scholarly journals The Clinical Value and Variation of Antithyroid Antibodies during Pregnancy

2020 ◽  
Vol 2020 ◽  
pp. 1-17
Author(s):  
Chuyu Li ◽  
Jing Zhou ◽  
Zengshu Huang ◽  
Xinyao Pan ◽  
Wingting Leung ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Thyroid Stimulating Hormone ◽  
Adverse Outcomes ◽  
Thyroid Peroxidase ◽  
Thyroid Antibodies ◽  
Reference Levels ◽  
Clinical Value ◽  
Antithyroid Antibodies ◽  
Tight Association ◽  
Receptor Antibodies

Antithyroid antibodies, which include thyroid-stimulating hormone receptor antibodies (TRAbs), thyroid peroxidase antibodies (TPOAbs), and thyroid globulin antibodies (TgAbs), are widely known for their tight association with thyroid autoimmune diseases. The variation in all three kinds of antibodies also showed different trends during and after pregnancy (Weetman, 2010). This article reviewed the the physiological changes, while focusing on the variation of thyroid antibodies concentration in women during and after pregnancy, and adverse consequences related to their elevation. Since abnormal elevations of these antithyroid antibodies may lead to adverse outcomes in both mothers and fetuses, special attention must be paid to the titer of the antibodies during pregnancy. The molecular mechanisms of the variations in those antibodies have yet to be explained. The frequency and timing of thyroid antibody measurement, as well as different reference levels, also remain to be elucidated.

Thyroid evaluation of children and adolescents with Williams syndrome in Zhejiang Province

2017 ◽  
Vol 30 (12) ◽  
Author(s):  
Wei-Jun Chen ◽  
Chai Ji ◽  
Dan Yao ◽  
Zheng-Yan Zhao
Keyword(s):  
Children And Adolescents ◽  
Thyroid Function ◽  
Williams Syndrome ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Zhejiang Province ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Thyroid Antibodies ◽  
Free Triiodothyronine

AbstractBackground:The objective of the study was to describe the prevalence of abnormal thyroid function and volume in children and adolescents with Williams syndrome (WS) in Zhejiang Province, China.Methods:Thyroid function, including thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and thyroid antibodies (thyroid peroxidase and thyroglobulin) were measured in 83 patients with WS, aged 0.2–16.5 years. Twenty-three patients were followed for an average of 1.7 years (0.4–4.1), and multiple TSH determinations were considered. Thyroid ultrasonography was performed on 49 patients.Results:One patient was diagnosed with overt hypothyroidism, and 23 patients (27%) had subclinical hypothyroidism (SH). Thyroid antibodies were absent in all patients. In five age groups (0–1 years, 1–3 years, 3–6 years, 6–9 years, 9–18 years), the prevalence of patients with subclinical hypothyroidism was 25%, 28.5%, 44.4%, 16.7% and 4.7%, respectively. Through ultrasound examination, 21 patients (42%) were observed to have thyroid hypoplasia (TH), and there were no cases of thyroid haemiagenesis. The incidence rate of TH increased with age, rising from 20% in the youngest group to 66% in the oldest.Conclusions:SH and TH is common in children and adolescents with WS. Yearly evaluation of thyroid must be performed in all patients in this population, regardless of the result of the neonatal screening. Age under 6 years and existing thyroid abnormalities are risk factors for developing SH, and a shorter follow-up interval is needed for screening in these individuals, SH is often self-limiting, and clinicians should be alert to overt hypothyroidism.

scholarly journals CARRIAGE OF THYROID ANTIBODIES AS A RISK FACTOR IN THE DEVELOPMENT AND PROGRESSION OF ENDOCRINE OPHTHALMOPATHY

2017 ◽  
Vol 25 (2) ◽  
pp. 270-278
Author(s):  
V. G. Likhvantseva ◽  
M. S. Afanasyev ◽  
E. A. Rudenko ◽  
С. С. Afanasyev ◽  
E. V. Korosteleva ◽  
...  
Keyword(s):  
Risk Factor ◽  
Clinical Course ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Thyroid Autoantibodies ◽  
Thyroid Antibodies ◽  
Increased Risk ◽  
Endocrine Ophthalmopathy ◽  
Toxic Goiter ◽  
Stimulating Hormone

