Autoimmune Thyroid Disease with Fluctuating Thyroid Function

Thyroid function was assessed in 94 patients with rheumatic heart disease presenting consecutively to a cardiology clinic. Despite previous reports of an association with autoimmune thyroid disease, abnormal thyroid function occurred no more commonly in this group than would be anticipated in a normal population.

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Association between PCOS and autoimmune thyroid disease: a systematic review and meta-analysis

Endocrine Connections ◽

10.1530/ec-18-0309 ◽

2018 ◽

Vol 7 (11) ◽

pp. 1158-1167 ◽

Cited By ~ 8

Author(s):

Mírian Romitti ◽

Vitor C Fabris ◽

Patricia K Ziegelmann ◽

Ana Luiza Maia ◽

Poli Mara Spritzer

Keyword(s):

Systematic Review ◽

Thyroid Function ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Reference Group ◽

Polycystic Ovary ◽

Meta Analysis ◽

Reproductive Age ◽

Cross Sectional ◽

Autoimmune Thyroid

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder affecting women of reproductive age. PCOS has been associated with distinct metabolic and cardiovascular diseases and with autoimmune conditions, predominantly autoimmune thyroid disease (AITD). AITD has been reported in 18–40% of PCOS women, depending on PCOS diagnostic criteria and ethnicity. The aim of this systematic review and meta-analysis was to summarize the available evidence regarding the likelihood of women with PCOS also having AITD in comparison to a reference group of non-PCOS women. We systematically searched EMBASE and MEDLINE for non-interventional case control, cross-sectional or cohort studies published until August 2017. The Ottawa–Newcastle Scale was used to assess the methodological quality of studies. Statistical meta-analysis was performed with R. Thirteen studies were selected for the present analysis, including 1210 women diagnosed with PCOS and 987 healthy controls. AITD was observed in 26.03 and 9.72% of PCOS and control groups respectively. A significant association was detected between PCOS and chance of AITD (OR = 3.27, 95% CI 2.32–4.63). Notably, after geographical stratification, the higher risk of AITD in PCOS women persisted for Asians (OR = 4.56, 95% CI 2.47–8.43), Europeans (OR = 3.27, 95% CI 2.07–5.15) and South Americans (OR = 1.86, 95% CI 1.05–3.29). AIDT is a frequent condition in PCOS patients and might affect thyroid function. Thus, screening for thyroid function and thyroid-specific autoantibodies should be considered in patients with PCOS even in the absence of overt symptoms. This systematic review and meta-analysis is registered in PROSPERO under number CRD42017079676.

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Thyroid Disease in Pregnancy

US Endocrinology ◽

10.17925/use.2008.04.01.100 ◽

2008 ◽

Vol 04 (01) ◽

pp. 100

Author(s):

N Pearce Elizabeth ◽

M Leung Angela

Keyword(s):

Pregnant Women ◽

Thyroid Function ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Thyroid Dysfunction ◽

Thyroid Function Test ◽

Autoimmune Thyroid ◽

Thyroid Screening ◽

Function Test ◽

In Pregnancy

The spectrum of thyroid disease in pregnancy has implications for both the mother and the developing fetus. Here we review the interpretation of thyroid function test values, thyrotoxicosis, hypothyroidism, iodine requirements, autoimmune thyroid disease, and thyroid screening recommendations as they pertain to pregnant women. It should be noted that the management of thyroid dysfunction in pregnancy should be closely co-ordinated with obstetricians and other providers.

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Expression levels of the thyrotropin receptor gene in autoimmune thyroid disease: coregulation with parameters of thyroid function and inverse relation to major histocompatibility complex classes I and II

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.76.5.1349 ◽

1993 ◽

Vol 76 (5) ◽

pp. 1349-1356 ◽

Cited By ~ 2

Author(s):

F. Schuppert

Keyword(s):

Major Histocompatibility Complex ◽

Thyroid Function ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Receptor Gene ◽

Thyrotropin Receptor ◽

Inverse Relation ◽

Expression Levels ◽

Autoimmune Thyroid ◽

Histocompatibility Complex

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Antibody-induced modulation of TSH receptor post-translational processing

Journal of Endocrinology ◽

10.1677/joe-07-0058 ◽

2007 ◽

Vol 195 (1) ◽

pp. 179-186 ◽

Cited By ~ 13

Author(s):

Takao Ando ◽

Rauf Latif ◽

Terry F Davies

Keyword(s):

Amino Acid ◽

Thyroid Function ◽

Thyroid Disease ◽

Antigen Processing ◽

Autoimmune Thyroid Disease ◽

Neutral Type ◽

Tsh Receptor ◽

Neutral Group ◽

Α Subunit ◽

Autoimmune Thyroid

The post-translational processing of the TSH receptor (TSHR) includes intra-molecular cleavage with the loss of a 50 amino acid ectodomain region and the formation of two subunits (α and β), followed by likely α subunit shedding. TSHR antibodies (TSHR-Abs), which are directed at the ectodomain, may influence thyroid function by stimulating or inhibiting TSHR signaling or may bind without any such influence (the neutral group of antibodies). When we examined the characteristics of a series of monoclonal TSHR-Abs, we found that many were able to inhibit receptor cleavage and enhance TSHR expression. This was especially apparent with the neutral type of TSHR-Abs directed to the cleaved region of the ectodomain (aa 316–366). Indeed, such inhibition appeared to be epitope dependent with TSHR-Abs directed to regions after residues 335–354 showing no such activity. We propose that this aberrant process, whereby TSHR-Abs influence antigen processing, is a novel mechanism for the maintenance and exacerbation of autoimmune thyroid disease.

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Thyroid Function, Lipid Profile, Insulin Resistance, Homocysteine and High Sensitivity C-Reactive Protein in Patients with Autoimmune Thyroid Disease.

