Thyroid Autoimmunity In Patients Research Articles

The association of gluten-free diet with thyroid autoimmunity in patients with celiac disease: a meta-analysis.

Background: Thyroid autoimmunity is an immune response to thyroid antigens that causes varying degrees of thyroid dysfunction. The sole effective treatment for Celiac Disease (CD) is a gluten-free diet (GFD). However, the association between GFD and thyroid autoimmunity in patients with CD has not been confirmed. Methods: A comprehensive search of several databases, involving PubMed, Embase, Web of Science, Medline, and Cochrane databases, was conducted to identify studies that primarily addressed the effects of GFD on thyroid autoimmunity in CD subjects. The meta-analysis involved studies that compared the risk of ATPO and ATG antibody positivity in CD patients with GFD, the risk of developing AITD, and the risk of developing thyroid dysfunction. Fixed-effects models or random-effects models were used to calculate the odds ratios (ORs) and their 95% confidence intervals (95% CIs). Results: A total of 10 observational studies met the inclusion criteria and included 6423 subjects. The results indicated that GFD is positively associated with thyroid autoimmunity in the children subgroup of CD patients (OR = 1.61, 95%CI 1.06-2.43, P = 0.02). However, there was no significant difference in thyroid autoimmunity between the group adhering to GFD and the control group in the total CD population. Conclusion: The results seem to indicate that subjects with a more pronounced autoimmunity (such as to have an early onset of CD) appear to have a greater risk of thyroid autoimmunity.

A Cross-Sectional Study to Determine the Prevalence of Thyroid Autoimmunity in Patients with Chronic Spontaneous Urticaria

Abstract Background: Chronic spontaneous urticaria (CSU) can be a distressing condition for both the patient and the treating doctor due to the lack of a definite underlying etiology. The condition has been found to be associated with autoimmune (AI) conditions, which brings to light possible pathogenesis being shared by AI conditions and chronic urticaria. This can help us understand the condition better as well as have a bearing on the treatment. Thyroid autoimmunity is one such condition which has commonly been associated with chronic urticaria. Objectives: To determine the prevalence of thyroid autoimmunity in patients with CSU. To determine the correlation between thyroid autoantibodies level and the severity and duration of CSU. Materials and Methods: Forty-eight adult patients of CSU were enrolled, in whom thyroid autoimmunity was determined by detecting the levels of anti-thyroid peroxidase (anti-TPO) antibody. Urticaria Activity Score was used to determine the activity of the disease. Results: Nine out of 48 (18.75%) patients showed raised anti-TPO antibody levels. Eight out of those 9 (88.89%) patients were female. No correlation was found between the duration of disease and the antibody levels. A significant association was found between the disease activity and anti-TPO antibody levels. Conclusion: The prevalence of thyroid autoimmunity is higher in patients of CSU compared to the general population. The condition occurs more frequently and with greater severity in the female population.

A case-control study to assess the association of Alopecia areata with thyroid dysfunction and thyroid Autoimmunity.

Several previous studies have suggested a positive association between Alopecia Areata and thyroid disorders. However, there is a paucity of such studies in our country. Our study aimed to know the frequency of thyroid dysfunction and thyroid autoimmunity in patients reporting to Dermatology Outdoors with Alopecia Areata (AA) and to compare it with normal controls. This was a Case-Control study conducted at the Dermatology outpatient of a tertiary care hospital in Pakistan. 102 patients with AA and 102 age and sex-matched controls were enrolled. The age of onset of the disease, the involved sites and the presence of other associated diseases were noted. Venous blood samples were taken from patients and controls for Thyroid function tests and Anti- Thyroid peroxidase antibodies (Anti-TPO Ab). The data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. The mean age of onset of the disease was 30.37±12.53. 91.2% of patients had the classic patch type of AA. The most commonly involved site was Scalp. Associated diseases were found in eight (7.8%) patients. Thyroid dysfunction was found in two patients and none of the Controls. Both the patients had Subclinical thyroid disease. The p-value was 0.157, which was not statistically significant. Thyroid autoimmunity (raised Anti-TPO Ab titre) was detected in five (4.90%) patients and none of the Controls. The p-value was 0.024, which was statistically significant. AA is significantly associated with Thyroid autoimmunity but there is no significant association between AA and clinical or subclinical thyroid disease.

