TPO Ab Research Articles

Prevalence of Thyroid Peroxidase Antibody and Pregnancy Outcome in Euthyroid Autoimmune Positive Pregnant Women from a Tertiary Care Center in Haryana.

Objective:To study the prevalence of thyroid peroxidase autoantibody in euthyroid pregnant women and to evaluate the association between thyroid peroxidase autoantibody and pregnancy outcomes.Materials and Methods:One thousand thirty consecutive pregnant women attending the antenatal clinic over a period of 1 year and were carrying a healthy singleton uncomplicated intrauterine pregnancy and consuming iodized salt were recruited for the study. Outcomes of the pregnancy was compared between TPO antibody positive euthyroid women (group 1) and TPO antibody negative euthyroid women (group 2).Results:Out of 1030 women, 164 (18.9%) were detected TPO antibody positive with euthyroid status. The mean FT4 and TSH level were significantly different in those who were TPO Ab positive as compared TPO Ab negative euthyroid pregnant women. No correlation was observed between the maternal age, gestational age and gravidity with anti TPO antibody levels. Eighteen (12%) women in Group 1and 5 (3.3%) women in Group 2 had miscarriages and the difference was found to be statistically significant (P value of 0.004). Twenty-one (14%) women in Group 1 and 5 (3.3%) women in Group 2 had preterm deliveries, which was also found to be statistically significantly (p value of 0.001). Other pregnancy related complications like Intrauterine death, IUGR, preeclampsia and PIH though are present in comparatively higher number in TPO Ab positive euthyroid pregnant women as compared to TPO Ab negative euthyroid pregnant women but this difference was not found to be statistically significant.Conclusions:To conclude with the present study shows that a good number of pregnant women with euthyroid status have TPO Ab positivity and this is associated with some adverse pregnancy outcomes like miscarriage and preterm birth of the baby.

Trimester Specific Nutritional Status of Iodine among Euthyroid Pregnant Women

Objective: To evaluate the present nutritional status of iodine among euthyroid pregnant women by measurement of urinary iodine levels. Material and Methods: 381 pregnant women attending antenatal clinic in the obstetrics and gynaecology department were included in study. Out of 381, 285 euthyroid women were selected as study population. Median urinary iodine levels (MUI) were compared among euthyroid pregnancy women according to trimester of gestation and thyroid peroxidase antibody (TPO Ab) level. Results: MUI level of euthyroid pregnant women was 119.2 μg/L (IQR=35.8-310.95) with 2.5th and percentile 97.5th being 5.55 μg/L and 1058.68 μg/L respectively. Out of 285 euthyroid women, 153(53.68%) were having MUI level below 150 μg/L. Trimester specific MUI levels decreased from 193.2 μg/L to 111.8 μg/L to 97.65 μg/L as gestational age increased from 1st to 2nd to 3rd trimesters respectively but this decrease with gestational age was not statistically significant. MUI levels of Anti-TPO antibody positive and negative euthyroid women were 153.8 μg/L and 118.4 μg/L respectively without being statistically significant (p=0.98). 138(54.12%) of Anti-TPO antibody negative and 15(50%) of Anti-TPO antibody positive were having MUI level below 150 μg/L. Conclusions: In the present study, we found that 53.68% of pregnant women were having MUI levels in iodine deficient range as per WHO guidelines.

Association of vitamin D insufficiency/deficiency with thyroid artery Doppler ultrasonography in patients with Hashimoto thyroiditis.

Background & Objective:During the course of the autoimmune thyroid diseases, ultrasonography change parallel to histopathology. Vitamin D is associated with autoimmune diseases and thus can affect thyroid blood flow. Our aim was to investigate the relationship between vitamin D insufficiency/deficiency and thyroid hemodynamic indices in patients with Hashimoto thyroiditis.Methods:A total of 93 patients who presented to Sakarya University Endocrinology outpatient clinic from April to September 2016 and diagnosed with Hashimoto thyroiditis were included in this study. Clinical and serologic data, thyroid antibodies and 25(OH)D3 were evaluated. Mean peak systolic velocity(mPSV), mean end-diastolic velocity (EDV), mean resistive index (RI) flows of superior and inferior thyroid arteries were measured with B-mode Doppler ultrasonography.Results:Vitamin D insufficiency/deficiency was detected in 59 (63.4%). TPO Ab and TgAb levels were found higher in patients with vitamin D insufficiency/deficiency. In the normal vitamin D group, superior thyroid artery mPSV (32.21±6.73cm/s) and EDV(13.27±2.80 cm/s) were higher than in the low vitamin D group [mPSV (28.32±8.99cm/s) and EDV(10.67±3.68 cm/s)] (P=0.034, P=0.001, respectively). Inferior thyroid artery EDV value was higher in the normal compared to the low vitamin D group (0.032). RI measured in all arteries were higher in the vitamin D insufficient/deficient group compared to the Vitamin D normal group (p=0.001).Conclusion:Vitamin-D insufficiency/deficiency has led to reduced parenchymal blood supply and increased micro-vascular resistance in Hashimoto thyroiditis patients.

