General properties of autoimmune thyroid diseases and associated morbidities

AbstractBackgroundAutoimmune thyroid diseases (ATDs) can be classified into two basic diseases: Graves’ disease (GD) and Hashimoto’s thyroiditis (HT). Here, we review the effectiveness of laboratory and imaging methods used for the early diagnosis of ATD and draw attention to methods that may improve screening.MethodsRetrospective data of 142 patients diagnosed with ATD between January 2010 and December 2015 at our paediatric endocrinology clinic were used. Sociodemographic characteristics, clinical findings, treatments and follow-up data of patients were statistically evaluated.ResultsOf the ATD cases, 81% (n = 115) were female. The median age was 12.5 ± 3.5 (range 1–17) years and 91% (n = 129) of patients were in puberty. There was a significant positive correlation between the height (standard deviation score) and follow-up time for patients with HT (r = 0.156, p < 0.01). Thyroglobulin antibody (TgAb) positivity was found in 75% (45/60) of females with a positive maternal ATD history (p = 0.045). Thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) values were significantly altered during the treatment follow-up period in female patients with GD and HT, while only fT4 values were found to be significantly altered in boys with HT.ConclusionAlthough GD and HT have similar mechanisms, they differ in terms of treatment duration and remission and relapse frequencies. Ultrasonography (USG) screening is a non-invasive procedure that is suitable for all patients with ATD. Based on our results, TgAb could be useful in the screening of girls with a history of maternal ATD.

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Simultaneous assay for three types of thyrotropin receptor antibody activities using FRTL-5 cells in patients with autoimmune thyroid diseases

Acta Endocrinologica ◽

10.1530/eje.0.1310359 ◽

1994 ◽

Vol 131 (4) ◽

pp. 359-368 ◽

Cited By ~ 5

Author(s):

Yi Zhu ◽

Luc Portmann ◽

Nicole Dénéréaz ◽

Thérèse Lemarchand-Béraud

Keyword(s):

Thyroid Function ◽

Antithyroid Drug ◽

Thyroid Diseases ◽

Thyrotropin Receptor ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Receptor Antibody ◽

Thyrotropin Receptor Antibody ◽

Number Of Patients

Zhu Y, Portmann L, Dénéréaz N. Lemarchand-Béraud T. Simultaneous assay for three types of thyrotropin receptor antibody activites using FRTL-5 cells in patients with autoimmune thyroid diseases. Eur J Endocrinol 1994;131:359–68. ISSN 0804–4643 The relationships between the different circulating thyrotropin receptor antibodies (TSH-R-abs) in autoimmune thyroid disease (AITD) are complex. In order to investigate them, we have developed an assay for the simultaneous measurement of three types of TSH-R-abs: TSH-binding inhibiting immunoglobulin (TBII); thyroid-stimulating antibody (TS-ab) and TSH-stimulation blocking antibody (TSB-ab). A large number of patients with Graves' disease (GD)—untreated and treated—Hashimoto's thyroiditis (HT), primary myxedema (PM) and non-immune goiter (NIG) were investigated. In untreated Graves' patients the frequency of positive TS-ab and TBII sera was found to be 90 and 69%, respectively, the presence of TS-ab and/or TBII being detected in 98%. After long-term antithyroid treatment administered to GD patients, the frequency of positivity of both TBII and TSab was decreased, whether hyperthyroidism was cured or not. The TSB-ab was detected in the serum of 8% of patients with GD, and the frequency of TSB-ab did not increase following treatment and alteration in thyroid function. No significant correlation was found between TSB-ab and thyroid function in Graves' patients. Besides, we found that all the GD patients presenting positive TSB-ab were also TBII positive. A follow-up study of the three TSH-R-abs was performed in 35 patients with GD during a mean of 14.3 ± 8.5 months (4–34 months) of antithyroid drug treatment. Ten out of 24 patients (42%) with positive TBII and 16 out of 32 (50%) with positive TS-ab turned from positive to negative during the time of follow-up. Regarding relapse in hyperthyroid GD, we found that TS-ab was positive in 80% and TBII was positive in 40% of the patients with Graves' relapse, indicating that the presence of TS-ab is a better index for relapse prediction in Graves' hyperthyroidism than TBII. The TSB-ab was found with higher frequency in HT and PM than in GD, i.e. 21%, 18% and 8%, respectively. The TSB-ab positivity was correlated significantly with TBII in our patients with AITD when TSB-ab was positive. This new simultaneous assay of the three TSH-R-abs should be very helpful for further investigation of the autoimmune aspects of AITD and it should help us to progress in a better understanding of the pathogeny of the different AITDs. Thérèse Lemarchand-Béraud, Division of Endocrinology and Metabolism, University Hospital (CHUV), CH-1011 Lausanne, Switzerland

