Prevalence Of Thyroid Antibodies Research Articles

Autoimmune thyroid disease in women with ages between 35 to 45 years based on Azar cohort data

Introduction: Autoimmune thyroid diseases are common findings in women of childbearing age that could affect fertility rate, pregnancy outcome and complications after pregnancy. These diseases also correlated with other autoimmune diseases. Objectives: In this study, we aim to evaluate the autoimmune thyroid disease in women aged 35 to 45 years based on Azar cohort study data. Patients and Methods: In this cross-sectional analytical study, 507 women 35-45 years old without previous thyroid disease from Azar cohort study were evaluated. Demographic findings, data related to previous pregnancies, abortion, miscarriage, infertility and gestational diabetes were recorded for all patients. Blood samples were taken from all patients to measure TSH and anti-thyroid peroxidase (anti-TPO) levels. Anti-TPO levels ≥40 IU/mL were considered positive. Results: In the studied women, miscarriage occurred in 5.3%, abortion in 27.6% and infertility in 7.3%. Gestational diabetes was reported in 3.9%. The positive anti-TPO prevalence was 21.5%. Patients with positive anti-TPO compared to those with negative anti-TPO had significantly higher cases of hypothyroidism (P<0.001). There was no difference between patients with and without positive anti-TPO regarding miscarriage (5% versus 6.4%), abortion (27.4% versus 28.4%), infertility (7.5% versus 6.4%) and gestational diabetes (7.9% versus 3.6%) (P>0.05). There was no correlation between age and anti-TPO levels. Conclusion: The prevalence of thyroid antibodies in our study population is higher than previous studies. Anti-TPO positivity has no significant effect on pregnancy outcome in this population. Further studies are necessary to define the exact effect of anti-TPO on pregnancy outcomes.

ASSOCIATION OF SERUM AUTO-ANTIBODIES AND THYROID FUNCTION TEST IN PATIENTS WITH NON-NEOPLASTIC THYROID DISEASES IN SHENDI LOCALITY, SUDAN

Background: Thyroid disorders are the most second endocrine problem after diabetes mellitus in society. Environmental, immunological, and genetic factors lead to the development of thyroid disorders. Objectives: The study intended to evaluate the role of thyroid antibodies and hormones in the diagnosis of thyroid diseases, as well as the prevalence of thyroid antibodies in patients having thyroid disorders living in Shendi locality. Study design: The current research was prospective, case - control, hospital-based study carried out from 2013-2017, in El-Mek Nimir Uiversity Hospital in Shendi town- Northern Sudan.-. River Nile State. Two hundred and eighty-three (283) participants selected randomly as study population, of whom Hundred and eleven (111) patients with hypothyroidism; Seventy-two (72) patients with hyperthyroidism; Hundred (100) healthy normal subjects as control group. Participants were recruited from outpatient clinics in El-Mek Nimir Uiversity Hospital in Shendi Thyroid hormones profile (TSH, T4, T3, fT3, and fT4) and Thyroid antibodies (Anti-thyroid peroxidase and antithyroglobulin) were measured. Results: The study revealed that (60.7%) had hypothyroidism, (39.3%) had hyperthyroidism, (91.9%) of hypothyroidism were female, and only (8.1%) were male, while (84.7%) of hyperthyroidism were female while male represented only (15.3%) of them. The current study revealed that 107 of the case group (58.5%) were positive when evaluated for thyroid peroxidase antibodies (TPO Ab), with level more than (40.0 IU/ml). 72 (64.9%) of them were hypothyroidism, whereas a 35 (48.6%) of them were hyperthyroidism. As regard Thyroglobulin antibodies (Tg Ab), 73 (39.9%) of the case studied were positive, 51 (69.9%) of them were hypothyroidism, and 22 (30.1%) of them were hyperthyroidism. The study also revealed statistically significant positive correlation between the presence of TPO Ab and the values of fT3

Evaluation of Different Methods for the Detection of Anti- Thyroglobulin Autoantibody: Prevalence of Anti-Thyroglobulin Autoantibody and Anti-Microsomal Autoantibody in Thyroid Cancer Patients.