Detection of misdiagnosed thyroid dysfunction in early pregnancy: using nonpregnant and pregnancy specific reference intervals

Objective: The objective was to assess the prevalence of misdiagnosed thyroid dysfunction during the first trimester of pregnancy when nonpregnant reference intervals used. Materials and Methods: This study, conducted on 233 pregnant women of age between 18 and 35 years during first trimester. Serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroperoxidase antibodies (TPO Ab) analyzed and thyroid disorders were grouped, based on the first trimester-specific reference intervals and correlated with nonpregnant reference intervals. Results: The overall prevalence of autoimmunity was 12.4%. The prevalence of subclinical hypothyroid (SCH) was significantly higher than euthyroid when first trimester-specific reference intervals used rather than nonpregnant reference intervals. If the nonpregnant reference intervals were applied to our study group, 27.9% pregnant women with TSH above the first trimester-specific reference intervals would not have been identified and misclassified as euthyroid. 22.7% would have missed the diagnosis as SCH. 5.2% with low FT4 levels, among this 3% and 2.1% would not have been identified as overt hypothyroid and isolated hypothyroxinemia. The relative risk of autoimmunity was significantly 3.66 times more in SCH than euthyroid, when first trimester-specific reference intervals used. Conclusion: Misdiagnosis of SCH, overt hypothyroid and autoimmune thyroid disorders occurred during the first trimester of pregnancy if nonpregnant reference intervals used. Undiagnosed hypothyroidism in pregnant women may adversely affect their fetuses; therefore the early and appropriate detection of thyroid dysfunction require reliable pregnancy-specific reference intervals of the thyroid hormones.

Prevalence of hypothyroidism and thyroid nodule in chronic hemodialysis Iranian patients.

End stage renal disease (ESRD) reasons several changes in the function of thyroid gland as; lower levels of thyroid hormones, altered hormone metabolism, and increased iodine storage. The aim of this study was to evaluate the prevalence of nodular goiter and hypothyroidism in hemodialysis (HD) patients compared with normal population. This cross-sectional study was conducted among HD patients and healthy people as the control group for thyroid function evaluation. Thyroid gland was evaluated by physical examination and ultrasonography. Blood level of FT3, FT4, TSH, TPO Ab, and urinary iodine excretion were checked in both groups. Data were analyzed using SPSS-17 and P-value less than 0.05 was considered as the significance level. Eighty six HD patients (57.2 ± 17.2 mean age, 48 men) and 86 healthy people (56.6 ± 16.8 mean age, 48 men) were enrolled in this study. Goiter was confirmed by physical examination in 29.0% of the HD patients and 12.8% of the control group (P = 0.04). Nodular goiter that was shown by ultrasonography was found in 27.9% and 3.5% of the HD and control groups, respectively (P = 0.01). HD patients had a higher frequency of reduced FT3 (40.9% vs. 4.6%, P < 0.01) and increased TSH (18.6% vs. 8.1%, P < 0.03(. TPO Ab was positive in 15.1% of the HD and 11.6% of the control groups (P = 0.14). The high incidence of nodular goiter and hypothyroidism in ESRD patients shows that screening for thyroid dysfunction and goiter, using appropriate laboratory tests, should be considered in evaluations of ESRD patients.

Subclinical hypothyroidism in pregnancy: An emerging problem in Southern West Bengal: A cross-sectional study.

