Lechuga-Gómez EE, Domínguez-Herrera JG

Language: Spanish
References: 20
Page: 123-131
PDF size: 100.62 Kb.

ABSTRACT

Objective: To evaluate the thyroid antibodies association with clinical manifestations in patients with Autoimmune Thyroid Disease. Subjects: 430 patients: Graves’ Disease, Chronic Hashimoto’s Thyroiditis, Subacute Thyroiditis and Control Patients. Methods: All patients had anamnesis and physical evaluation. We measured Thyrotropin (TSH) receptor antibodies (thyrotropin binding inhibiting immunoglobulin –TBII–, thyroid stimulating immunoglobulin –TSAb–, thyroid growth stimulating immunoglobulin –TGI– and thyrotropin blocking antibody –TBAb–) and anti-thyroglobulin antibody (TgAb) as well as anti-thyroid peroxidase antibody (TPOAb). We determinate association between clinical manifestations with autoantibodies. Results: TRAb was more frequent in hyperthyroid vs hypothyroid patients (60.4 vs 32.5%, p=0.001) specially TBII (39.5 vs 14.9%, p=0.001), TGI (11.3 vs 4.4%, p=0.010) and TSAb (25.7 vs 12.4%, p 0.001). Clinical manifestations associated to TBII were diarrhea OR 3.35 (95% CI, 1.80-6.23, p 0.001), weight loss OR 2.37 (95% CI, 1.13-498, p 0.022 ), tremor OR 2.15 (95% CI 1.18-3.89, p 0.011), heat intolerance OR 2.27 (95% CI, 1.14-4.52, p 0.019), tachicardia OR 2.38 (95% CI, 1.04-5.44 p 0.04). Conclusion: Thyroid antibodies are strongly associated to extra-thyroid manifestations, specially diarrhea, weight loss, tremor and heat intolerance.

REFERENCES

1. Pratt D, Novotny M, Kaberlein G, Dudkiewicz A, Gleicher N. Antithyroid antibodies and the association with non-organ specific antibodies in recurrent pregnancy loss. Am J Obstet Gynecol 1993; 168: 837-841.

2. Stagnaro-Green A. Post partum thyroiditis: prevalence, etiology and clinical implications. Thyroid Today 1993; 16: 1-11.

3. Hay ID. Thyroiditis: a clinical update. Mayo Clin Proc 1985; 60: 836-843.

4. Livolsi VA. The pathology of autoimmune thyroid disease: a review. Thyroid 1994; 4: 333-339.

5. Roitt IM, Doniach D. A reassessment of studies on the aggregation of thyroid autoimmunity in families of thyroiditis patients. Clin Exp Immunol 1967; 2(Suppl): 727-736.

6. Chopra IJ, Solomon DH, Chopra U, Yoshihara E, Terasaki PI, Smith F. Abnormalities in thyroid function in relatives of patients with Graves’ disease and Hashimoto’s thyroiditis: lack of correlation with inheritance of HLA-B8. J Clin Endocrinol Metab 1977; 45: 45-54.

7. Kurihara H, Sasaki J, Takamatsu M. Twenty cases with Hashimoto disease changing to Graves’ disease. In: Nagataki S, Mori T, Torizuka K. Eds. Eighty Years of Hashimoto disease. Amsterdam: Elsevier Science 1993: 249-253.

8. Anthony PW, Leslie JD. Autoimmunity to the Thyroid Gland. In: The Thyroid and its Diseases Chapter 7. 2000.

9. Roitt IM, Doniach D, Campbell PN, Hudson RV. Auto-antibodies in Hashimoto’s disease (lymphadenoid goitre). Lancet 1956; 2: 820-821.

10. Kasagi K, Kousaka T, Higuchi K, Iida Y, Misaki T, Alam MS et al. Clinical significance of measurements of antithyroid antibodies in the diagnosis of Hashimoto’s thyroiditis: comparison with histological findings. Thyroid 1996; 6(5): 445-450.

11. Lavard L, Perrild H, Jacobsen BB, Hoier-Madsen M, Bendinelli G, Vitti P. Prevalence of thyroid peroxidase, thyroglobulin and thyrotropin receptor antibodies in a long-term follow up of juvenile Graves´ disease. Autoimmunity 2000; 32(3): 167-172.

12. Khoo DH, Ho SC, Seah LL, Fong KS, Tai ES, Chee SP et al. The combination of absent thyroid peroxidase antibodies and high thyroid-stimulating immunoglobulin levels in Graves’ disease identifies a group at markedly increased risk of ophtalmopathy. Thyroid 1999; 9(12): 1175-1180.

13. Bjoro T, Holmen J, Kruger O, Midthjell K, Hunstad K, Schreiner T et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The health study of nord-trondelag (HUINT). Eur J Endocrinol 2000; 143(5): 639-647.

14. Bryhni B, Aanderud S, Sundsfjord J, Rekvig OP, Jorde R. Thyroid antibodies in northern Norway: prevalence, persistence and relevance. J Intern Med 1996; 239(6): 517-523.

15. Knobel M, Barca MF, Pedrinola F, Medeiros-Neto G. Prevalence of anti-thyroid peroxidase antibodies in autoimmune and nonautoimmune thyroid disorders in a relatively low-iodine environment. J Endocrinol Invest 1994; 17(11): 837-842.

16. Salabe GB, Salabe-Lotz H, Ilardi I, Petracca C, Bile K. Low prevalence of thyroid antibodies in a Somalian population. J Clin Lab Immunol 1982; 9(1): 55-57.

17. Toldy E, Locsei Z, Kalmar I, Varga L, Kovacs LG. Thyroid antibodies [Diagnostic value of thyroid antibodies] Orv Hetil 1996; 137(38): 2075-2080.

18. Akamizu T, Kohn LD, Hiratam H, Saijo M, Tahara K, Nakao K. Hashimoto’s thyroiditis with heterogeneous antithyrotropin receptor antibodies: unique epitopes may contribute to the regulation of thyroid function by the antibodies. J Clin Endocrinol Metab 2000; 85(6): 2116-2121.

19. Massoudi MS, Meilahn EN, Orchard TJ, Foley TP, Kuller LH, Costantino JP et al. Prevalence of thyroid antibodies among healthy middle-aged women. Findings from the thyroid study in healthy women. Ann Epidemiol 1995; 5(3): 229-233.

20. Gómez JM, Soler J, Navarro MA. Thyroid stimulating antibodies in patients with Graves’ ophthalmopathy. Thyroidology 1991; 3(2): 59-61.