BI-RADS 2) occurred in 63.7% of women, and changes in BI-RADS 3 were detected in 11.1%. Structural and functional changes of the thyroid gland were found in 53.4% women, of the frequency of diffuse goiter I – II st. was did not differ between clinical groups (p> 0.05). At the same time, the prevalence of autoimmune thyroiditis was higher in patients with dyshormonal pathology of the reproductive system compared with women without gynecological pathology (p = 0.0001). Euthyroid status in patients with combined dyshormonal pathology occurred 1.5 to 1.9 times less frequently than in patients with endometriosis, uterine leiomyoma and PCOS (p≤0,0005). 27.7% of women had excess weight, obesity of the 1st degree - in 34.9%, obesity of the second degree in 9.7% of women, which in general accounted for 72.3% of the examined. The most often severe vitamin D deficiency (level 25 (OH) D on average 6.3 ± 1.5 ng / ml) among women with D deficiency was detected in 53.3% of cases with PCOS and in 70.5% of women with combined dyshormonal diseases of the reproductive organs (p <0.05) in the absence of severe deficit D in women without gynecological pathology, which is a convincing indicator of the importance of vitamin D for the normal functioning of the female reproductive system.Conclusions. Comorbidity is a serious problem for reproductive health and requires a change in the diagnostic and treatment approaches from disease-oriented recommendations to patient-centered approaches based on an integrated assessment of the patient.

Autoimmune disease, familial clustering and thyroid carcinoma coexistent with autoimmune thyroiditis in children and adolescence: A cross-sectional study from the Czech Republic.

The prevalence of autoimmune thyroiditis (AIT), as the most common autoimmune disease (AD) and papillary thyroid cancer (PTC) is steadily rising in children. The aim of this study was to determine the coexistence of other AD and thyroid carcinoma (TC) in AIT. The cross-sectional study conducted at a tertiary center comprised AIT children (< 19 years). Data on age/sex, thyroid function and ultrasound, autoantibodies, associated AD, familial occurence of AD and the occurence of TC for each child were collected. In total, 231 eligible patients (77% females) were included. The most common onset (66%) was during adolescence. At onset, hypothyroidism was detected in 59.3%; hashitoxicosis in 1.3%. The positivity of both autoantibodies was present in 60.6%, the negativity was in 3,5%. We confirmed a high frequency (44.6%) of AD with AIT predominance in parents and/or grandparents of patients and in siblings (7.4%). 15.2% had at least 1 comorbid AD, of which type 1 diabetes mellitus was the most common (8.5%). Over a period of 7 years TC was diagnosed in 16 patients (mean age 13.5 years) with predominance of PTC in 15 (94%) patients. AIT had concurrently 69% patients. 56% of patients had metastases (89% in AIT subjects). An invasive PTC was present in 44% (86% in AIT subjects). The prevalence rate of AD in AIT and first-degree relatives is high, and several new associations have been reported. Providers should be aware of comorbidities and TC in AIT as this would help in early diagnoses and timely interventions.

What a Low Prevalence of Autoimmune Thyroiditis in Sickle Cell Diseases

What a Low Prevalence of Autoimmune Thyroiditis in Sickle Cell Diseases

Prevalence of autoimmune thyroiditis in patients with type 1 diabetes: a long-term follow-up study

PurposeType 1 diabetes mellitus (DM) is associated with autoimmune diseases such as thyroiditis. Therefore, we aimed to investigate the prevalence of autoimmune thyroiditis in patients with type 1 DM.MethodsA total of 102 patients who were diagnosed and followed up (mean age, 8.1±4.0 years) in Ajou University Hospital were enrolled in this study. All the patients were evaluated for beta cell autoimmunity, including insulin autoantibody, glutamic acid decarboxylase antibodies (GADA), and islet cell antibody. Moreover, autoantibodies to thyroid peroxidase and thyroglobulin were assessed at initial diagnosis and annually thereafter.ResultsThe mean patient age (49 men and 53 women) was 19.2±4.8 years. The prevalence of at least one thyroid antibody was 30.4%. Patients with thyroid anti­bodies had a significantly higher frequency of GADA at the time of the diagnosis. Autoimmune thyroiditis was more prevalent in the older age group. GADA was a significant risk factor for development of thyroid autoantibodies after diagnosis of type 1 DM (odds ratio, 4.45; 95% confidence interval, 1.399–14.153).ConclusionsIn patients with type 1 DM, the prevalence of autoimmune thyroiditis was higher than in the general population. Moreover, GADA positivity at diagnosis was associated with thyroid autoimmunity.