Background:Prevalence of subclinical hypothyroidism (SCH) in pregnancy varies widely in different parts of our country, but it has multiple adverse outcomes in both the mother and fetus.Objectives:This study was conducted to evaluate the prevalence of SCH in pregnant women during the first trimester and to identify the prevalence of thyroid autoimmunity in pregnant women.Materials and Methods:This cross-sectional study (March 2014 to February 2015) was conducted among the pregnant women attending antenatal clinic in their first trimester at a tertiary care center. Morning samples of study participants were analyzed for free thyroxin (FT4), thyroid stimulating hormone (TSH), and thyroid peroxidase antibody (TPO Ab). Data expressed as mean ± standard deviation and percentage (%) as applicable.Results:Of the 510 subjects, 168 had TSH value >2.5 μIU/ml (32.94%) with normal FT4 and they were diagnosed as SCH. TSH level >4.5 μIU/ml was estimated in 13.92% (71) of the subjects. TPO Ab was positive in 57 (33.93%) of subclinical hypothyroid and 5 (1.47%) of normal subjects. 70.42% (50) of the subjects with TSH >4.5 μIU/ml had positive TPO Ab.Conclusions:Prevalence of SCH is high in South Bengal and routine thyroid screening at the first antenatal visit should be done to reduce the social and financial burden caused by SCH.

Organ-specific autoimmunity in relation to clinical characteristics in children with long-lasting type 1 diabetes.

The aim of this study was to assess the prevalence of diabetes and other organ-specific autoantibodies (Ab) associated with various autoimmune conditions, in Polish children with type 1 diabetes mellitus (T1DM). In this study 114 patients, aged 13.4 years, with mean diabetes duration 5.2 years were included. Ab to islet cell antigens: glutamic acid decarboxylase (GAD), insulinoma antigen 2 (IA-2), zinc transporter 8 (ZnT8), together with thyroid peroxidase Ab (TPO Ab), thyroglobulin Ab (Tg Ab), tissue transglutaminase Ab (tTG Ab) and 21-hydroxylase Ab (21-OH Ab) were measured. The prevalence of at least one diabetes associated Ab was found in 87%, with the highest prevalence of 64% for ZnT8 Ab. In patients with disease duration <5 years, at least one antibody was present in 90%, the most prevalent was ZnT8 Ab (72%). In patients with duration >10 years, 50% had at least one antibody. The prevalence of other than islet cell autoimmunity was high (34%). Thyroid Ab were detected in 26% patients, 42% in girls vs. 8% in boys, p<0.001. tTG Ab were found in 11% patients, with a greater prevalence in children with early onset (p=0.01). 21-OH Ab were found in 2.6% T1DM patients. Islet Ab were found in most T1DM children and remained positive even 10 years after onset. ZnT8 Ab emerged as an important marker for the diagnosis of T1DM in the Polish children. Screening for non-diabetes Ab in T1DM may be helpful in identifying subclinical cases of autoimmune thyroid, celiac or Addison's disease (AD).

Positivity rates of antithyroid antibody, antinuclear antibody and thyroid peroxidase antibody in different types of vitiligo.

Vitiligo is associated with various autoimmune disorders, and organ-specific autoantibodies are frequently found in patients with this disorder. Vitiligo is classically divided into segmental vitiligo (SV) and nonsegmental vitiligo (NSV), and it is believed that the pathogenesis differs between these two types. As the NSV type is related to an autoimmune mechanism, autoantibody detection rates are likely to be higher in the NSV type than in the segmental type; however, no comparative studies have been performed. To analyse the rates of autoantibody positivity according to the clinical features in patients with vitiligo. Rates of antithyroid antibody (Tg Ab), antinuclear antibody (ANA) and thyroid peroxidase antibody (TPO Ab) positivity were analysed and compared according to the sex, clinical type and age of onset of 807 patients with vitiligo. There were 106 patients with SV (13.1%) and 701 patients with NSV (86.9%). Tg Ab and ANA positivity did not differ between the SV and NSV types. A positive TPO Ab result was obtained in 16 patients with SV (15.1%) and 173 patients with NSV (24.7%). The TPO Ab positivity rate was significantly higher in NSV (χ² = 4.14, P < 0.05). The positivity rates of the three autoantibodies differed significantly according to age of onset (P = 0.001, P = 0.02 and P < 0.001 for Tg Ab, ANA and TPO Ab positivity, respectively). The TPO Ab positivity rate also showed a sex difference (P < 0.001). The positivity rates for the three autoantibodies showed differences according to age of onset and sex. The rates of Tg Ab and ANA positivity showed no significant differences according to clinical type, but the TPO Ab positivity rate was significantly different between SV and NSV. It appears likely that an autoimmune mechanism contributes to the pathogenesis of SV.