Four anti-thyroglobulin autoantibodies (TgAb) assays were evaluated for their reference interval, method agreement, concordance etc. Prevalence of TgAb and anti-thyroid peroxidase was studied in differentiated thyroid cancer (DTC) and control. Reference intervals for TgAb assays varied from method to method due to varied assay designs. For TgAb correlation coefficients ranged from 0.74 to 0.99 whereas concordance ranged from 81 to 96.1%. Prevalence of thyroid antibodies mainly TgAb was increased in DTC primarily in females. Use of sensitive immunoassays is recommended for thyroid autoantibody measurement. Diagnosis and follow-up are difficult in DTC with coexisting thyroid autoimmunity. Hence, careful monitoring with regular surveillance is suggested.

Association of thyroid antibodies status on the outcomes of pregnant women with hypothyroidism (maternal hypothyroidism on pregnancy outcomes, MHPO-4)

BackgroundAutoimmunity increases with age and is often commonly evaluated in women of the reproductive age group. Prevalence of thyroid antibodies is common even in euthyroid pregnant women. We aim to compare the association of thyroid antibody status on the maternal and neonatal outcomes in pregnant women with hypothyroidism.MethodsWe conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital. Information was collected on pregnant women who have been diagnosed with hypothyroidism before conception or during their antenatal period. Laboratory data were recorded for thyroid peroxidase antibodies, anti-thyroglobulin antibodies, and thyroid-stimulating hormone levels. Maternal and neonatal outcomes were also noted from medical file records. Data analysis was performed on Statistical Package for the Social Sciences version 20.0.ResultsOverall, 146 out 718 cases were included for final analysis. Thyroid peroxidase antibodies were positive in 66.4% and anti-thyroglobulin was positive in 52.1% cases, whereas 43.8% of cases had both antibodies positive. Pre-gestational diabetes was significantly associated with thyroid autoimmunity. There was a 73% less chance of gestational hypertension for thyroid autoimmune groups. Gestational diabetes and maternal (chronic) hypertension were found to have an independent effect on postpartum hemorrhage. Hypertensive disorders in pregnancy were found to have an independent risk for premature birth.ConclusionOur study reports a 74.7% prevalence of positive thyroid antibodies in hypothyroid pregnant women, with higher association with pre-gestational diabetes. Gestational hypertension was least likely to occur in thyroid autoimmune groups. None of the outcomes were independently associated with worse outcomes.

Study the Association between the Thyroid Autoimmunity Markers and Polycystic Ovary Syndrome in Euthyroid Women

Polycystic ovary syndrome during childbearing age is consider as one of the commonest endocrine disease in reproductive age females, with a prevalence of 4% to 15%. The clinical expression of PCOS is variable, but mostly includes anovulation or oligo-ovulation, clinical or biochemical hyperandrogenism and ovarian polycystic picture in U\S. Objective: To determine the levels and prevalence of thyroid antibodies in euthyroid women has PCOS.Patients and method: A case control study carried in the Infertility clinic of the Babylon Teaching Hospital for maternity and children in Al-Hila city, Babylon governorate, /Iraq in the period from October 1, 2018 to the end of Nov. 2019. Results: the current study found a highly statistically significant association between the studied group among the BMI (P 0.05). Eighty percent of the patients (PCOS) group, and 20% in control group presented with family history with thyroid disease. Anti-TG were negative in (85.72%) of the PCOS group patients, 8.57% of the patients with borderline positive and only (5.71%) were positive (>110 IU/ml). TSH level in PCOS group (2.3 ± 0.5) were increase with significant association than that in control group (2.1 ± 0.8), highly significant increase were found in Anti-TPO, Anti-TG, free testosterone and LH in PCOS group than that in control group (P<0.001).Conclusion: There is increased risk of thyroid disease with increase in thyroid Autoimmunity Markers in PCOS patients.