Vitamin D insufficiency is not associated with thyroid autoimmunity in Slovak women with Hashimoto´s disease.

This prospective case-control study included 57 women with AITD and 41 age- and BMI-matched controls. All subjects were examined for summer and winter serum 25(OH)D, thyroid autoantibodies (a-TPO, a-TG), freeT4 and TSH concentrations. Thyroid volume was measured by ultrasound. There were no significant differences in serum 25(OH)D between AITD and control groups. No significant correlation between 25(OH)D and thyroid autoantibodies was found either in the whole cohort or in AITD women. The prevalence of vitamin D insufficiency was 60.31 % in AITD women and 52.5 % in the control group. No significant association between VD and thyroid autoantibodies, thyroid hormones and thyroid volume was detected in this study. Authors conclude that VD insufficiency is common in Slovak premenopausal women independently of the presence of AITD. Vitamin D insufficiency is not associated with thyroid autoimmunity in patients with early diagnosis of AITD (Tab. 3, Ref. 31). Text in PDF www.elis.sk Keywords: vitamin D, autoimmune thyroid disease, thyroid autoantibodies.

Organ-specific autoimmune markers in adult patients with type 1 diabetes mellitus.

We aimed to investigate the presence of thyroid, celiac disease (CD) and anti-parietal cell antibodies (APCA) in adult type 1 diabetes (T1DM) patients. Data of 287 T1DM patients >16years old were reviewed retrospectively. Thyroid disease related, CD related antibodies and APCA were evaluated. Patients were divided into early onset (<30years old) and late-onset (≥30years old) TIDM, and ≤10years, 11-20years and >20years according to disease duration. There were 142 (49.5%) female and 145 (50.5%) male patients. The median age at diagnosis and disease duration were 21 (2-53) and 6.91 (0-50.8)years, respectively. Antibody positivity rates were anti-glutamic acid decarboxylase (anti-GAD) 72.8%, anti-insulin 9.1%, anti-islet cell 25.7%, antithyroid peroxidase (anti-TPO) 34.8%, anti-thyroglobulin 19.9%, anti-endomysial IgA (EMA-IgA) 7.6%, anti-gliadin IgA (AGA-IgA), 12.2%, AGA-IgG 13.0%, tissue transglutaminase IgA 7.1% and APCA 14.4%. One hundred twenty-eight (44.6%) patients had at least one non-diabetes autoantibody. Thyroid autoantibodies and dysfunction were significantly higher in women than men. Anti-TPO positivity was higher in the late-onset group (P=.044). Anti-GAD level was correlated with thyroid related antibody positivity in male patients with positive anti-GAD (r: .340, P: .006). The positivity of EMA-IgA and AGA-IgA was higher in patients with disease duration >20years (P=.017 and .039, respectively). Almost half of the adult T1DM patients were positive for at least one non-diabetic antibody. It is important to investigate thyroid autoimmunity in patients diagnosed with T1DM at any age, including advanced age. CD associated antibody positivity increases with disease duration, suggesting that they should be re-evaluated at clinical suspicion, even if prior tests were negative.

Impact of Thyroid Autoimmunity on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes and Fetal Weight.