Screening of endocrine organ-specific humoral autoimmunity in 47,XXY Klinefelter's syndrome reveals a significant increase in diabetes-specific immunoreactivity in comparison with healthy control men.

The aim of this study was to evaluate the frequency of humoral endocrine organ-specific autoimmunity in 47,XXY Klinefelter's syndrome (KS) by investigating the autoantibody profile specific to type 1 diabetes (T1DM), Addison's disease (AD), Hashimoto thyroiditis (HT), and autoimmune chronic atrophic gastritis (AG). Sixty-one adult Caucasian 47,XXY KS patients were tested for autoantibodies specific to T1DM (Insulin Abs, GAD Abs, IA-2 Abs, Znt8 Abs), HT (TPO Abs), AD (21-OH Abs), and AG (APC Abs). Thirty-five of these patients were not undergoing testosterone replacement therapy TRT (Group 1) and the remaining 26 patients started TRT before the beginning of the study (Group 2). KS autoantibody frequencies were compared to those found in 122 control men. Six of 61 KS patients (9.8 %) were positive for at least one endocrine autoantibody, compared to 6.5 % of controls. Interestingly, KS endocrine immunoreactivity was directed primarily against diabetes-specific autoantigens (8.2 %), with a significantly higher frequency than in controls (p = 0.016). Two KS patients (3.3 %) were TPO Ab positive, whereas no patients were positive for AD- and AG-related autoantigens. The autoantibody endocrine profile of untreated and treated KS patients was not significantly different. Our findings demonstrate for the first time that endocrine humoral immunoreactivity is not rare in KS patients and that it is more frequently directed against type 1 diabetes-related autoantigens, thus suggesting the importance of screening for organ-specific autoimmunity in clinical practice. Follow-up studies are needed to establish if autoantibody-positive KS patients will develop clinical T1DM.

The Impact of Subclinical Hypothyroidism or Thyroid Autoimmunity on Coronary Vasospasm in Patients without Associated Cardiovascular Risk Factors.

Background and ObjectivesSubclinical hypothyroidism is associated with endothelial dysfunction and impaired coronary flow reserve. However, the effect of subclinical hypothyroidism or thyroid autoimmunity on variant angina has yet to be determined.Subjects and MethodsAmong 385 consecutive patients without associated cardiovascular risk factors who underwent coronary angiography with the ergonovine provocation test (EPT), 165 had a positive EPT {EPT(+)} and 220 had a negative EPT {EPT(-)}. The relationship between coronary artery spasm and the presence of subclinical thyroid dysfunction as well as serum thyroid peroxidase autoantibody (TPO Ab) was evaluated.ResultsThe proportion of patients with subclinical hypothyroidism among those who were EPT(+) was significantly higher than that in those who were EPT(-) (18% vs. 11%, p=0.001). However, there was no significant difference in the proportion of patients with subclinical hyperthyroidism between the groups. Moreover, EPT(+) patients showed significantly more positive TPO Ab (33% vs. 14%, p<0.001) than those with EPT(-). There was a positive correlation between EPT(+) and TPO positivity (r=0.226, p<0.001), subclinical hypothyroidism (r=0.112, p=0.033), and body mass index (r=0.123, p=0.018). Binary logistic regression analysis revealed that the significant predictors of EPT(+) were body mass index {adjusted odds ratio (OR)=1.042, 95% confidence interval (CI)=1.005-1.080}, presence of subclinical hypothyroidism (OR=3.047, 95% CI=1.083-8.572), TPO Ab titer (OR=1.028, 95% CI=1.015-1.041), and the presence of TPO Ab (OR=4.904, 95% CI=1.544-15.567).ConclusionSubclinical hypothyroidism and the presence of TPO Ab are significantly associated with coronary vasospasm in patients without cardiovascular risk factors.

Increase in Peripheral CD3-CD56brightCD16- Natural Killer Cells in Hashimoto's Thyroiditis Associated with HHV-6 Infection.