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Coexistence of Autoimmune Hyper- and Hypothyroidism in a Kindred with Reduced Sensitivity to Thyroid Hormone

European Thyroid Journal ◽

10.1159/000506424 ◽

2020 ◽

Vol 9 (5) ◽

pp. 263-268

Author(s):

Yasmine Abdellaoui ◽

Dimitra Magkou ◽

Sofia Bakopoulou ◽

Ramona Zaharia ◽

Marie-Laure Raffin-Sanson ◽

...

Keyword(s):

Thyroid Hormone ◽

Thyroid Hormone Receptor ◽

Thyroid Stimulating Hormone ◽

Graves Disease ◽

Free Triiodothyronine ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Autoimmune Hypothyroidism ◽

First Time ◽

Receptor Antibodies

Introduction: Resistance to thyroid hormone beta (RTHβ) is a rare disease with an autosomal dominant transmission. Diagnosis may be challenging especially in patients with hyper- or hypothyroidism. Case Presentation: A 31-year-old male patient with suppressed thyroid-stimulating hormone (TSH), elevated free thyroxine and free triiodothyronine, along with high thyroid receptor antibodies was diagnosed with Graves’ disease. Benzylthiouracil was started. One month later, reduced sensitivity to thyroid hormones was suspected because of persistently high thyroid hormone levels contrasting with high TSH level. Molecular analysis highlighted a 10c.1357C>T p.P453S mutation in the thyroid hormone receptor beta gene (THRB). RTHβ was diagnosed. Several relatives also had RTHβ (the mother, the young son, and 2 out of 3 siblings). Autoimmune hypothyroidism was present in the mother, whereas 2 out of 3 siblings had asymptomatic autoimmunity. Discussion/Conclusion: Both Graves’ disease and autoimmune hypothyroidism were described in patients with RTHβ. We show here for the first time that autoimmune hypo- and hyperthyroidism may coexist in kindred with RTHβ. Seven previously published cases of Graves’ disease and RTHβ were retrieved and analyzed. Treatments and thyroid hormone level targets are discussed as well as the possible link between RTHβ and autoimmune thyroid diseases.

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Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?

Nutrients ◽

10.3390/nu12061769 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1769 ◽

Cited By ~ 6

Author(s):

Jovana Knezevic ◽

Christina Starchl ◽

Adelina Tmava Berisha ◽

Karin Amrein

Keyword(s):

Immune System ◽

Gut Microbiota ◽

Thyroid Function ◽

Thyroid Stimulating Hormone ◽

Thyroid Diseases ◽

Bacterial Strains ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Beneficial Effects ◽

The Impact

A healthy gut microbiota not only has beneficial effects on the activity of the immune system, but also on thyroid function. Thyroid and intestinal diseases prevalently coexist—Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) are the most common autoimmune thyroid diseases (AITD) and often co-occur with Celiac Disease (CD) and Non-celiac wheat sensitivity (NCWS). This can be explained by the damaged intestinal barrier and the following increase of intestinal permeability, allowing antigens to pass more easily and activate the immune system or cross-react with extraintestinal tissues, respectively. Dysbiosis has not only been found in AITDs, but has also been reported in thyroid carcinoma, in which an increased number of carcinogenic and inflammatory bacterial strains were observed. Additionally, the composition of the gut microbiota has an influence on the availability of essential micronutrients for the thyroid gland. Iodine, iron, and copper are crucial for thyroid hormone synthesis, selenium and zinc are needed for converting T4 to T3, and vitamin D assists in regulating the immune response. Those micronutrients are often found to be deficient in AITDs, resulting in malfunctioning of the thyroid. Bariatric surgery can lead to an inadequate absorption of these nutrients and further implicates changes in thyroid stimulating hormone (TSH) and T3 levels. Supplementation of probiotics showed beneficial effects on thyroid hormones and thyroid function in general. A literature research was performed to examine the interplay between gut microbiota and thyroid disorders that should be considered when treating patients suffering from thyroid diseases. Multifactorial therapeutic and preventive management strategies could be established and more specifically adjusted to patients, depending on their gut bacteria composition. Future well-powered human studies are warranted to evaluate the impact of alterations in gut microbiota on thyroid function and diseases.