Phagocytosis Deficiency of Macrophages in NOD.H-2h4 Mice Accelerates the Severity of Iodine-Induced Autoimmune Thyroiditis.

Apoptosis occurs in many autoimmune diseases. Excess iodine induces thyrocyte apoptosis and increases the incidence and prevalence of autoimmune thyroiditis (AIT). However, the sequence of events between the appearance of thyrocyte apoptosis and the occurrence of thyroiditis remains uncharacterized. Furthermore, few studies have investigated the role of macrophage phagocytosis in the development of AIT. Therefore, we evaluated the relationship between apoptosis and inflammatory infiltration in NOD.H-2h4 mouse thyroids by comparing the sequence of events in tissue samples. We also investigated the role of macrophages by comparing macrophage phagocytosis function in BALB/c, C57BL/6, and NOD.H-2h4 mice treated with different levels of iodine. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays and thyroid inflammatory scores revealed that apoptosis (2weeks) occurred before inflammatory infiltration (4weeks). Phosphatidylserine (PS) expression on the extracellular surface of the cell membrane and double-stranded DNA fragments associated with apoptosis appeared at 2 and 8weeks, respectively. Additionally, although apoptosis was enhanced in the thyroids of mice supplemented with excess iodine (0.05±0.12 vs 1.63±0.82% for BALB/c, 0.09±0.14 vs 1.51±0.34% for C57BL/6, and 0.07±1.11 vs 4.72±0.62% for NOD.H-2h4 mice), only NOD.H-2h4 mouse thyroids presented with inflammation. Furthermore, macrophages from NOD.H-2h4 mice (44.46±1.79%) exhibited decreased phagocytotic activity relative to that in BALB/c (54.21±4.58%) and C57BL/6 (58.96±4.04%) mice. There were no differences in phagocytosis function between NOD.H-2h4 mice supplemented with excess iodine or left untreated (24.50±2.66 vs 21.71±1.79%, p=0.06). In conclusion, deficiencies in the apoptosis clearance of macrophages in NOD.H-2h4 mice may constitute an early pathogenic mechanism in AIT that is not influenced by iodine intake.

Ultrasound variants of autoimmune thyroiditis in children and adolescents and their clinical implication in relation to papillary thyroid carcinoma development

BackgroundThe prevalence of autoimmune thyroiditis (AIT) and papillary thyroid carcinoma (PTC) is rising in children and adolescents, and the coincidence of AIT and PTC is as high as 6.3–43%.ObjectiveTo investigate the ultrasound manifestation of AIT in relation to PTC development in paediatric patients.Patients179 paediatric patients (133 females), mean (SD) age: 13.9 (3.03) years diagnosed with AIT and referred for ultrasound evaluation. Eight patients were diagnosed with PTC (6 females).MethodsRetrospective analysis of thyroid ultrasound scans of patients diagnosed with AIT. Thyroid and autoimmune status was assessed based on TSH, fT4, fT3 and increased aTPO and/or aTG and/or TRAB levels. In patients with PTC, total thyroidectomy was performed.ResultsAnalysis of thyroid US scans revealed that the following five ultrasound variants of AIT were observed in 179 patients: the most common in 35.2%—diffuse thyroiditis with hypoechogenic background and normoechogenic parenchyma, in 30.2%—diffuse thyroiditis with irregular background, in 18.9% nodular variant with normoechogenic background, in 11.7%—micronodulations and in 3.9%—diffuse hypoechogenic background. Eight cases of PTC were diagnosed in nodular variant of AIT with normoechogenic irregular background.ConclusionPatients with AIT and nodular variant with normoechogenic irregular background of the thyroid gland on US scans are in the risk group of developing PTC and should be followed up with regular neck US assessment.

