High Prevalence of Antinuclear Antibodies in Children with Thyroid Autoimmunity

Background. Antinuclear antibodies (ANA) are a hallmark of many autoimmune diseases and can be detected many years before disease onset. Autoimmune thyroid diseases (AITD) are frequently associated with other organ- and non-organ-specific autoimmune disorders.Objectives. To assess the prevalence of ANA in pediatric patients with AITD and their clinical correlations.Methods. Ninety-three consecutive pediatric patients with AITD were enrolled (86 children with chronic lymphocytic thyroiditis and 7 with Graves’ disease). ANA, anti-double DNA (anti-dsDNA) antibodies, anti-extractable nuclear antigen (anti-ENA), anti-cyclic citrullinated peptide antibodies (anti-CCP), and rheumatoid factor (RF) was obtained. Signs and symptoms potentially related to rheumatic diseases in children were investigated by a questionnaire.Results. ANA positivity was found in 66/93 children (71%), anti-ENA in 4/93 (4.3%), anti-dsDNA in 1/93 (1.1%), RF in 3/93 (3.2%), and anti-CCP in none. No significant differences were found between the ANA-positive and ANA-negative groups with respect to age, sex, L-thyroxine treatment, or prevalence of other autoimmune diseases. Overall, parental autoimmunity was found in 23%.Conclusions. ANA positivity was demonstrated in 71% of children with AITD. ANA positivity was not related to overt immune-rheumatic diseases. However, because the positivity of ANA can occur even many years before the onset of systemic autoimmune diseases, prospective studies are warranted.

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Rheumatic Disease Autoantibodies in Patients with Autoimmune Thyroid Diseases

Medical Principles and Practice ◽

10.1159/000490569 ◽

2018 ◽

Vol 27 (4) ◽

pp. 332-336 ◽

Cited By ~ 3

Author(s):

Renato Nisihara ◽

Yasmine Gorczevski Pigosso ◽

Nathalia Prado ◽

Shirley R.R. Utiyama ◽

Gisah A. De Carvalho ◽

...

Keyword(s):

Rheumatic Diseases ◽

Positive Association ◽

Latex Agglutination ◽

Thyroid Diseases ◽

Nuclear Antigen ◽

Rheumatic Disorder ◽

Older Individuals ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Organ Specific

Background: Patients with autoimmune thyroid diseases (ATD) such as Graves’ disease (GD) and Hashimoto thyroiditis (HT) may have non-organ specific autoantibodies such as antinuclear antibodies (ANA) and rheumatoid factor (RF). Aim: To study the prevalence of rheumatic autoantibodies in a group of ATD patients without known rheumatic diseases and to evaluate its association with the patients’ epidemiological and treatment profiles. To follow positive non-organ specific autoantibody-positive ATD individuals to investigate whether they will develop a rheumatic disorder. Methods: A sample of 154 ATD patients (70 HT and 84 GD; mean age 45.3 ± 14.2) had determination of ANA by immunofluorescence, using hep-2 cells as substrate, extractable nuclear antigen profile by ELISA kits and RF by latex agglutination. Epidemiological and treatment profiles were obtained through chart review. These patients were followed for the mean period of 5 years, between 2010 and 2015. Results: Positive ANA was found in 17.5% (27/154) of the patients: anti-Ro/SS-A in 4/154 (2.5%); anti-RNP in 4/154 (2.5%), and anti-La/SS-B in 3/154 (1.9%). None had anti-Sm antibodies. RF was detected in 12/154 (7.7%) of ATD patients and was more common in older individuals (p = 0.007). There was a positive association between the presence of RF and ANA (p = 0.03; OR 3.89; 95% CI 1.1–13.3). None of the patients with positive autoantibodies developed clinical rheumatic diseases during the period of observation. Conclusion: We found rheumatic autoantibodies in 17.5% of ATD patients without rheumatic diseases. None of them were associated with the appearance of clinical rheumatic disorder during the period of 5 years.