10.1210/endo-meetings.2010.part3.p12.p3-580 ◽

2010 ◽

pp. P3-580-P3-580

Author(s):

C Neves ◽

R Ramalho ◽

C Guimaraes ◽

M Beltrao ◽

M Alves ◽

...

Keyword(s):

Insulin Resistance ◽

Lipid Profile ◽

Thyroid Function ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

High Sensitivity ◽

C Reactive Protein ◽

Autoimmune Thyroid ◽

Reactive Protein

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Thyroid Function and Human Reproductive Health

Endocrine Reviews ◽

10.1210/er.2009-0041 ◽

2010 ◽

Vol 31 (5) ◽

pp. 702-755 ◽

Cited By ~ 504

Author(s):

G. E. Krassas ◽

K. Poppe ◽

D. Glinoer

Keyword(s):

Thyroid Function ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Controlled Ovarian Hyperstimulation ◽

Male Reproduction ◽

Antithyroid Drugs ◽

Premature Delivery ◽

Ovarian Hyperstimulation ◽

Autoimmune Thyroid ◽

The Impact

Via its interaction in several pathways, normal thyroid function is important to maintain normal reproduction. In both genders, changes in SHBG and sex steroids are a consistent feature associated with hyper- and hypothyroidism and were already reported many years ago. Male reproduction is adversely affected by both thyrotoxicosis and hypothyroidism. Erectile abnormalities have been reported. Thyrotoxicosis induces abnormalities in sperm motility, whereas hypothyroidism is associated with abnormalities in sperm morphology; the latter normalize when euthyroidism is reached. In females, thyrotoxicosis and hypothyroidism can cause menstrual disturbances. Thyrotoxicosis is associated mainly with hypomenorrhea and polymenorrhea, whereas hypothyroidism is associated mainly with oligomenorrhea. Thyroid dysfunction has also been linked to reduced fertility. Controlled ovarian hyperstimulation leads to important increases in estradiol, which in turn may have an adverse effect on thyroid hormones and TSH. When autoimmune thyroid disease is present, the impact of controlled ovarian hyperstimulation may become more severe, depending on preexisting thyroid abnormalities. Autoimmune thyroid disease is present in 5–20% of unselected pregnant women. Isolated hypothyroxinemia has been described in approximately 2% of pregnancies, without serum TSH elevation and in the absence of thyroid autoantibodies. Overt hypothyroidism has been associated with increased rates of spontaneous abortion, premature delivery and/or low birth weight, fetal distress in labor, and perhaps gestation-induced hypertension and placental abruption. The links between such obstetrical complications and subclinical hypothyroidism are less evident. Thyrotoxicosis during pregnancy is due to Graves’ disease and gestational transient thyrotoxicosis. All antithyroid drugs cross the placenta and may potentially affect fetal thyroid function.

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Autoantibodies against complement C1q correlate with the thyroid function in patients with autoimmune thyroid disease

Clinical & Experimental Immunology ◽

10.1111/j.1365-2249.2008.03670.x ◽

2008 ◽

Vol 153 (1) ◽

pp. 96-101 ◽

Cited By ~ 15

Author(s):

E. Potlukova ◽

J. Jiskra ◽

Z. Limanova ◽

P. Kralikova ◽

D. Smutek ◽

...

Keyword(s):

Thyroid Function ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Autoimmune Thyroid ◽

Complement C1q

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Autoantibodies against complement C1q correlate with the thyroid function in patients with autoimmune thyroid disease

Molecular Immunology ◽

10.1016/j.molimm.2007.06.079 ◽

2007 ◽

Vol 44 (16) ◽

pp. 3941 ◽

Cited By ~ 1

Author(s):

Eliska Potlukova ◽

Jan Jiskra ◽

Zdenka Limanova ◽

Petra Sandova ◽

Daniel Smutek ◽

...

Keyword(s):

Thyroid Function ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Autoimmune Thyroid ◽

Complement C1q

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“Small Thyroid Gland” in Reproductive Women without Autoimmune Thyroid Disease—Ultrasonographic Evaluation as a Useful Screening Tool for Hypothyroidism

Journal of Clinical Medicine ◽

10.3390/jcm10091828 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1828

Author(s):

Justyna Milczarek-Banach ◽

Piotr Miśkiewicz

Keyword(s):

Thyroid Gland ◽

Thyroid Function ◽

Predictive Factor ◽

Thyroid Disease ◽

Autoimmune Thyroid Disease ◽

Thyroid Volume ◽

Childbearing Age ◽

Cross Sectional ◽

Autoimmune Thyroid ◽

Tsh Levels

Proper thyroid function is important for women of childbearing age, as hypothyroidism affects fertility, pregnancy and offspring. The upper reference limit for thyrotropin (TSH) in pregnancy was defined as <2.5 mU/L in the first trimester. Recommendations include either universal screening of TSH before pregnancy, or identifying individuals at “high risk” for thyroid illness. “Small thyroid gland” not associated with autoimmune thyroid disease (AITD) seems to be a reason for hypothyroidism and probably should be included in target case finding procedure before pregnancy. The purpose of this cross-sectional study was to analyze relationships between the thyroid volume and its function, and to determine the thyroid volume as a predictive factor for TSH levels above 2.5 µIU/mL in reproductive women without AITD. We included 151 women without AITD, and aged 18–40. Blood and urine samples were analyzed for parameters of thyroid function. Ultrasound examination of the thyroid was performed. The thyroid volume was negatively correlated with TSH. Women with a thyroid volume in the 1st quartile for the study population presented higher TSH levels versus women in the 4th quartile (p = 0.0132). A thyroid volume cut-off point of 9 mL was the predictive factor for TSH levels above 2.5 µIU/mL (p = 0.0037).

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