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Significance of Circulating Anti-Thyroid Stimulating Hormone (TSH) Receptor Antibodies in Patients with Autoimmune Thyroid Diseases

Journal of UOEH ◽

10.7888/juoeh.11.393 ◽

1989 ◽

Vol 11 (4) ◽

pp. 393-401

Author(s):

Takashi FUJIHIRA

Keyword(s):

Thyroid Stimulating Hormone ◽

Thyroid Diseases ◽

Tsh Receptor ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Receptor Antibodies ◽

Tsh Receptor Antibodies ◽

Stimulating Hormone

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There Is No Elevation of Immunoglobulin E Levels in Albanian Patients with Autoimmune Thyroid Diseases

Journal of Thyroid Research ◽

10.1155/2014/283709 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Hatixhe Latifi-Pupovci ◽

Besa Gacaferri-Lumezi ◽

Violeta Lokaj-Berisha

Keyword(s):

Immunoglobulin E ◽

Allergic Diseases ◽

Serum Levels ◽

Thyroid Stimulating Hormone ◽

Thyroid Diseases ◽

Control Group ◽

Graves Disease ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Significant Difference

Background. Studies in several ethnic groups reported high incidence of elevated levels of immunoglobulin E (IgE) in patients with autoimmune thyroid diseases (ATD), especially in patients with Graves’ disease.Objective. To study association between serum levels of IgE and thyroid stimulating hormone receptor antibodies (TRAb) in Albanian patients with ATD.Material and Methods. Study was performed in 40 patients with Graves’ disease, 15 patients with Hashimoto’s thyroiditis, and 14 subjects in the control group. The IgE levels were measured by immunoradiometric assay, whereas the TRAb levels were measured by radioreceptor assay.Results. In all groups of subjects the IgE levels were within reference values (<200 kIU/L). Significant difference in mean concentration of IgE was found between two groups of Graves’ disease patients, and those with normal and elevated TRAb levels (22.57 versus 45.03,P<0.05). Positive correlation was found between TRAb and IgE only in Graves’ disease patients (r=0.43,P=0.006).Conclusion. In Albanian patients with ATD there is no elevation of IgE levels. This could be the result of low prevalence of allergic diseases in Albanian population determined by genetic and environmental factors.

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Implication of VDR rs7975232 and FCGR2A rs1801274 gene polymorphisms in the risk and the prognosis of autoimmune thyroid diseases in the Tunisian population

Balkan Journal of Medical Genetics ◽

10.2478/bjmg-2020-0011 ◽

2020 ◽

Vol 23 (1) ◽

pp. 69-76

Author(s):

S Mestiri ◽

I Zaaber ◽

I Nasr ◽

H Marmouch

Keyword(s):

Fragment Length Polymorphism ◽

Thyroid Diseases ◽

Tunisian Population ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Thyroglobulin Antibody ◽

Significant Difference ◽

Pcr Rflp ◽

Mutation System ◽

Polymerase Chain

AbstractHashimoto’s thyroiditis (HT) and Graves’ disease (GD) are autoimmune thyroid diseases (AITD) that cause hypothyroidism and hyperthyroidism, respectively. The vitamin D receptor (VDR) and the Fey receptor IIA (FcγRIIA), are implicated in the etiology of AITD. This study was conducted to examine the implication of VDR rs7975232 and FCGR2A rs 1801274 variations in the susceptibility and the prognosis of AITD in the Tunisian population. The rs7975232 and rs1801274 (R131H) polymorphisms were analyzed in 162 controls and 162 AITD patients (106 HT and 56 GD) by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and amplification of refractory mutation system-PCR (ARMS-PCR), respectively. No significant difference was demonstrated for the rs7975232 between patients and controls. However, a significant association was shown between the rs1801274 polymorphism and AITD or HT in the dominant (p = 0.03 or p = 0.01), codominant (p = 0.019 or p = 0.026) and allelic (p = 0.011 or p = 0.012) models. The rs7975232 was associated with the absence or the presence of anti-thyroglobulin antibody, with the age of AITD and GD patients during the first diagnosis (p = 0.01 and p = 0.009, respectively) and with a high T4 level at the beginning of HT disease. However, the FCGR2A gene polymorphism was associated with a low T4 level at the beginning of GD disease. In conclusion, this study indicates that only the FCGR2A variation could be related to AITD and HT susceptibility and that VDR and FCGR2A gene variations constitute factors to prognosticate the severity of AITD, HT and GD.

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