Study the Association between the Thyroid Autoimmunity Markers and Polycystic Ovary Syndrome in Euthyroid Women

Polycystic ovary syndrome during childbearing age is consider as one of the commonest endocrine disease in reproductive age females, with a prevalence of 4% to 15%. The clinical expression of PCOS is variable, but mostly includes anovulation or oligo-ovulation, clinical or biochemical hyperandrogenism and ovarian polycystic picture in U\S. Objective: To determine the levels and prevalence of thyroid antibodies in euthyroid women has PCOS.Patients and method: A case control study carried in the Infertility clinic of the Babylon Teaching Hospital for maternity and children in Al-Hila city, Babylon governorate, /Iraq in the period from October 1, 2018 to the end of Nov. 2019. Results: the current study found a highly statistically significant association between the studied group among the BMI (P&lt;0.001), while no significant association between the studied groups regarding the age (P&gt;0.05). Eighty percent of the patients (PCOS) group, and 20% in control group presented with family history with thyroid disease. Anti-TG were negative in (85.72%) of the PCOS group patients, 8.57% of the patients with borderline positive and only (5.71%) were positive (&gt;110 IU/ml). TSH level in PCOS group (2.3 ± 0.5) were increase with significant association than that in control group (2.1 ± 0.8), highly significant increase were found in Anti-TPO, Anti-TG, free testosterone and LH in PCOS group than that in control group (P&lt;0.001).Conclusion: There is increased risk of thyroid disease with increase in thyroid Autoimmunity Markers in PCOS patients.

Less Favorable Lipid Profile and Higher Prevalence of Thyroid Antibodies in Women of Reproductive Age with High-Normal TSH-Retrospective Study.

High-normal TSH can be associated with metabolic abnormalities and infertility. Aims of this study are to analyze retrospectively if routinely measured blood laboratory and anthropometric parameters differ between women of reproductive age with TSH < 2.5 mIU/L and with TSH ≥ 2.5 mIU/L. Retrospective analysis was performed in 466 female inpatients, aged 13–51, hospitalized in an endocrine department. The group of 280 patients with normal thyroid tests (TSH 0.27-4.2 mIU/L; normal FT3 and FT4) was selected and it was divided into two subgroups, i.e., with TSH < 2.5 mIU/L and TSH ≥ 2.5 mIU/L (n = 66; 23.6%). After excluding patients on L-thyroxine treatment (n = 240), those with TSH ≥ 2.5 mIU/L constituted 22.92% (n = 55). In the group of 280 patients with normal thyroid tests, an abnormally high concentration of triglycerides and an abnormally low HDLC/cholesterol ratio occurred more frequently in women with TSH ≥ 2.5 mIU/L than those with TSH < 2.5 mIU/L (17% vs. 7%, p = 0.017; 14% vs. 5%, p = 0.015, respectively). Increased concentration of thyroid antibodies, i.e., TPOAb, occurred more frequently in patients with TSH ≥ 2.5 mIU/L than those with TSH < 2.5 mIU/L (27% vs. 9%, p = 0.001). The same differences were found in the group of 240 patients after excluding those on L-thyroxine treatment. Blood lymphocyte concentration was the only independent linear parameter associated with TSH ≥ 2.5 mIU/L (OR = 1.551, p = 0.024) but only in the group of 280 patients with normal thyroid tests. TSH concentration correlated positively with blood lymphocyte (r = 0.129, p = 0.031) and TPOAb (r = 0.177, p = 0.005) concentrations but only in the group of 280 patients with normal thyroid tests. Less favorable lipid profiles and a higher prevalence of thyroid antibodies in women of reproductive age with high-normal TSH suggests that L-thyroxine treatment should be considered in such patients. The significance of a positive association between high-normal TSH and blood lymphocytes requires further evaluation.

Chronological association between alopecia areata and autoimmune thyroid diseases: A systematic review and meta-analysis.