Hashimoto's thyroiditis (HT) is a very common autoimmune disease of the thyroid. In addition to genetic background, several viruses, including herpesviruses, have been suggested to play a role as possible environmental triggers of disease, but conclusive data are still lacking. Previous results showed that HT patients have an increased cellular immune response directed against the HHV-6 U94 protein and increased NK activity directed against HHV-6 infected thyrocytes.In this study, we characterized the antiviral antibody response and the NK cells activity and subtype in HHV-6 infected HT patients. The results showed that HT subjects have increased prevalence and titer of anti-U94 antibodies and a higher amount of CD3-CD56(bright)CD16(-)NK cell percentages compared to controls. Furthermore, the cell activation of CD3(-)CD56(bright) NK cells in HT patients significantly correlates with TPO and Tg Ab levels.The results suggest that HHV-6 might contribute to HT development, increasing NK cell secretion of inflammatory cytokines that could sustain the persistence of an inflammatory status in HT patients.

ASSOCIATION BETWEEN CRYOGLOBULINEMIA AND THYROID DYSFUNCTION IN HEPATITIS C CARRIERS

Introduction: Cryoglobulinemia is a biomarker of autoimmunity correlated with hepatitis C virus (HCV) infection. Objective: Report the association between the presence of mixed-cryoglobulinemia and thyroid dysfunction (TD) in hepatitis C virus carriers before and during treatment with pegylatedinterferon-alpha (Peg-IFN-α). Methods: Prospective cohort study. Results: Sixty-five untreated HCV patients, 38 women and 27 men were included in this study. Mean age of patients was 49.61 ± 11.83 years. Cryoglobulinemia was demonstrated in 24 (36.92%) patients. The TD was demonstrated in 2 patients (3.10%) before treatment with IFN-α, in 4 patients (6.20%) at 12th week, and 8 patients (12.30%) at 24th week; whereas autoimmune thyroid (TPO-Ab) positive was demonstrated in 3 patients (4.60%) before treatment, in 7 patients (10.80%) at 12th week, and 12 patients (18.50%) at 24th week. In the sample analyzed, the risk of a patient with cryoglobulinemia develop TD was 2.74 (95% CI: 1.95–12.95) times that of a patient without cryoglobulinemia in the 12th week of treatment and 1.83 (95% CI: 1.03–7.08) times in the 24th week of antiviral treatment, and risk of a patient with cryoglobulinemia for develop TPO Ab positive was 2.44 (95% CI: 1.46–5.98) times that of a patient without cryoglobulinemia in the 12th week of treatment, and 1.31 (95% CI: 1.05–2.89) times in the 24th weeks of antiviral treatment. Conclusion: We concluded that thyroid function evaluation should be recommended for HCV carriers that are seropositive for cryoglobulinemia.

Thyroid peroxidase antibody positivity and triiodothyronine levels are associated with pediatric Graves’ ophthalmopathy

Graves' ophthalmopathy (GO) occurs commonly in children with Graves' disease (GD). However, there are limited studies on the clinical manifestations and thyroid autoantibodies in pediatric GO. The aim of this study was to investigate the prevalence and risk factors of GO in childhood GD. Clinical and biochemical data from children and adolescents with GD were retrospectively reviewed. Eighty patients under 19 years of age were included in the present study. We compared the clinical and biochemical differences between patients with and without GO. Thirty-nine percent of the patients had GO, and 81% of the GO patients were females. Of these, two patients showed unilateral GO. Triiodothyronine (T3) levels were higher in GO patients than in those without GO. Anti-thyroglobulin antibody and thyroid stimulating hormone receptor antibody titers were not significantly different between the two groups. Anti-thyroid peroxidase antibody (TPO Ab) positivity was 68% in the patients with GO and only 47% in the patients without GO. In multivariate regression analysis, high T3 levels and TPO Ab positivity were related to the presence of GO. In children and adolescents with GD, TPO Ab positivity and high T3 levels could act as predictive factors for the presence of GO.

Reference intervals for thyroid markers in early pregnancy determined by 7 different analytical systems

The aim of the study was to verify differences between reference intervals for thyroid-stimulating hormone (TSH) and free thyroxine (FT4), as well as the cut-off for anti-thyroid peroxidase antibodies (TPO Ab) in pregnant women. Additionally, to compare these reference intervals with those recommended by the manufacturers for a healthy population. Levels of TSH, FT4, and TPO Ab were determined in a group of pregnant women (n = 216) with no history of thyroid dysfunction. Simultaneously, reference intervals for thyroid function tests were established with 7 different analytical systems representing those immunoassays most often used globally. The reference intervals for FT4 were slightly different, according to the system used by each manufacturer. Those for Architect, Centaur, Modular E170, and RIA Immunotech were slightly higher than those for Immulite 2500 and AIA 2000; the lowest being for UniCel DxI (8.13–13.2 pmol/L). For TSH, a higher interval (0.25–3.86 mU/L) is recommended for Modular E170 and IRMA Immunotech; and a lower one (0.17–2.81 mU/L) for Immulite 2500 and AIA 2000. The established cut-off limits for TPO-Ab differ according to the system used and are similar to those recommended by their manufacturers.