Several studies have reported the association between thyroid autoimmunity (TAI) and in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes. However, the findings remain controversial. We performed a large-scale retrospective cohort study to verify the effect of the presence of thyroid antibodies on IVF/ICSI outcomes and fetal growth and to evaluate the association between the types and titers of thyroid antibodies and adverse IVF/ICSI outcomes. A total of 16481 patients with infertility were referred to the Reproductive Center of Peking University Third Hospital for their first IVF/ICSI treatment between January 2018 and June 2019.Patients who sought IVF/ICSI treatment due to tubal or male factors infertility and who achieved fresh embryo transfer were included in our study. Finally, 778 patients with thyroid antibody positivity were selected as the TAI group, and 778 age-matched patients were included in the control group. The number of oocytes retrieved and high-graded embryos and the rates of clinical pregnancy, miscarriage, live birth, and preterm delivery were compared between the TAI and control groups. In addition, subgroup analysis was performed to demonstrate whether different types and titers of thyroid antibodies had different effects on IVF/ICSI outcomes. After adjusting for thyroid function, anti-Müllerian hormone levels, basal follicle stimulating hormone levels, basal estradiol levels and antral follicle count, the number of oocytes retrieved in the TAI group was significantly lower than that in the control group. No significant differences were observed between the two groups in the rates of clinical pregnancy, miscarriage, preterm delivery, live birth, and birth weight in singletons; however, the birth weight in twin pregnancy was significantly lower in the TAI group than in the control group. Subgroup analysis showed no association between the types or titers of thyroid antibodies and adverse IVF/ICSI outcomes. In conclusion, the presence of TAI in patients with infertility did not impair embryo quality or affect pregnancy outcomes, including clinical pregnancy, miscarriage, preterm delivery, and live birth. However, it decreased the number of oocytes retrieved and birth weight in twin pregnancy.

Evaluation of thyroid function and thyroid autoimmune disease in patients with non-alcoholic fatty liver disease.

Aim of the studyEvaluation of thyroid function and thyroid autoimmunity in patients with non-alcoholic fatty liver disease (NAFLD).Material and methodsA case control study. Fifty patients with NAFLD and 50 control subjects matched by gender and age were recruited. Serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) were measured to assess thyroid function. Thyroid autoimmune disease was evaluated by measuring thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibodies (TgAb). The FIB-4 score and the APRI score were calculated to assess the degree of fibrosis. The association between thyroid parameters and NAFLD was explored.ResultsAbout one quarter of patients with NAFLD had hypothyroidism compared to 10% of the control group whilst 6% of NAFLD patients had hyperthyroidism compared to 2% of the controls. NAFLD cases showed substantially higher TSH and lower FT4 compared to controls; meanwhile, levels of fibrosis indices (FIB-4 and APRI score) were significantly higher among hypothyroid patients in both cases and controls. TSH had a positive strong correlation with FIB-4 and APRI score, whereas FT4 had a negative significant correlation with both fibrosis indicators, and this clinical relationship was similar in NAFLD cases and controls.ConclusionsHypothyroidism is more prevalent among patients with NAFLD compared to controls and high levels of TSH with low FT4 might be a risk factor for NAFLD and may impact the development of liver fibrosis. The role of thyroid autoimmunity in NAFLD needs further assessment. NAFLD patients should be monitored by yearly TSH and FT4 testing.

Prevalence of thyroid dysfunction and thyroid autoimmunity in polycystic ovary syndrome: A multicenter study from Bangladesh

Background: Women with polycystic ovary syndrome (PCOS) have increased risks of thyroid dysfunction and thyroid autoimmunity. Data are limited regarding the prevalence of thyroid dysfunction and thyroid autoimmunity in patients with PCOS. Objective: The objective of this study was to evaluate thyroid function and thyroid autoimmunity in patients with PCOS. Materials and Methods: In this cross-sectional study, 500 women newly-diagnosed with PCOS attending the endocrinology outpatient departments of several tertiary hospitals of Bangladesh were evaluated. Serum thyroid-stimulating hormone (TSH), free thyroxine, and anti-thyroid peroxidase (anti-TPO) were measured in all. Results: The prevalence of thyroid dysfunction was 17% (11% subclinical hypothyroidism, 5.2% overt hypothyroidism, 0.4% subclinical hyperthyroidism, and 0.4% overt hyperthyroidism). Patients with normal and abnormal thyroid function had similar mean age, body mass index, waist circumference, diastolic blood pressure (BP), fasting plasma glucose, plasma glucose 2 h after oral glucose tolerance test, serum total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total testosterone, and prolactin levels. The frequencies of menstrual irregularities, acne, a first-degree family member with thyroid dysfunction, acanthosis nigricans, biochemical hyperandrogenism, and hyperprolactinemia were also similar. The patients with thyroid dysfunction had lower modified Ferriman–Gallwey score and hirsutism frequency. More patients in the thyroid dysfunction group had a history of weight gain during the course of PCOS onset. Higher rates of subfertility and goiter were also observed in patients with thyroid dysfunction; systolic BP was higher in this group. More than one-fifth (20.6%) of the study participants were positive for the anti-TPO antibody. Conclusions: Thyroid dysfunction and thyroid autoimmunity in Bangladeshi PCOS patients are very common.