The association between alopecia areata (AA) and autoimmune thyroid diseases (AITD) has been suggested; however, the chronological relationship between AA and AITD remains elusive. A systematic review and meta-analysis were conducted to assess the association between AA and AITD focusing on the prevalence of thyroid antibodies, thyroid diseases and serological thyroid dysfunctions, respectively. Data collection was performed in October 2018 by searching for articles in two electronic databases: Medline and Embase. Case-control, cohort and cross-sectional studies were included. Meta-analysis of studies eligible for quantitative synthesis was performed to estimate pooled odds ratios of thyroid antibodies; thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab), diagnosed thyroid diseases and serological thyroid dysfunctions. Four hundred and eighty nine research papers were identified and 17 studies with 262581 patients and 1302655 control subjects were included for quantitative synthesis. AA was significantly associated with both TPO-Ab and TG-Ab. In comparison, there was no significant association between AA and diagnosed hypothyroidism or hyperthyroidism and serological hypothyroidism or hyperthyroidism. In conclusion, AA is significantly associated with the existence of thyroid antibodies rather than with clinical or laboratory thyroid abnormality. Lack of long-term follow-up data is a limitation of the existing published work. Our findings do not support routine screening of thyroid diseases for asymptomatic AA patients but highlight the potential future risk of AITD particularly in severe and refractory AA.

Pediatric TSH Reference Intervals and Prevalence of High Thyroid Antibodies in the Lebanese Population.

The aims of this study are to establish reference values for TSH in Lebanese schoolchildren; to look at the relationship between TSH and age, gender, BMI, socioeconomic status (SES), and thyroid antibodies (TAb); and to investigate the prevalence of abnormal TAb in this population. 974 Lebanese schoolchildren aged 8–18 years were recruited from 10 schools of different SES. Third-generation TSH, TPO-Ab, and Tg-Ab measurements were performed using the IMMULITE chemiluminescent immunoassay. The mean TSH is 2.06 ± 1.05 μUI/ml. TSH values are inversely correlated with age (p < 0.0001), are higher in boys than in girls (resp., 2.14 ± 1.10 and 1.98 ± 0.99 μUI/ml, p = 0.017), and are positively correlated with BMI (p < 0.0001). They are also significantly higher in subjects from low-SES schools (p = 0.03) and in girls with positive TAb (p = 0.026). In boys, TSH is independently associated with age, BMI, and schools' SES (p = 0.01, p = 0.03, and p = 0.026, resp.) while in girls, the association is only significant for age and TAb (p = 0.0001 and p = 0.015, resp.). The prevalence of TAb is 4.3% (3% for TPO-Ab and 2.1% for Tg-Ab). Our results showed higher TSH values in the pediatric Lebanese population compared to western populations. TSH varies according to age, gender, BMI, and SES and is associated in girls with TAb.

Prevalence of thyroid dysfunction with adequate and excessive iodine intake in Hebei Province, People's Republic of China.

To explore (i) the prevalence of thyroid dysfunction in populations with adequate and excessive iodine intakes and (ii) the effect of iodine exposure on the prevalence of thyroid dysfunction. Cross-sectional study was conducted in Hebei in 2010. The population was classified as having adequate or excessive iodine intake according to the iodine concentration in drinking water. Demographic information was collected by questionnaire. Levels of serum thyroid hormones, thyroid autoantibodies and iodine in drinking water and urine were measured. Villages with adequate or excessive drinking water iodine in Hebei Province, People's Republic of China. A total of 854 men and women aged 20-50 years who had lived in the surveyed areas for over 5 years, including 348 from the adequate iodine area (AIA) and 506 from the excessive iodine area (EIA). Median urinary iodine concentration was 185 μg/l in AIA and 1152 μg/l in EIA. The prevalence of thyroid dysfunction in AIA was 10.3%, which included 1.1% with hypothyroidism and 8.1% with subclinical hypothyroidism; and 20.6% in EIA, which included 3.6% with hypothyroidism and 13.6% with subclinical hypothyroidism. The positive rates of thyroglobulin antibody were 16.1% in AIA and 11.9% in EIA; the positive rates of thyroperoxidase antibody were 20.7% in AIA and 16.4% in EIA. Excessive iodine intake may lead to increased prevalence of biochemical thyroid dysfunction, especially biochemical hypothyroidism. This is not related to an increase in prevalence of thyroid antibodies. Women are more susceptible to iodine excess.