The natural course of Hashimoto's thyroiditis in children and adolescents.

Hashimoto's thyroiditis (HT) is the most common cause of thyroid disease in children and adolescents, but little is known about the long-term follow-up of HT. The aim of this study was to analyze the clinical and laboratory characteristics and to observe the natural course of HT in children and adolescents. We retrospectively reviewed 153 patients with HT diagnosed before 18 years of age. Subjects were grouped into euthyroid, subclinical hypothyroidism, overt hypothyroidism, and hyperthyroidism on the basis of the thyroid function test. Of the 153 subjects, 133 were followed up (range 6∼181 months) at our clinic every 6 months for evaluation of goiter size, thyroid function, thyroid peroxidase antibodies (TPO Ab), and thyroglobulin antibodies (TG Ab) serum concentration. Thyroid function tests at the time of presentation revealed euthyroid in 72 patients (47.1%), subclinical hypothyroidism in 48 (31.4%), overt hypothyroidism in 22 (14.4%), and hyperthyroidism in 11 (7.2%). Serum TPO Ab and TG Ab significantly decreased in the subclinical hypothyroidism group with levothyroxine treatment. Also, there was a significant decrease in the mean serum TG Ab levels among the overt hypothyroid patients during the follow-up period, although TPO Ab levels were not significantly different when compared to their baseline TPO Ab levels. Most children with HT were euthryoid and remained euthyroid during follow-up. However, thyroid function should still be monitored periodically for early detection and treatment of overt hypothyroidism. Our data also showed that levothyroxine treatment may have beneficial effects on the thyroid antibody titers.

The impact of thyroid autoimmunity on arterial stiffness in postmenopausal patients with fibromyalgia

The exact mechanism of arterial stiffness in fibromyalgia (FM) remains unclear. The present study aimed to evaluate the association between thyroid function and markers of arterial function in postmenopausal FM patients. This study included 163 postmenopausal FM patients without any known cardiovascular diseases and within a normal reference range of thyroid-stimulating hormone (TSH) level. Clinical parameters including the Fibromyalgia Impact Questionnaire (FIQ), the pain visual analogical scale (VAS) and tender point counts were measured. Vascular function was assessed by brachial-ankle pulse wave velocity (baPWV) and flow-mediated dilation (FMD). We evaluated the associations between arterial markers and serum TSH, free thyroxin, as well as serum thyroidperoxidase autoantibody (TPO Ab). Patients with a high baPWV (≥1490cm/s) showed more positive TPO Ab (65% vs. 10%, P=0.006) than those with a normal baPWV. Additionally, the baPWV values of patients with positive TPO Ab were significantly different from those with negative TPO Ab. Age, FIQ and TPO Ab were significantly correlated with baPWV and FMD (all P<0.05). Multiple linear regression analysis revealed that the only significant predictors of baPWV were age, FIQ and the presence of TPO Ab after adjustment for traditional risk factors. A significant association was also found between FMD and positive TPO Ab. Age, functional status and presence of TPO Ab were significantly associated with increased arterial stiffness in postmenopausal FM patients. Given the combined thyroid autoimmunity in FM patients, a re-evaluation of the effects on the vasculature may be necessary.

Thyroid functions and autoimmunity in Egyptian children with chronic hepatitis C virus infection before interferon treatment