Prevalence of hypothyroidism and thyroid autoimmunity in polycystic ovarian syndrome patients: A North Indian study

Background: There is limited data regarding the prevalence of hypothyroidism and thyroid autoimmunity in patients with polycystic ovarian syndrome (PCOS). Objective: To evaluate thyroid status and frequency of hypothyroidism and thyroid autoimmunity in patients with PCOS in comparison to age-matched controls. Materials and Methods: In a case–control study conducted at Gynecology outpatients department of our institute, 70 consecutive PCOS women diagnosed by Rotterdam criteria as well as 70 age-matched controls were evaluated. All patients underwent history, physical examination, thyroid function tests, and anti-thyroid peroxidase antibody (TPO Ab) tests. All patients who had positive TPO Ab also underwent ultrasonography of thyroid. Results: Mean serum thyroid-stimulating hormone (TSH) in PCOS was significantly higher (5.11 ± 4.41 uU/ml vs. 3.62 ± 3.38 uU/ml; P = 0.026) than age-matched controls. Subclinical hypothyroidism (14.3% vs. 7.1%) and TPO Ab positivity (25.7% vs. 17.1%) were numerically higher in PCOS patients as compared to age-matched controls, although not statistically significant. Conclusions: Mean serum TSH was significantly higher in PCOS patients as compared to age-matched controls. Numerically higher percentage of patients with PCOS had subclinical hypothyroidism and TPO Ab positivity; however, these were not statistically significant.

Author response: Alemtuzumab CARE-MS II 5-year follow-up: Efficacy and safety findings.

There are some inconsistencies and misunderstandings in Dr. Avasarala's analysis on the incidence of thyroid autoimmunity in patients with relapsing multiple sclerosis (RMS) treated with alemtuzumab.

Thyroid Autoimmunity and Thyroid Cancer - The Pathogenic Connection: A 2018 Update.

The association between thyroid cancer and thyroid autoimmunity has long been suggested, but remains to be elucidated for several decades. Here the data on this issue are updated by summarizing relevant papers published between 2012 and early 2018. Although numerous papers demonstrated the significant increase in the prevalence of thyroid autoimmunity (positive intrathyroidal lymphocyte infiltration and/or anti-thyroglobulin/thyroid peroxidase antibodies) in patients with thyroid cancers as compared to those with benign nodules, and also the significant increase in the prevalence of papillary thyroid cancer (PTC) in patients with thyroid autoimmunity as compared to those without, there are some crucial biases that should be taken into account for their interpretation. However, a difference in the incidence of thyroid autoimmunity in patients with PTCs and those with other types of thyroid cancers appears to support the significant association of two conditions. Thyroid autoimmunity is, at least partly, likely to be elicited against antigens shared by normal and cancerous thyroid tissues, thereby inducing autoimmunity. At the same time, elevated TSH levels (even within the normal reference ranges), which often accompany Hashimoto's patients are a risk factor for thyroid cancer. However, it is still unclear whether or not the co-existence of thyroid autoimmunity impacts on cancer characteristics and prognosis. This issue needs to be further investigated with large-scale prospective studies.

Thyroid autoimmunity in patients with empty sella syndrome

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Zika virus and autoimmunity. One-step forward.