Ürtikerli Hastalarda Tiroid Otoimmunitesinin Araştırılması

Objective: An autoimmune etiology has been suggested in up to one-third of cases of chronic idiopathic urticaria (CIU). It is known that thyroid autoimmunity may be associated with urticaria. The objective of our present study was to verify the prevalence of thyroid antibodies in the patients with urticaria. Material and Methods: Seventy nine patients aged 14–70 years, who met criteria for urticaria, and 40 agedmatched healthy controls (10 males and 30 females) were participated in this study. Serum thyroid-stimulating hormone (TSH), free T3, free T4, anti-peroxidase (TPO), and anti-thyroglobulin (anti-Tg) antibody levels were measured. Results: The total ATA positive rate was 26.7% in the CIU group. The prevalence of anti-TG, and anti-TPO were 10.7 %, 17.9 % respectively. The prevalance of anti TPO was significantly higher in patients with CIU than controls (p=0,023). The total ATA positive rate was %10 in the acute urticaria. Conclusion: We determined that the prevalance of thyroid antibodies was significantly higher in our CIU patients. It is important to evaluate the relationship between thyroid auto-immunity and thyroid function in CIU patients. Understanding this relationship will be potentially useful in evaluating the treatment benefits of either thyroidhormones or anti-thyroid drugs in resistant cases of CIU

Prevalence of Thyroid Disorder in Egyptian Children with Type I Diabetes Mellitus and the Prevalence of Thyroid Antibodies Among them

Type I diabetes mellitus (IDDM) may be associated with an autoimmune disorders including autoimmune thyroid disease (reaction to thyroid antigens including thyroid peroxidase (anti-TPO) so we aimed to see prevalence of thyroid disorder in a sample group of Egyptian children (8-12 years) with type I diabetes mellitus and to investigate the prevalence of thyroid auto antibodies among them. Five hundred children with prior diagnosis of type I diabetes mellitus and 500 normal euthyroid non diabetic children were included. Glucose, HbA1c, antibodies to thyroperoxidase (anti-TPO), FT3, FT4 and thyroid-stimulating hormone (TSH) levels were determined. Mean age was 10.16 ± 0.07; 9.66 ± 0.08 for control and diabetic children respectively. Mean duration of diabetes was 4.10 ± 0.06 year. The anti-TPO antibody test was positive in 56 out of the 500 children studied (11.2%), resulting in prevalence of 11.2%. Children with positive anti-TPO antibodies had abnormal TSH levels (subclinical hypothyrodism). Mean glycated hemoglobin was higher in IDDM children (8.55 ± 0.03 vs. 4.95 ± 0.03 (P 5 μU/ml); and 5.88 vs. 3.0 μU/ml (diabetic vs. normal control); P<0.001). 56 children of 500 (11.2%) had TSH over 5 μU/ml (range 5.05: 6.9 μU/ ml). Subclinical hypothyroidism was observed in 11.2% among children with thyroid autoimmunity.