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Vitamin D and autoimmune thyroid diseases (part 1)

Ukrainian Journal of Pediatric Endocrinology ◽

10.30978/ujpe2021-3-6 ◽

2021 ◽

pp. 6-15

Author(s):

N. V. Volkova ◽

A. V. Solntseva

Keyword(s):

Vitamin D ◽

Autoimmune Diseases ◽

Immune Cells ◽

Therapeutic Potential ◽

Immunosuppressive Agents ◽

Thyroid Tissue ◽

Thyroid Diseases ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Autoimmune Pathology

Autoimmune thyroiditis (AIT) and Graves’ disease (GD) are common autoimmune diseases, and their prevalence assessed as 5 % of general population. Currently, selective immunosuppressive agents for pathogenetic treatment of autoimmune pathology are being developed. Vitamin D with the known antiinflammatory and immunoregulatory properties, is also of great interest. The first part of the article reviews the roles of various immune cells in the pathogenesis of autoimmune thyroid diseases, which is necessary to reveal the therapeutic potential of calcitriol in these disorders. Classically, AIT was considered to be mediated by Thelpers type 1 (Th1), and GD — by Thelpers type 2 (Th2). This misunderstanding was based on the idea that humoral immunity is controlled by Th2 cytokines, and cellular immunity — by Th1. In the past decades, the role of new subsets of immune cells in the pathogenesis of autoimmune thyroid diseases is being studied, displacing the traditional paradigm of Th1/Th2 dichotomy. It has been established that Thelpers type 17 (Th17) play an important role in the development of various inflammatory and autoimmune diseases, previously classified as Th1dependent pathologies. The involvement of T and Bregulatory lymphocytes in the autoimmune process is also of particular interest. It was found that these cells accumulate in inflamed thyroid tissue in patients with thyroid pathology, but they are unable to suppress the immune response effectively. Further research will help to find out which immune cells can become targets for vitamin D agonists in the complex treatment of autoimmune diseases.

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Autoimmune thyroid disease and other non-endocrine autoimmune diseases

Medicinski pregled ◽

10.2298/mpns1104183t ◽

2011 ◽

Vol 64 (3-4) ◽

pp. 183-187 ◽

Cited By ~ 10

Author(s):

Ljiljana Todorovic-Djilas ◽

Tijana Icin ◽

Jovanka Novakovic-Paro ◽

Ivana Bajkin

Keyword(s):

Autoimmune Disease ◽

Autoimmune Diseases ◽

Lupus Erythematosus ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Good Reason ◽

The Body ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Organ Specific

Introduction, Autoimmune diseases are chronic conditions initiated by the loss of immunological tolerance to self-antigens. They constitute heterogeneous group of disorders, in which multiple alterations in the immune system result in a spectrum of syndromes that either target specific organs or affect the body systematically. Recent epidemiological studies have shown a possible shift of one autoimmune disease to another or the fact that more than one autoimmune disease may coexist in a single patient or in the same family. Numerous autoimmune diseases have been shown to coexist frequently with thyroid autoimmune diseases. Autoimmune thyroid disease and other organ specific non-endocrine autoimmune diseases. This part of the study reviews the prevalence of autoimmune thyroid disease coexisting with: pernicious anaemia, vitiligo, celiac disease, autoimmune liver disease, miastenia gravis, alopecia areata and sclerosis multiplex, and several recommendations for screening have been given. Autoimmune thyroid disease and other organ non-specific non-endocrine autoimmune diseases. Special attention is given to the correlation between autoimmune thyroid disease and rheumatoid arthritis, systemic lupus erythematosus, syndrome Sj?gren, systemic sclerosis and mixed connective tissue disease. Conclusions. Screening for autoimmune thyroid diseases should be recommended in everyday clinical practice, in patients with primary organ-specific or organ non-specific autoimmune disease. Other?wise, in patients with primary thyroid autoimmune disease, there is no good reason of seeking for all other autoimmune diseases, although these patients have a greater risk of developing other autoimmune disease. Economic aspects of medicine require further analyzing of these data, from cost/benefit point of view to justified either mandatory screening or medical practitioner judgment.