The influence of the carrier of thyroid autoantibodies (to thyroid-stimulating hormone receptor, to thyroglobulin, to thyroid peroxidase) on the clinical course of endocrine ophthalmopathy (EOP), developed on the background of diffuse toxic goiter (139 patients). We studied the role of carrier of monoantibodies and their combinations. It has been proven a direct link between the presence of the analyzed thyroid autoantibodies and the clinical course of EOP. It is shown that the presence of antibodies to thyroid peroxidase and anti-thyroglobulin antibodies is not a lesser important risk factor for the development of EOP in patients with diffuse toxic goiter than the presence of antibodies to the receptor for thyroid-stimulating hormone, and the multiple carriers is associated with more frequent development of active forms of EOP and higher amplitude of inflammation of the orbit. Thus, serological indices and spectrum of thyroid antibodies revealed the depth of systemic disorders of autoimmunity, associated with an increased risk of the development of local autoimmune inflammation in the orbit and can serve as prognostic risk markers of development of highly active and severe forms of EOP.

scholarly journals A case report of thyroid-associated Orbitopathy with elevated TPO antibodies

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Radwan El Othman ◽  
Christelle Ephrem ◽  
Elsie Touma ◽  
Souheil Hallit ◽  
Rola El Othman
Keyword(s):  
Oral Treatment ◽  
Thyroid Stimulating Hormone ◽  
Extraocular Muscles ◽  
Thyroid Peroxidase ◽  
Biological Investigation ◽  
Case Presentation ◽  
Ocular Manifestations ◽  
Immune Mediated ◽  
Euthyroid Patient ◽  
Receptor Antibodies

Abstract Background Thyroid associated orbitopathy (TAO) is defined as an immune mediated inflammatory process affecting the extraocular muscles, connective and adipose tissue of uncertain etiopathogenesis. TAO are classically described in Grave’s disease (GD) however it may occur in euthyroid and hypothyroid patients. Those patients usually test positive for Thyroid Stimulating Hormone receptor antibodies (TRAb). For instance, only few cases of severe Hashimoto’s thyroiditis (HT) associated orbitopathy with negative TRAb are reported to date. Case presentation Herewith we report a rare case of a middle-aged female who presented with bilateral progressive upper and lower palpebral edema and a unilateral marked proptosis associated with asthenia, headache and decrease in visual acuity. Biological investigation was notable for high levels of anti-thyroid peroxidase antibodies (Anti-TPO) in an otherwise euthyroid patient with negative TRAb. Orbital Magnetic resonance imaging revealed edema of the extraocular muscles and inflammation of periorbital soft tissue. The patient received a treatment with intravenous methylprednisolone followed by oral treatment with prednisone. This regimen was both effective and safe with minimal metabolic side effects in our patient. Conclusion Minor ocular manifestations of HT are common; however, severe sight threatening ophtalmopathy in the absence of TRAb is rare. Multiple differential diagnosis should be considered and investigated before diagnosing this rare entity. Management of similar cases is currently based on reports and no clear guidelines have been elaborated, corticosteroids is the mainstream of treatment with a potential benefit of selenium supplementation in mild to moderate cases.

scholarly journals Second-Trimester Reference Intervals for Thyroid Tests: The Role of Ethnicity

2007 ◽  
Vol 53 (9) ◽  
pp. 1658-1664 ◽  
Author(s):  
Sonia L La’ulu ◽  
William L Roberts
Keyword(s):  
Thyroid Function ◽  
Thyroid Function Test ◽  
Reference Interval ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Adverse Outcomes ◽  
Thyroid Peroxidase ◽  
Serum Samples ◽  
Free Triiodothyronine ◽  
Thyroglobulin Autoantibodies

Abstract Background: Thyroid function changes during pregnancy, complicating the diagnosis of thyroid disorders. Maternal thyroid dysfunction has been associated with a variety of adverse outcomes. We evaluated thyroid function test results by ethnicity and week of gestation during the 2nd trimester of pregnancy. Methods: We collected 3064 blood specimens in serum tubes from Asians (13%), blacks (22%), Hispanics (23%), and whites (42%). We measured thyroid-stimulating hormone (TSH), total and free thyroxine (TT4 and FT4), total and free triiodothyronine (TT3 and FT3), thyroglobulin autoantibodies (TgAb), and thyroid peroxidase autoantibodies (TPOAb) by use of an ARCHITECT i2000SR (Abbott Diagnostics). The TSH reference interval was calculated for samples negative for both TgAb and TPOAb and reference intervals for TT4, FT4, TT3, and FT3 in antibody-negative samples with normal TSH. Results: Serum samples were positive for TgAb in 10.6%, 1.8%, 6.2%, 6.5%, and 5.9% of Asian, black, Hispanic, white, and combined groups, respectively. Samples were positive for TPOAb in 12.4%, 4.1%, 11.8%, 12.3%, and 10.4% of the same groups, respectively. The nonparametric reference intervals for all participants were 0.15–3.11 mIU/L (TSH), 9.3–15.2 pmol/L (0.72–1.18 ng/dL; FT4), 89.0–176.3 nmol/L (6.90–13.67 μg/dL; TT4), 3.82–5.96 pmol/L (2.48–3.87 pg/mL; FT3), and 1.82–3.68 nmol/L (118–239 ng/dL; TT3). Conclusions: Blacks had lower prevalences of TgAb and TPOAb positivity and of increased serum TSH. The prevalence of TgAb and TPOAb positivity was highest in Asians. Whites had the highest prevalence of increased TSH. The lower and upper reference limits of TT3 were significantly lower for Asians. Reference intervals for women in the 2nd trimester were different from those of nonpregnant individuals.