The Essential Role of Anti-Thyroid Antibodies in Chronic Idiopathic Urticaria

Background. An autoimmune etiology has been suggested in up to one-third of cases of chronic idiopathic urticaria (CIU), in which it has been proposed that a subset of cases are associated with thyroid autoimmunity. The objective of our present study was to verify the prevalence of thyroid antibodies in the patients with CIU. Methods. Sixty patients aged 12–51 years, who met criteria for CIU, and 40 aged-matched healthy controls (18 males and 22 females) were participated in this study. Serum anti-thyroid antibodies (ATAs), thyroid hormones, total immunoglobulin E (IgE), and food allergen-specific IgE antibodies were measured. The CIU group was treated with anti-H1 and anti-H2 histamines for 3 weeks. Results. The total ATA positive rate was 27.3% (33% males and 25% females) in the CIU group. The prevalence of anti-thyroglobulin antibodies, anti-TSH-receptor antibodies, and anti-thyroid peroxidase antibodies were 16.6%, 83.3%, and 8.3%, respectively. The thyroid hormones, T3, and T4, and the TSH were within the normal limits. The radioallergosorbent test was negative for food allergens, and only 18% of the patients had a total IgE concentration >200 IU/mL. Conclusion. ATAs were found in 27% of the patients with CIU, but these antibodies did not dysregulate thyroid hormone secretion nor did they mediate any clinical manifestations.

Idiopathic chronic urticaria and thyroid autoimmunity

Urticaria is one of the most frequent dermatosis, being its prevalence in general population estimated about 20%. This prospective case-control study was aimed at determining the prevalence of thyroid autoimmune disorders in a cohort of patients with chronic urticaria (CU), all living within an area with mild-to-moderate iodine deficiency. Fifty four consecutive patients affected by CU were recruited and compared to 108 healthy controls. Assessment of the thyroid function included measurement of serum concentrations of TSH, FT3, FT4, anti-thyreoglobulin (anti-TG) and anti-peroxidase (anti-TPO) antibodies. Ultrasound scan of the thyroid gland was performed in all subjects using a 7.5 MHz linear transducer. All subjects were followed up for 6 months. The prevalence of thyroid antibodies was significantly higher in our cohort of patients with CU than in controls (22% vs. 6.5 %). Hashimoto's thyroiditis was also more frequent in patients than controls (18.5% vs. 1.8%). These frequencies do not differ from those previously reported by some other authors and confirm the association between CU and thyroid autoimmunity also in the area of iodine deficiency. However, presence of antibodies or thyroiditis does not seem to influence clinical course of CU. These results suggest that screening for thyroid function may be useful in all the patients with CU.

High titre of antiglutamic acid decarboxylase autoantibody is a strong predictor of the development of thyroid autoimmunity in patients with type 1 diabetes and latent autoimmune diabetes in adults

Type 1 diabetes mellitus (T1DM) is frequently associated with autoimmune thyroid diseases (AITD), but little is known about the risk of AITD in latent autoimmune diabetes in adults (LADA). We evaluated the genetic and immunological factors involved in the development of thyroid autoimmunity in patients with LADA and T1DM. One hundred and ninety T1DM and 135 LADA patients were recruited in the study. Thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), glutamic acid decarboxylase antibody (GADA) and thyroid function were measured. The cytotoxic-lymphocyte-associated antigen-4 (CTLA-4) +49A/G and CT60 polymorphisms and the human leucocyte antigen (HLA)-DQA1-DQB1 genotype were determined. The prevalence of thyroid antibodies (TGAb and/or TPOAb) and thyroid dysfunction was 27·4% and 9·5% in patients with T1DM, and 21·5% and 11·1% in patients with LADA. Thyroid-antibody-positive T1DM patients had higher frequencies of GADA and HLA-DQA1*03-DQB1*0401 haplotypes than thyroid-antibody negatives (P < 0·05). Thyroid-antibody-positive LADA patients had higher GADA titre, lower C-peptide levels and higher frequencies of HLA-DQA1*03-DQB1*0401 haplotypes (P < 0·05). The CTLA-4 +49A/G and CT60 polymorphism was associated with T1DM complicated with thyroid autoimmunity (OR = 2·33 and 2·54). Logistic regression revealed that only high-titre GADA was associated with development of thyroid autoimmunity in patients with T1DM and LADA (OR = 3·50 and 3·10, respectively), and the presence of thyroid antibody predicted high risk for thyroid dysfunction in patients with T1DM and LADA (OR = 9·25 and 10·70, respectively). Regular screening of thyroid antibody and function are recommended, especially in patients with T1DM and LADA with high GADA titre.