Background: The association of thyroid dysfunction with hepatitis C virus (HCV) infected children who are on interferon therapy is well established. But thyroid functions in untreated chronic HCV children is an aspect which the present study intended to explore. Settings and Design: Cross-sectional controlled study. Materials and Methods: The study included 30 children with chronic hepatitis C (Group 1; mean age 9.86 ± 2.22 years). Thirty healthy children age- and sex-matched were included as control group (Group 2; mean age 8.54 ± 2.31 years). Measurement of thyroid stimulating hormone (TSH), free thyroxine (FT 4 ), and free triiodothyronine (FT 3 ), as well as anti-thyroid peroxidase antibodies (TPO Ab) and anti-thyroglobulin (Tg Ab) were done. Results: Mean TSH levels were significantly higher in the group 1 as compared to control (P < 0.001). Subclinical hypothyroidism was detected in 13.3% in the study group vs 3.3% in the control group (P < 0.001). Positive levels of TPO Ab and Tg Ab were found to be 23.3% and 13.3% in Group 1 compared with 6.6% and 3.3% in controls, respectively. We also observed a significant positive correlation between TSH levels and age, HCV duration, viral load, anti-TPO Abs, antiTg Abs, and negative correlation with FT4. Conclusions: Both subclinical hypothyroidism and thyroid autoimmunity are common in Egyptian children with chronic hepatitis C before interferon treatment.

Pregnancy and Thyroid Dysfunction: Need for Universal Screening - A Pilot Study

Aim: 1. To determine Thyroid dysfunction and antiTPO antibody status in pregnant women. 2. To know the benefit of LT4 therapy in maternal pregnancy outcome (antiTPO ab+ve vs antiTPO ab-ve groups) and 3. To determine the maternal and fetal outcomes in hypothyroid pregnant women and to decide whether universal screening of pregnant women for hypothyroidism is required or not. Materials and methods: A prospective study was done in mamata general hospital in the dept. of obg, over a period of 1 ½ years.105 antenatal women were included in the study. Outcome in these pregnancies were observed and analysed using appropriate statistical method. Results: There were only 3 patients with spontaneous abortions, 3 patients with pregnancy induced hypertention and only 1 patient had preterm delivery. There was more of thyroid dysfunction in anti TPO Ab +ve cases. But there was no significant adverse effect on pregnancy outcome in patients who were treated. Conclusion: Though our study included only a small number of antenatal women who were screened for thyroid abnormality since it was only a pilot study done in our hospital since our area is endemic for thyroid disorders due to iodine deficiency we recommend Universal screening to rule out thyroid dysfunction in pregnancy because the maternal and fetal complications can be reduced by early screening, diagnosing and correcting thyroid abnormality. DOI: http://dx.doi.org/10.3329/bjms.v13i1.14173 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 49-52

Reference ranges of serum TSH, FT4 and thyroid autoantibodies in the Thai population: the national health examination survey

Data on reference intervals of thyroid functions in Southeast Asia are limited. The aim of this study was to provide reference ranges of thyroid functions and thyroid autoantibodies in Thais. Serum samples from 2545 apparently healthy non-pregnant subjects, aged ≥14 years, from the fourth Thai National Health Examination Survey were measured for TSH, FT4, antithyroperoxidase (TPO Ab), antithyroglobulin (Tg Ab) and antithyrotrophin receptor antibodies (TRAb). A reference population was selected from the disease-free population by excluding those who had thyroid autoantibodies and TSH > 20 mIU/l. For the total population, median TSH and FT4 levels were 1·94 mIU/l and 1·35 ng/dl, respectively. TSH was higher and FT4 was lower in females than in males. Based on National Academy of Clinical Biochemistry criteria, the reference intervals (2·5th-97·5th percentile) were: TSH, 0·34-5·11 mIU/l; FT4, 0·98-1·79 ng/dl; TPO Ab, 5-84·88 IU/ml; Tg Ab, 10-118·2 IU/ml; and TRAb, 0·3-1·24 IU/l. With the new reference ranges, hypothyroidism was found in 4·16% of the total population (0·78% overt and 3·38% subclinical hypothyroidism) and hyperthyroidism was found in 3·18% (0·94% overt and 2·24% subclinical hyperthyroidism). Positive TPO Ab, Tg Ab and TRAb were found in 8·96%, 12·26% and 5·93%, respectively. The upper normal limit of TSH tended to increase with age, particularly for those aged 80 years and older. The reference interval for TSH needs to be derived from each specific population. Slightly elevated TSH concentrations in the elderly could be considered acceptable, with no need for thyroxine treatment.

SAT0395 Thyroid Autoimmunity, Not Thyroid Hormone, was Associated with Arterial Stiffness in Euthyroid FM Female Patients.

BackgroundMuscle symptoms are frequent in thyroid diseases, and it has been recognized that there are significant similarities between the clinical findings in FM and symptoms of thyroid dysfunction. Some recent...