scholarly journals A Prospective Investigation of Graves' Disease and Selenium: Thyroid Hormones, Auto-Antibodies and Self-Rated Symptoms

2015 ◽  
Vol 4 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Jan Calissendorff ◽  
Emil Mikulski ◽  
Erik H. Larsen ◽  
Marika Möller
Keyword(s):  
Placebo Group ◽  
Clinical Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Depression And Anxiety ◽  
Free Triiodothyronine ◽  
Hormone Levels ◽  
Mental Symptoms ◽  
Thyroid Receptor ◽  
Receptor Antibodies

Background: In Graves' thyrotoxicosis tachycardia, weight loss and mental symptoms are common. Recovery takes time and varies between patients. Treatment with methimazole reduces thyroid hormone levels. According to previous research, this reduction has been faster if selenium (Se) is added. Objective: The objective was to investigate whether supplementing the pharmacologic treatment with Se could change the immune mechanisms, hormone levels and/or depression and anxiety. Methods: We prospectively investigated 38 patients with initially untreated thyrotoxicosis by measuring the thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), thyroid receptor antibodies and thyroid peroxidase auto-antibodies before medication and at 6, 18 and 36 weeks after commencing treatment with methimazole and levo-thyroxine, with a randomized blinded oral administration of 200 µg Se/day or placebo. The selenoprotein P concentration was determined in plasma at inclusion and after 36 weeks. The patients were also assessed with questionnaires about depression, anxiety and self-rated symptoms before medication was started and after 36 weeks. Results: FT4 decreased more in the Se group at 18 weeks (14 vs. 17 pmol/l compared to the placebo group, p = 0.01) and also at 36 weeks (15 vs. 18 pmol/l, p = 0.01). The TSH increased more in the Se group at 18 weeks (0.05 vs. 0.02 mIU/l, p = 0.04). The depression and anxiety scores were similar in both groups. In the Se group, the depression rates correlated negatively with FT3 and positively with TSH. This was not seen in the placebo group. Conclusions: Se supplementation can enhance biochemical restoration of hyperthyroidism, but whether this could shorten clinical symptoms of thyrotoxicosis and reduce mental symptoms must be investigated further.

No Connection between Long-Term Lithium Treatment and Antithyroid Antibodies

2019 ◽  
Vol 52 (05) ◽  
pp. 232-236 ◽  
Author(s):  
Agnieszka Kraszewska ◽  
Katarzyna Ziemnicka ◽  
Jerzy Sowiński ◽  
Ewa Ferensztajn-Rochowiak ◽  
Janusz K. Rybakowski
Keyword(s):  
Filtration Rate ◽  
Lithium Treatment ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Antithyroid Antibodies ◽  
Female Patients ◽  
Bipolar Patients

Abstract Introduction The studies on the effect of lithium treatment on antithyroid antibodies showed either a higher concentration of these antibodies in patients receiving lithium compared to those lithium-naive or no difference between these groups. In lithium-treated bipolar patients, some researchers pointed to an association between antithyroid antibodies and other features of thyroid dysfunction such as hypothyroidism and decrease of glomerular filtration rate. Methods We compared antithyroid antibodies in 98 patients (30 male, 68 female) with bipolar disorder, aged 62±13 years, who received lithium for 19±10 years to 39 patients (12 male, 27 female), aged 57±10 years, who were never treated with lithium. The antibodies against thyroid peroxidase (TPOAb), against thyroglobulin (TGAb), and thyroid-stimulating hormone (TSH) receptors (TSHRAb) were estimated. Results No difference in the percentages of antibodies occurrence was found between groups, although the concentrations of TGAb were higher in patients receiving lithium. In lithium-treated patients, the presence of TPOAb was associated with lower concentrations of free triiodothyronine and the presence of TGAb, with higher concentrations of TSH. In females, the levels of TGAb were associated with lower thyroid volume. The concentrations of TPOAb correlated positively with the duration of lithium therapy in males, and those of TPOAb and TGAb negatively, with such duration, in female patients. Conclusion The results obtained showed no significant connection between long-term lithium treatment and antithyroid antibodies. In bipolar patients receiving lithium longitudinally, antithyroid antibodies can be associated with some indexes of thyroid function. However, they behave differently in male and female patients.