Autoimmune thyroiditis in antinuclear antibody positive children without rheumatologic disease

BackgroundChildren are commonly referred to a pediatric rheumatology center for the laboratory finding of an Anti-nuclear antibody (ANA) of undetermined significance. Previous studies regarding adult rheumatology patients have supported an association between ANA and anti-thyroid antibodies, with the prevalence of thyroid antibodies being significantly higher in patients referred to a rheumatology center for an ANA without evidence of connective tissue disease compared to the general population. The purpose of the present study was to determine the frequency of thyroid antibodies in children referred to a pediatric rheumatology center for a positive ANA without evidence of a connective tissue disease.MethodsA retrospective chart review was performed on children who were referred to our pediatric rheumatology center between August 2003 and March 2007 for positive ANA with concurrent thyroid antibody and thyroid function tests performed who did not fulfill criteria for a specific connective tissue disease. Laboratory and clinical features were recorded and analyzed. Mean and standard deviation were used to describe continuous data. Chi-square or Fisher's exact tests were used to compare proportions between variables.ResultsOne-hundred and four ANA-positive patients with concurrent thyroid studies were evaluated (88% female, 93% Caucasian, mean age 11.9 ± 4.0 years). Half of patients had an ANA titer ≥ 1:320. The ANA pattern was speckled in 60% of the patients. Thyroid antibodies were detected in 30% of the patients. Anti-Thyroglobulin (ATG) was detected in 29% and Anti-thyroid peroxidase (ATPO) in 21% of the patients; of these children, 14% had hypothyroidism. ANA pattern and titer were not associated with anti-thyroid antibody positivity.ConclusionThyroid antibodies associated with chronic lymphocytic thyroiditis, ATG and ATPO, were detected significantly higher in ANA-positive children without a rheumatologic condition (30%) as compared to the general pediatric population (1.3 - 3.4%). ANA titer and pattern did not help predict the presence or absence of thyroid antibodies. Given the high frequency of thyroid antibodies and increased risk of developing hypothyroidism over time, routine evaluation of ATG and ATPO with thyroid function tests in ANA-positive children is recommended.

Prevalence and Determinants of Thyroid Disorders in Elderly Patients With Affective Disorders: Lithium and Nonlithium Patients

To determine the prevalence and determinants of thyroid dysfunction in older patients with affective disorders divided into lithium and nonlithium patients. This study was conducted as a retrospective cross-sectional study in patients of 65 years and older with affective disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. The presence of thyroid disorders was determined on the index date defined as the date of the first available thyroid-stimulating hormone in 2005. The presence of thyroid disorder was diagnosed according to defined criteria and in case of a previous diagnosis, confirmed by researching the medical files. In a subgroup of 45 lithium patients, thyroperoxidase- and thyroglobulin antibodies were determined. A total of 79 lithium patients and 85 nonlithium patients were included. The prevalence of hypothyroidism (subclinical and clinical) was 35.4% among the lithium patients, with women having a prevalence as high as 41.3% and men 12.6%. In the nonlithium patients, the prevalence was 7.1%; very close to that in the general population. No other determinant than female gender was identified. Seventeen of the 26 lithium patients were diagnosed with hypothyroidism in the first 31/2 years after the start of lithium. The prevalence of thyroid antibodies was 27% in 45 lithium patients, which was no different than the prevalence in the same age group in the general population. The prevalence of hypothyroidism during lithium treatment was very high in the elderly, especially in women. Autoimmunity did not seem to play a major part in lithium-associated hypothyroidism in this age group. The timeframe between start of lithium and diagnosis of hypothyroidism suggests an individual susceptibility. The prevalence of hypothyroidism in nonlithium patients with affective disorders was not very different from the general population.