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Immunological Mechanisms of Autoimmune Thyroid Diseases: A Shift in The Traditional TH1/TH2 Paradigm

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences ◽

10.2478/prolas-2019-0012 ◽

2019 ◽

Vol 73 (2) ◽

pp. 67-77

Author(s):

Tatjana Zaķe ◽

Sandra Skuja ◽

Aivars Lejnieks ◽

Valērija Groma ◽

Ilze Konrāde

Keyword(s):

Thyroid Autoimmunity ◽

Treg Cells ◽

Thyroid Diseases ◽

Autoimmune Response ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Th17 Lymphocytes ◽

Immunological Mechanisms ◽

Thyroid Autoantigens ◽

The Impact

Abstract Autoimmune thyroid diseases (AITD) mainly include Hashimoto’s thyroiditis (HT) and Graves’ disease (GD), which are characterised by the presence of circulating antibodies against various thyroid autoantigens and infiltration of the thyroid gland by autoreactive lymphocytes. Despite the significant advancement in the knowledge of AITD pathogenesis in the last decade, the specific immunological mechanisms responsible for development of the disease are not thoroughly understood. Classically, HT has long been considered as a T helper (Th)1-mediated disease, while a Th2-driven autoimmune response is dominant for GD development. However, this classification has changed due to the description of Th17 lymphocytes, which suggested participation of these cells in AITD, particularly HT pathogenesis. Moreover, a shift in the balance between Th17 and T regulatory (Treg) cells has been observed in thyroid autoimmunity. We have observed overexpression of IL-17, the prominent effector cytokine of Th17, within thyroid tissues from HT and GD patients in our studies. The present review will focus on recent data regarding the role of Treg and Th17 lymphocytes in AITD pathogenesis. In addition, the impact and proposed mechanisms of the predominant environmental factors triggering the autoimmune response to the thyroid will be discussed.

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Manifest hyperthyroidism in patient with autoimmune hepatitis (clinical observation)

Medical alphabet ◽

10.33667/2078-5631-2021-35-52-56 ◽

2021 ◽

pp. 52-56

Author(s):

M. A. Livzan ◽

O. V. Gaus ◽

D. A. Gavrilenko

Keyword(s):

Autoimmune Diseases ◽

Autoimmune Hepatitis ◽

Clinical Guidelines ◽

Thyroid Disease ◽

Liver Diseases ◽

Sclerosing Cholangitis ◽

Clinical Observation ◽

Primary Biliary Cholangitis ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid

Among patients with autoimmune hepatitis concomitant autoimmune diseases occur in 40 % of cases. The most commonly associated autoimmune hepatitis is primary biliary cholangitis, primary sclerosing cholangitis and thyroid disease. With regard to the association of autoimmune liver diseases with each other there is experience in management and this is reflected in the clinical guidelines. Information on the features of comorbidity in autoimmune hepatitis and autoimmune thyroid diseases is very limited. This article presents our own clinical observation of the manifestation of thyrotoxicosis against the background of autoimmune hepatitis.

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Impact of Abdominal Obesity on Thyroid Auto-Antibody Positivity: Abdominal Obesity Can Enhance the Risk of Thyroid Autoimmunity in Men

International Journal of Endocrinology ◽

10.1155/2020/6816198 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Jazyra Zynat ◽

Suli Li ◽

Yanrong Ma ◽

Li Han ◽

Fuhui Ma ◽

...

Keyword(s):

Waist Circumference ◽

Abdominal Obesity ◽

Thyroid Autoimmunity ◽

Large Population ◽

Overweight And Obesity ◽

Thyroid Peroxidase ◽

Hip Circumference ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Logistic Analysis

Background. The interrelation between obesity and autoimmune thyroid diseases is complex and has not been confirmed. The aim of the present study was to observe the relationship between thyroid autoimmunity and obesity, especially abdominal obesity, in a large population. Methods. A total of 2253 residents who had lived in Xinjiang for more than 3 years were enrolled. Serum thyroid hormone concentration, thyroid autoantibodies, lipid parameters, Weight, height, and waist and hip circumference were measured. Results. The prevalence of thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) positive was 32.1% (21.2% in men and 37% in women, P<0.01). Compared with women, men had significantly higher TG levels, waist circumference, and hip circumference levels (P<0.01), while women showed higher TSH, TPOAb, and TgAb levels (P<0.01). The prevalence of overweight and obesity was 71.1% in men and 63.5% in women. Men had a higher prevalence of abdominal obesity than women (56.6% in men and 47.6% in women, P<0.01). TPOAb correlates positively with waist circumference (r = 0.100, P<0.05) in men. Binary logistic analysis showed that TPOAb positivity had increased risks of abdominal obesity in men, and the OR was 1.1044 (95% CI 1.035, 1.151, P<0.05). Conclusion. Our results indicate that men had higher lipid levels, thicker waist circumference, and higher prevalence of overweight, obesity, and abdominal obesity. Abdominal obesity is a risk factor for TPOAb positivity in men, suggesting that abdominal obesity can enhance the risk of thyroid autoimmunity in men.