The effect of thyroid antibody positivity on reference intervals for thyroid stimulating hormone (TSH) and free thyroxine (FT4) in an aged population

2005 ◽  
Vol 43 (12) ◽  
Author(s):  
Seija Eskelinen ◽  
Pauli Suominen ◽  
Tero Vahlberg ◽  
Minna Löppönen ◽  
Raimo Isoaho ◽  
...  
Keyword(s):  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Thyroid Peroxidase ◽  
Thyroid Antibodies ◽  
Thyroglobulin Antibodies ◽  
Thyroid Antibody ◽  
Aged Population ◽  
Antibody Positivity ◽  
Stimulating Hormone

AbstractOur aims were: 1) to analyze the effect of the methodology used to derive clinically feasible cut-off values for thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb), which exhibit highly skewed distributions; and 2) to describe the influence of thyroid antibodies on thyroid stimulating hormone (TSH) and free thyroxine (FT

scholarly journals Antithyroid autoantibodies in extrathyroid autoimmune diseases

2021 ◽  
Vol 17 (3) ◽  
pp. 234-240
Author(s):  
T.V. Sorokman ◽  
M.G. Gingulyak ◽  
O.V. Makarova
Keyword(s):  
Autoimmune Diseases ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid ◽  
Antithyroid Antibodies ◽  
Autoimmune Pathology ◽  
High Prevalence ◽  
Immunological Diseases ◽  
Antithyroid Autoantibodies

This review summarizes data on the incidence of autoimmune diseases and examines the prevalence of antithyroid antibodies in extrathyroid autoimmune diseases. In the world, about 5–7 % of the population suffers from one or another type of autoimmune diseases. Among the six most common autoimmune diseases, thyroid and associated diseases predominate. The high prevalence of autoimmune thyroid diseases raises questions about the potential role of antithyroid antibodies in the course of extrathyroid autoimmune diseases. It is believed that autoimmune di­seases are the result of interactions between triggers, autoantigens, genetic predisposition, impaired tolerance of autoantigens and mechanisms of apoptosis. Among the currently known antithyroid autoantibodies, antibodies to thyroglobulin (TgAb), thyroid peroxi­dase (TPO), as well as bispecific autoantibodies to thyroglobulin and thyroid peroxidase are of particular importance. Categories of functionally significant autoantibodies that mimic hormone function and provoke the development of autoimmune pathology as a result of binding to the receptor and subsequent stimulation of thyrocytes include antibodies to thyroid-stimulating hormone receptor (rTSH-Ab). Circulating antibodies against thyroid antigens are not limited to autoimmune diseases of the thyroid gland, but are also found in other autoimmune diseases, most often in rheumatoid arthritis, type 1 diabetes mellitus and celiac disease. The association with other immune pathologies further confirms that TPO antibodies were also detected in 15 % of patients with asthma, in 10–29 % of those with idiopathic purpura and vitiligo. The prevalence of TPO antibodies is slightly higher than TgAb, and rTSH-Ab are rarely registered in non-thyroid immunological diseases.

scholarly journals Thyroid autoimmunity and miscarriage

2004 ◽  
Vol 150 (6) ◽  
pp. 751-755 ◽  
Author(s):  
MF Prummel ◽  
WM Wiersinga
Keyword(s):  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Thyroid Autoimmunity ◽  
Case Control ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Age Difference ◽  
Thyroid Antibodies ◽  
Mild Thyroid Failure ◽  
Tsh Levels

To ascertain the strength of the association between thyroid autoimmunity and miscarriage, we performed a meta-analysis of both case-control and longitudinal studies performed since 1990 when this association was first described. A clear association between the presence of thyroid antibodies and miscarriage was found with an odds ratio (OR) of 2.73 (95 % confidence interval (CI), 2.20-3.40) in eight case-control and ten longitudinal (OR, 2.30; 95 % CI, 1.80-2.95) studies. This association may be explained by a heightened autoimmune state affecting the fetal allograft, of which thyroid antibodies are just a marker. Alternatively, the association can be partly explained by the slightly higher age of women with antibodies compared with those without (mean+/-S.D. age difference, 0.7+/-1.0 years; P<0.001). A third possibility is mild thyroid failure, as thyroid-stimulating hormone (TSH) levels in antibody-positive but euthyroid women are higher than in antibody-negative women: difference 0.81+/-0.58 mU/l (P=0.005). Randomized clinical trials with l-thyroxine (aiming at TSH values between 0.4 and 2.0 mU/l) and with selenium (to decrease antibodies against thyroid peroxidase) are clearly needed to elucidate further the nature of this association.