Thyroid hormone reference intervals and the prevalence of thyroid antibodies

To establish new reference intervals for thyrotropin (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) on the Beckman Coulter DxI 800 in healthy Turkish adults and assess the prevalence of laboratory evidence of thyroid antibodies in this population. Materials and methods: Specimens were obtained from 619 healthy volunteers (338 females, 281 males).The study was conducted with health care professionals and their relatives, The mean age of all the subjects was 34.7 and the median was 31 years, with ages ranging from 15 to 84. Moreover, the subjects had no evidence of thyroid autoimmunity or a history of drug use, both of which might interfere with thyroid function. Results: After exclusion of samples positive for thyroid antibodies (Antithyroperoxidase; TPOAb, Antithyroglobulin; TgAb), the final sample size for the evaluation of TSH, FT3, and FT4 reference ranges was 509 (254 females, 255 males) and the age range was 15-80 (mean 34.1, median 30). The prevalence of antithyroid antibodies was 17.8% in total and positive thyroid antibodies were more common among females (13.6%) than males (4.2%). We established the reference intervals for the healthy adults as 0.41-4.25 mIU/L for TSH, 0.61-1.06 ng/dL (7.85-13.64 pmol/L) for FT4, and 2.62-3.84 pg/mL (4.02-5.90 pmol/L) for FT3. Conclusion: The reference intervals of thyroid hormones vary considerably from those of other populations and the intervals recommended by the manufacturer. This underlines the need for population-specific reference ranges.

Hypothyroidism Secondary to Hypothalamic-Pituitary Dysfunction May Be Part of the Phenotype in Klinefelter Syndrome: A Case-Control Study

Klinefelter syndrome (KS) may involve a number of abnormalities besides the characteristic testicular insufficiency. Some studies have suggested that thyroid abnormalities may be common, but this has not been clarified. A case-control study of men with KS (n = 75) compared with age-matched men from the general population (n = 75) was organized, and thyroid function, thyroid volume by ultrasonography, and thyroid antibodies were examined. Men with KS were on average taller and heavier and tended to have a higher body mass index than the men in the control group. Serum free T(4) (fT4) was lower in men with KS than controls [mean (sd): 16.3 (2.35) vs. 17.6 (1.75) pmol/liter; P < 0.001], with clustering in or just below the lower part of the reference range for the assay. The ratio fT4 to free T(3) was low in KS (P < 0.001), whereas no differences between groups were observed in TSH, free T(3), TSH to fT4 ratio, thyroid volume, or the prevalence of thyroid antibodies. No difference in any of the variables were observed between testosterone-treated and untreated KS men. Adjustment for differences in height, weight, and concomitant disease in multivariate models did not alter the results. Men with KS had a general shift toward lower values in distribution of serum fT4 with no compensatory increase in serum TSH. The most likely mechanism is a decrease or change in set point of thyrotroph control of thyroid function.

Increased thyroid volume, prevalence of thyroid antibodies and impaired fasting glucose in young adults from organochlorine cocktail polluted area: Outcome of transgenerational transmission?

In 137 females (F) and 94 males (M) aged 21–35 years from organochlorines (OCs) polluted area (POLL) increased thyroid volume (ThV), prevalence of antibodies to thyroperoxidase (TPOab), thyrotropin receptor (TRab) and of impaired fasting glucose (IFG) was found compared to 116 F and 107 M from background pollution area (BCGR). In F and M from POLL also strikingly increased level of PCBs, DDE and HCB was found. Such findings were compared to the generation of their parents aged 41–55 years consisting of 320F/213M from POLL and 406F/231M from BCGR. However, in spite of strikingly lower level of those OCs in young adults from POLL, they showed about the same prevalence of adverse health signs as the old generation. From such reason 44 young F and 40 young M with lowest PCBs level from POLL were selected to obtain nearly the same PCB level as found in all young F and M from BCGR. In such PCB adjusted groups the prevalence of TPOab, TRab, IFG and increased ThV was still significantly higher than that in all young subjects from BCGR. At the same time, also the level of DDE and HCB in such PCBs adjusted groups was considerably lower. It was concluded that such adverse effects in young adults from POLL possibly did not result from their actual OCs levels, but very likely from their exposure to high OCs levels of their mothers during their prenatal and perinatal life. Thus, the data may be compatible with present views on transgenerational transmission of endocrine disruptors action.