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TGF-β Physiology as a Novel Therapeutic Target Regarding Autoimmune Thyroid Diseases: Where Do We Stand and What to Expect

Medicina ◽

10.3390/medicina57060621 ◽

2021 ◽

Vol 57 (6) ◽

pp. 621

Author(s):

Efstratios Kardalas ◽

Spyridoula Maraka ◽

Maria Papagianni ◽

George Paltoglou ◽

Charalampos Siristatidis ◽

...

Keyword(s):

Transforming Growth Factor Beta ◽

Transforming Growth Factor ◽

Thyroid Autoimmunity ◽

Treatment Options ◽

Thyroid Diseases ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Activation Pathways ◽

Novel Therapeutic

Transforming growth factor beta (TGF-β), as a master regulator of immune response, is deeply implicated in the complex pathophysiology and development of autoimmune thyroid diseases. Based on the close interplay between thyroid autoimmunity and TGF-β, scientific interest was shifted to the understanding of the possible role of this molecule regarding the diagnosis, prognosis, and therapy of these diseases. The main aim of this review is to present research data about possible treatment options based on the role of TGF-β in thyroid autoimmunity. Suggested TGF-β-mediated therapeutic strategies regarding autoimmune thyroid diseases include either the enhancement of its immunosuppressive role or inhibition of its facilitatory role in thyroid autoimmunity. For example, the application of hr-TGF-β can be used to bolster the inhibitory role of TGF-β regarding the development of thyroid diseases, whereas anti-TGF-β antibodies and similar molecules could impede its immune-promoting effects by blocking different levels of TGF-β biosynthesis and activation pathways. In conclusion, TGF-β could evolve to a promising, novel therapeutic tool for thyroid autoimmunity.

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Autoimmune thyroid disease

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.3136 ◽

2011 ◽

pp. 416-431 ◽

Cited By ~ 2

Author(s):

Anthony P. Weetman

Keyword(s):

Thyroid Autoimmunity ◽

Basic Knowledge ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Slow Progression ◽

Organ Specific ◽

Autoimmune Conditions ◽

Progression Of Disease ◽

Main Factors ◽

Ease Of Access

Along with neoplasia, autoimmunity is the most common cause of endocrine disease and, of this group of disorders, thyroid autoimmunity is the most frequent. Conversely, the autoimmune thyroid diseases are the most common organ-specific or nonorgan-specific autoimmune conditions affecting any site. This prevalence, the ease of access to the target organ, the often slow progression of disease, and the historical legacy of being the first distinctive autoimmune process to be defined, have ensured that there is now a reasonable understanding of the main factors involved in pathogenesis. This chapter assumes a basic knowledge of immunology; readers unfamiliar with this topic can obtain further details about the fundamental processes involved in self/non-self discrimination by the immune system elsewhere (1).

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High frequency of endocrine autoimmunity in patients with sarcoidosis

Acta Endocrinologica ◽

10.1530/eje.0.1340331 ◽

1996 ◽

Vol 134 (3) ◽

pp. 331-336 ◽

Cited By ~ 47

Author(s):

Konstantin I Papadopoulos ◽

Yngve Hörnblad ◽

Harriet Liljebladh ◽

Bengt Hallengren

Keyword(s):