Trends in the prevalence of autoimmune thyroiditis in the leading private health-care provider in Poland.

Autoimmune thyroiditis (AT) is one of the most common endocrine disorders affecting a significant percent of the population, especially women. It may have serious and long-lasting consequences. The etiology of AT is multifactorial and it arises from an interplas between environmental and genetic factors. Tendencies in AT prevalence and incidence are unclear. In Poland there are no national registers covering the data on AT prevalence. The aim of the investigation was to assess changes in diagnosing AT in the largest chain of outpatient medical centers in Poland. We compared freqnancy at which AT and hypothyroidism diagnoses were made during endocrinology consultations in the period 2006-2013. The data was extracted from the database of LUXMED (part of BUPA). Within 8 years, the prevalence of newly diagnosed AT dropped from 10.4% to 4.8% (p < 0.001) alongside with a decrease in the prevalence of newly diagnosed hypothyroidism from 17.8% to 7.7% (p < 0.00001). AT was widespread in young women aged 20-39. There were relatively more cases in the southern areas of Poland. The analyzed data does not support a hypothesis indicating a growing incidence of AT in the last years. Detailed epidemiological studies would be helpful in designing screening strategies for patients with this common disorder.

No association of psoriasis with autoimmune thyroiditis.

Common autoimmune diseases tend to coexist in the same patients. Few studies have examined the possible association between autoimmune thyroiditis and psoriasis or psoriatic arthritis (PsA), with inconsistent results. To investigate the prevalence of autoimmune thyroiditis in psoriatic patients with or without PsA, living in an iodine-sufficient area. We studied prospectively, 114 psoriatic patients with disease duration of 5-38 years, 30 of them with PsA, and 286 age- and body mass index (BMI)-matched subjects without psoriasis or known thyroid disease or autoimmune disease. A detailed medical history was obtained from all participants and clinical examination and laboratory evaluation was performed. Psoriasis severity was assessed with Psoriasis Area and Severity Index (PASI). Autoimmune thyroiditis was defined by the presence of positive autoantibodies to thyroid peroxidase and/or thyroglobulin. There was no difference in the prevalence of autoimmune thyroiditis between psoriatic patients and controls (20.2% vs. 19.6%). The prevalence of autoimmune thyroiditis in male and female psoriatic patients was similar (9.6% and 10.5% respectively), in contrast to the increased, as expected, prevalence in female vs. male controls (14.7% vs. 4.9%, P < 0.01). Detected cases with hypothyroidism due to autoimmune thyroiditis were similar in psoriatic patients and controls (7.9% and 7.0% respectively). Autoimmune thyroiditis in psoriatic patients was not related with age of psoriasis onset, psoriasis duration, PASI score, PsA and obesity. These data support that psoriatic patients with or without PsA do not have an increased risk for autoimmune thyroiditis.

Polycystic ovary syndrome and chronic autoimmune thyroiditis

Introduction: Polycystic ovary syndrome (PCOS) has been associated with an autoimmune origin, either per se or favoring the onset of autoimmune diseases, from a stimulatory action on the inflammatory response. Thus, autoimmune thyroiditis (AIT) could be more prevalent among women with PCOS.Objective: To evaluate the prevalence of AIT in women with PCOS.Study design: It was a cross-sectional study, in a tertiary center, including 65 women with PCOS and 65 women without this condition. Clinical and laboratory parameters were evaluated and a thyroid ultrasound scan was performed. Levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), anti-thyroid peroxidase (anti-TPO) antibodies, anti-thyroglobulin (anti-TG) antibodies, and thyroid ultrasound findings were evaluated.Results: The prevalence of subclinical hypothyroidism (SCH) in women with PCOS was 16.9% and 6.2% in the non-PCOS group. AIT was more common in the PCOS group compared with the non-PCOS group (43.1% versus 26.2%). But, when it was adjusted by weight and insulin resistance, the difference in the thyroiditis risk was not observed (OR 0.78, CI 0.28–2.16).Conclusion: AIT risk was similar in the PCOS and the non-PCOS group. SCH are more common in women with PCOS, highlighting a need for periodic monitoring of thyroid function.