Zika virus (ZIKV) infection has been associated with the development of Guillain-Barré syndrome (GBS) and idiopathic thrombocytopenic purpura (ITP). Whether ZIKV infection is related to other autoimmune diseases is unknown. Therefore, an association study to evaluate rheumatic and thyroid autoimmunity in patients with ZIKV disease was conducted through a panel of 14 autoantibodies. In addition, a literature review on ZIKV, and GBS and ITP was performed. Our results disclosed a lack of association of rheumatoid and thyroid autoimmunity with ZIKV disease. A total of 272 cases of GBS related to ZIKV were retrieved from the literature, the majority of them being males (54.8%). Electrophysiological findings indicated acute inflammatory demyelinating polyneuropathy as the most frequent subphenotype (75.7%). Up to date, twenty-four cases of ITP in patients with ZIKV disease have been published. Although a few fatal cases have been observed, most of the reported patients responded well to immunomodulatory treatment. A review of the mechanisms incriminated into the development of autoimmune phenomenon in ZIKV disease indicates molecular mimicry as the most plausible one. Nevertheless, more research aimed at deciphering ZIKV disease pathogenesis and its relationship with autoimmunity is warranted.

The determinants of thyroid autoimmunity in patients with polycystic ovary syndrome

The determinants of thyroid autoimmunity in patients with polycystic ovary syndrome

An evaluation of thyroid autoimmunity in patients with beta thalassemia minor: A case-control study.

Objective:The tendency to autoimmune diseases has been reported to be increased in beta thalassemia minor (BTM). The aim of this study was to evaluate whether thyroid autoimmunity is higher in BTM.Methods:Patients with BTM (n=86) and a healthy control group (n=93) were included in this cross-sectional case-control study. The two groups were compared in terms of anti-thyroglobulin (anti-TG) and anti-thyroid peroxidase (anti-TPO) and thyroid hormones.Results:In the BTM group, thyroid hormones and serum anti-TG and anti-TPO antibody levels were not statistically different from those of the control group. The BTM and control groups were similar in terms of anti-thyroid antibody (ATA) positivity prevalence. In the BTM group, anti-TG was 11.6% and anti-TPO was 14% positive, while these values were 14% and 12.9% positive, respectively in the control group (p=0.806 and p=0.989, respectively). The proportion of anti-TG and/or anti-TPO antibody positive subjects was found to be 20.9% in the BTM group, and 20.4% in the control group (p=0.919). The ratios of subjects with euthyroidism, hyperthyroidism and hypothyroidism were similar in both groups.Conclusions:As the thyroid autoimmunity prevalence in the BTM group was not increased compared to the control group, it can be considered that there is no necessity for routine ATA and thyroid hormone testing in subjects with BTM.

High prevalence of anti-TSH receptor antibody in fibromyalgia syndrome.

Fibromyalgia syndrome (FMS) is defined as chronic widespread pain that cannot be accounted for by any other medical disorder. Our aim was to explore the prevalence of thyroid autoimmunity in patients with FMS. For determining thyroid function in 207 FMS patients, we tested for the titers of free tri-iodothyronine, free thyroxine, thyroid-stimulating hormone (TSH), anti-thyroid peroxidase antibody (TPOAb), anti-thyroglobulin antibody (TgAb) and anti-TSH receptor antibody (TRAb). Twenty-five patients who had either subclinical hyper- or hypothyroidism, or overt hypothyroidism were excluded. Sixty-nine FMS patients with autoimmune thyroid diseases (AITD) (37.9%, 69/182) were identified. The prevalence of positivity for TRAb, TgAb and TPOAb was 20.3% (n = 37), 16.5% (n = 30) and 13.2% (n = 24), respectively. Compared to control populations in previous studies, the prevalence of TRAb positivity was high, and titers of TRAb were low (1.0-1.5 IU/L). The prevalence of TPOAb and TgAb positivity was not significantly higher than that reported in FMS patients in previous studies. Clinical symptom profiles were identical for FMS patients with and without AITD. We found a high prevalence of AITD among 207 patients with clinically defined FMS, with TRAb being especially prominent among these patients. Further study is needed to evaluate changes in thyroid function among FMS patients with AITD.

The effect of statin therapy on thyroid autoimmunity in patients with Hashimoto's thyroiditis: A pilot study.