scholarly journals Levothyroxine to increase live births in euthyroid women with thyroid antibodies trying to conceive: the TABLET RCT

2019 ◽  
Vol 6 (11) ◽  
pp. 1-72
Author(s):  
Rima K Dhillon-Smith ◽  
Lee J Middleton ◽  
Kirandeep K Sunner ◽  
Versha Cheed ◽  
Krys Baker ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Thyroid Function ◽  
Live Birth ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Controlled Trials ◽  
Thyroid Antibodies ◽  
Thyroid Peroxidase Antibodies

Background Thyroid autoantibodies, specifically thyroid peroxidase antibodies, have been associated with miscarriage and pre-term birth in women with a normal thyroid function. Small randomised controlled trials have found that treatment with levothyroxine may reduce such adverse outcomes in pregnancy. Objectives The Thyroid AntiBodies and LEvoThyroxine (TABLET) trial was conducted to explore the effects of levothyroxine in euthyroid women with thyroid peroxidase antibodies. A concurrent mechanistic study was conducted to examine the effect of levothyroxine on immune responses. Design This was a randomised, double-blind, placebo-controlled, multicentre study. Setting The TABLET trial was conducted in 49 hospitals across the UK between 2011 and 2016. Participants Euthyroid women who tested positive for thyroid peroxidase antibodies, were aged between 16 and 41 years and were trying to conceive either naturally or through assisted conception were eligible. Intervention Participants were randomised to levothyroxine at a dose of 50 µg daily or placebo. The intervention was commenced preconception and continued until the end of a pregnancy. Women were given a 12-month period to conceive from randomisation. Main outcome measures The primary outcome was live birth at ≥ 34 completed weeks of gestation. The secondary outcomes included miscarriage at < 24 weeks; clinical pregnancy at 7 weeks; ongoing pregnancy at 12 weeks; gestation at delivery; birthweight; appearance, pulse, grimace, activity and respiration (Apgar) scores; congenital abnormalities; and neonatal survival at 28 days of life. Methods Participants were randomised in a 1 : 1 ratio. Minimisation was implemented for age (< 35 or ≥ 35 years), number of previous miscarriages (0, 1 or 2, ≥ 3), infertility treatment (yes/no) and baseline thyroid-stimulating hormone concentration (≤ 2.5 or > 2.5 mlU/l) to achieve balanced trial arms. Women were followed up every 3 months while trying to conceive to check thyroid function and general well-being, and, once pregnant, were seen each trimester: 6–8 weeks, 16–18 weeks and 28 weeks. Any abnormal thyroid results were managed in line with clinical guidance at the time. Results Of the 19,556 women screened, 1420 women were eligible and 952 were randomised to receive levothyroxine (n = 476) or placebo (n = 476). Six women from each arm either were lost to follow-up or withdrew from the trial. A total 540 women became pregnant: 266 in the levothyroxine arm and 274 in the placebo arm. The live birth rate was 37% (176/470) in the levothyroxine group and 38% (178/470) in the placebo group, translating to a relative risk of 0.97 (95% confidence interval 0.83 to 1.14; p = 0.74) and an absolute risk difference of –0.4% (95% confidence interval –6.6% to 5.8%). A subset of 49 trial participants (26 in the levothyroxine arm and 23 in the placebo arm) were recruited to assess changes in their serum chemocytokine concentrations. Treatment with levothyroxine resulted in some changes in chemocytokine concentrations in the non-pregnant state and in early pregnancy, but these had no association with clinical outcome. Conclusions Levothyroxine therapy in a dose of 50 µg per day does not improve live birth rate in euthyroid women with thyroid peroxidase antibodies. Limitations Titration of the levothyroxine dose based on thyroid-stimulating hormone/thyroid peroxidase concentrations was not explored. Future work Future research could explore the efficacy of levothyroxine administered for the treatment of subclinical hypothyroidism. Trial registration Current Controlled Trials ISRCTN15948785 and EudraCT 2011-000719-19. Funding This project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research partnership.

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