Autoimmune Diseases ◽

Thyroid Disease ◽

High Frequency ◽

Autoimmune Thyroid Disease ◽

Thyroid Autoimmunity ◽

Addison’S Disease ◽

University Hospital ◽

Syndrome Type ◽

Type Ii ◽

Autoimmune Thyroid

Papadopoulos KI, Hörnblad Y, Liljebladh H, Hallengren B. High frequency of endocrine autoimmunity in patients with sarcoidosis. Eur J Endocrinol 1996;134:331–6. ISSN 0804–4643 Autoimmune diseases and sarcoidosis may be related and, especially, the association between sarcoidosis and autoimmune thyroid disease has long been recognized. The frequency and type of endocrine autoimmunity was examined in a series of Swedish patients with sarcoidosis. Of all patients (N = 89) with documented sarcoidosis attending the Department of Pulmonary Medicine between January 1980 and December 1991, 78 patients (44 males and 34 females; median age at the time of the study 48 years, range 22–81 years) were examined at the Department of Endocrinology, Malmö University Hospital, in the present study. Fifteen patients (19.2%) had clinical or serological evidence of endocrine autoimmunity. Two patients had Addison's disease, both with polyglandular autoimmune (PGA) syndrome type II; evidence of thyroid autoimmunity was found in 13 patients, eight with clinical autoimmune thyroid disease (ATD) (two with Graves' disease and six with autoimmune thyroiditis), of whom two had PGA syndrome type III, and five with isolated positive thyroid serology: two patients had insulin-dependent diabetes mellitus and one had premature ovarian failure. The frequencies of Addison's disease, clinical ATD and PGA syndrome type II were significantly higher compared with the frequencies found in the general population. In conclusion, a high frequency of endocrine autoimmunity in patients with sarcoidosis, occurring in about 20% of the cases, was demonstrated. Thyroid autoimmunity and polyglandular autoimmune syndromes occurred most frequently. Complex immunological and genetic mechanisms might explain the association of sarcoidosis and endocrine autoimmune diseases. Bengt Hallengren, Department of Endocrinology, Malmö University Hospital, S-205 02, Malmö, Sweden

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The Detection of Serum IgMs to Thyroglobulin in Subacute Thyroiditis Suggests a Protective Role of IgMs in Thyroid Autoimmunity

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa038 ◽

2020 ◽

Vol 105 (6) ◽

pp. e2261-e2270 ◽

Cited By ~ 4

Author(s):

Debora Ricci ◽

Alessandro Brancatella ◽

Michele Marinò ◽

Mario Rotondi ◽

Luca Chiovato ◽

...

Keyword(s):

De Novo ◽

Thyroid Autoimmunity ◽

High Serum ◽

Subacute Thyroiditis ◽

Autoimmune Response ◽

Enzyme Linked Immunosorbent Assay ◽

Serum Samples ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid

Abstract Context The role of serum immunoglobulin (Ig)Ms in autoimmune thyroid diseases is uncertain. Objective We looked for IgMs to thyroglobulin (Tg) in patients with subacute thyroiditis (SAT), which is characterized by high serum Tg levels, the possible de novo appearance of IgGs to Tg (TgAb-IgGs), and no autoimmune sequelae. Main Outcome Measures TgAb-IgMs and TgAb-IgGs were detected by binding to Tg using the enzyme-linked immunosorbent assay (ELISA). The upper reference limit of TgAb-IgMs and TgAb-IgGs was established in 40 normal subjects. We looked for TgAb-IgMs in 16 patients with SAT, 11 with Hashimoto’s thyroiditis (HT), and 8 with Graves’ disease (GD) who were all positive for TgAb-IgGs. IgM binding to bovine serum albumin (BSA), keyhole limpet hemocyanin (KLH), and glucagon in ELISA was measured. Inhibition of TgAb-IgMs binding to coated Tg was evaluated by preincubating serum samples or IgG-depleted samples with soluble Tg. Results TgAb-IgMs were positive in 10/16 patients with SAT, 2/11 with HT, and 1/8 with GD. TgAb-IgMs were higher in SAT (0.95; 0.42–1.13) (median; 25th–75th percentiles) than in HT (0.47; 0.45–0.51) and GD patients (0.35; 0.33–0.40) (P < .005 for both). IgM binding of SAT sera to BSA, KLH, and glucagon was significantly lower than Tg. Preincubation with soluble Tg reduced the binding of IgMs to coated Tg by 18.2% for serum samples and by 35.0% and 42.1% for 2 IgG-depleted samples. TgAb-IgM levels were inversely, although nonsignificantly, correlated with Tg concentrations. Conclusions Tg leak associated with thyroid injury induces the production of specific TgAb-IgMs, which, in turn, increases the clearance of Tg and might prevent the establishment of a persistent thyroid autoimmune response.

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