Statins have been found to exert antiinflammatory and immunomodulatory properties. The aim of this study was to compare the effects of intensive and less aggressive statin treatment on thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity in patients with Hashimoto's thyroiditis. The study included 38 adult women with Hashimoto's thyroiditis, who required statin therapy and were allocated into one of two groups. Patients at very high cardiovascular risk (n=16) received intensive statin treatment (rosuvastatin 20-40mg daily), while patients at moderate or moderately high cardiovascular risk (n=22) were treated with simvastatin (20-40mg daily) for the following 6 months. Serum levels of thyrotropin, total and free thyroid hormones, and high-sensitivity C-reactive protein (hsCRP), as well as titers of thyroid peroxidase and thyroglobulin antibodies were measured at the beginning and at the end of the study. Thirty-six individuals completed the study and were included in the final analyses. Apart from improving plasma lipids and reducing circulating levels of hsCRP, intensive, but not less aggressive, statin therapy reduced thyroid peroxidase and thyroglobulin antibody titers, as well as tended to reduce circulating levels of thyrotropin. The effect of intensive statin therapy on thyroid antibody titers was lipid-independent but correlated with treatment-induced changes in thyrotropin and hsCRP. Although 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors are able to reduce thyroid autoimmunity in women with Hashimoto's thyroiditis, intensive statin therapy is required to produce this effect.

Thyroid Autoimmunity In Patients With Recurrent Aphthous Stomatitis

Thyroid Autoimmunity In Patients With Recurrent Aphthous Stomatitis

Etiopathogenetic factors, thyroid functions and thyroid autoimmunity in melasma patients.

IntroductionMelasma is a common chronic, acquired pigmentation disorder with a significant impact on the quality of life of patients.AimTo investigate the etiopathogenetic factors, thyroid functions and thyroid autoimmunity in patients with melasma.Material and methodsForty-five women with melasma and 45 age-matched healthy women were included in the study group. A detailed history was taken from the patients including triggering factors of melasma. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), anti-thyroglobulin (AbTG) and anti-thyroid peroxidase (Ab-TPO) were measured and thyroid ultrasonography was performed for each subject.ResultsIn 26.7% of patients, pregnancy, in 17.8%, oral contraceptive use and in 13.3%, intense sunlight exposure were the triggering factors. 17.8% of patients had a family history of melasma. FT4, TSH and AbTG levels were significantly higher in the patient group.ConclusionsThe results suggest that a combination of factors including pregnancy, oral contraceptive use, sunlight and genetic factors often trigger melasma. Thyroid hormones and thyroid autoimmunity may also play a role in the pathogenesis which needs to be proven by further studies.

Autoimmune thyroid disease in Colombian patients with systemic lupus erythematosus.

To determine the prevalence and the predictive factors of autoimmune hypothyroidism (AH) within a systemic lupus erythematosus (SLE) cohort and to analyse the current information concerning the prevalence and impact of autoimmune thyroid disease (AITD) and thyroid autoimmunity in patients with SLE. A total of 376 patients with SLE were assessed for the presence of the following: (i) confirmed AH, (ii) positive thy-roperoxidase/thyroglobulin antibodies [TPOAb/TgAb] without hypothyroidism, (iii) nonautoimmune hypothyroidism and (iv) SLE patients with neither. Multivariate analysis and a classification and regression tree model were used to analyse data. The current information was discussed through a systematic literature review (SLR). In our cohort, the prevalence of confirmed AH was 12%. However, in euthyroid patients with SLE, TPOAb and TgAb were observed in 21% and 10%, respectively. Patients with confirmed AH were significantly older and had later age at onset of the disease. Smoking (adjusted odds ratio (AOR) 6·93, 95% CI 1·98-28·54, P = 0·004), Sjögren's Syndrome (SS) (AOR 23·2, 95% CI 1·89-359·53, P = 0·015) and positivity for anticyclic citrullinated peptide (anti-CCP) (AOR 10·35, 95% CI 1·04-121·26, P = 0·047) were associated with AH-SLE, regardless of gender and duration of the disease. Smoking and SS were confirmed as predictors of AH-SLE. In the SLR, the prevalence of AITD ranged from 1% to 60%. The factors associated with this polyautoimmunity were female gender, older age, smoking, certain autoantibodies, SS, and cutaneous and articular involvement. AITD is frequent in SLE and does not affect the severity of SLE. Identified risk factors will assist clinicians in the search for AITD. Our results encourage smoke-free policies in patients with SLE.