scholarly journals Restricted thyroglobulin antibody epitope specificities in subjects with type 1 diabetes mellitus

2009 ◽  
Vol 161 (3) ◽  
pp. 489-493 ◽  
Author(s):  
O E Okosieme ◽  
C N Wijeyaratne ◽  
J H Lazarus ◽  
L D K E Premawardhana
Keyword(s):  
Thyroid Peroxidase ◽  
Thyroglobulin Antibodies ◽  
Autoimmune Thyroid ◽  
Thyroglobulin Antibody ◽  
High Prevalence ◽  
Patients At Risk ◽  
Healthy Control ◽  
A Prospective Study ◽  
Design And Methods

ObjectivesFollowing iodisation in Sri Lanka we observed a high prevalence of thyroglobulin antibodies (TgAbs) in type 1 diabetic (T1DM) patients. The clinical significance of these TgAbs is uncertain. We sought to obtain a detailed epitope analysis of TgAbs in T1DM patients recruited from diabetes clinics and to compare these with TgAb epitope specificities in patients with autoimmune thyroid disease (AITD) and healthy individuals in that country.Design and methodsWe used a panel of 10 Tg-MAbs in competitive ELISA reactions in a prospective study of subjects recruited from Colombo, to determine the epitopes recognised by TgAb-positive patients with T1DM (n=58, 34F:24M, median age 16 years), AITD patients (n=42, 33F:9M, median age 37 years) and healthy subjects (n=50, 39F:11M, median age 27 years). The outcomes were a comparison of reactivity with six Tg clusters (I–VI) in these subjects, and the relation of epitope specificity patterns with free thyroxine and TSH.ResultsPatients with T1DM and AITD but not healthy control subjects preferentially recognised the immunodominant clusters, I, III and IV. Patients with these narrow epitope specificities had higher median TSH levels (1.60 vs 1.06;P=0.01), and were more frequently positive for antibodies to thyroid peroxidase than those with broad specificities (52.3 vs 7.1%;P=0.004).ConclusionsThe TgAb epitope specificities in euthyroid Sri Lankans with T1DM are similar to AITD patients. TgAb epitope studies may potentially identify T1DM patients at risk of thyroid dysfunction.

scholarly journals A prospective study of thyroid function, morphology and autoimmunity in young patients with type 1 diabetes

2003 ◽  
pp. 245-251 ◽  
Author(s):  
D Hansen ◽  
FN Bennedbaek ◽  
M Hoier-Madsen ◽  
L Hegedus ◽  
BB Jacobsen
Keyword(s):  
Type 1 Diabetes ◽  
Thyroid Dysfunction ◽  
Young Patients ◽  
Thyroid Peroxidase ◽  
Diabetic Patients ◽  
Specific Marker ◽  
Autoimmune Thyroid ◽  
High Prevalence

OBJECTIVE: Thyroid autoantibodies (TA) and thyroid ultrasonography are widely used in the diagnosis of autoimmune thyroid disease (AITD). However, we know little of the significance of having ultrasonographic abnormalities (USabn) without having any other signs of AITD. In a previous population-based study of 105 young patients with type 1 diabetes (T1DM) we found a high prevalence (42%) of USabn. In the present study we evaluate the development of both USabn and TA in a 3-Year follow-up of this cohort. DESIGN: Of the 105 previously investigated children and adolescents with T1DM (aged 5-21 Years), 101 were re-examined. Serum concentrations of tri-iodothyronine (T(3)), thyroxine (T(4)), TSH, thyroid peroxidase antibodies (TPOab) and thyroglobulin antibodies (Tgab), as well as thyroid size and morphology were determined in all patients. RESULTS: During the 3 Years follow-up period, the prevalence of thyroid dysfunction increased from 5 to 8%, the prevalence of TPOab was unchanged at 13%, while the prevalence of Tgab decreased from 14 to 7%. The prevalence of USabn increased from 42 to 49%. Most patients presented USabn at both examinations. Patients with USabn had a higher prevalence of TA than those without USabn (P=0.038) and higher serum levels of TSH (P=0.027). All patients with thyroid dysfunction presented with USabn. However, many patients with USabn had no other signs of AITD. CONCLUSIONS: A high prevalence of thyroid dysfunction, TA and thyroid USabn were found in young patients with T1DM. Thyroid USabn was a sensitive but non-specific marker of AITD and is therefore unsuitable for screening purposes. Instead, we recommend regular screening using serum TSH in the follow-up of young diabetic patients.

scholarly journals Seasonality of month of birth of patients with Graves’ and Hashimoto’s diseases differ from that in the general population

2007 ◽  
Vol 156 (6) ◽  
pp. 631-636 ◽  
Author(s):  
Gerasimos E Krassas ◽  
Konstantinos Tziomalos ◽  
Nikolaos Pontikides ◽  
Hadas Lewy ◽  
Zvi Laron
Keyword(s):  
General Population ◽  
Perinatal Period ◽  
Thyroid Peroxidase ◽  
Month Of Birth ◽  
Autoimmune Thyroid ◽  
Common Etiology ◽  
Antibody Titers ◽  
Low Levels ◽  
Antibody Levels

Objective: We aimed to test the viral hypothesis in the pathogenesis of autoimmune thyroid disease (AITD). Design: We determined the pattern of month of birth (MOB) distribution in patients with AITD and in the general population and searched for differences between them. Methods: A total of 1023 patients were included in this study; 359 patients had Graves’ hyperthyroidism (GrH) and 664 had Hashimoto’s hypothyroidism (HH). We divided the patients with HH into three subgroups according to their thyroid peroxidase (TPO) antibody titers at diagnosis: low levels (<500 IU/ml), high levels (500–1000 IU/ml), and extremely high levels (>1000 IU/ml). We used cosinor analysis to analyze the data. Results: Overall, patients with GrH and HH had a different pattern of MOB distribution when compared with the general population and between groups. Furthermore, among both patients with GrH and HH, both genders had a different pattern of MOB distribution when compared with the general population and this pattern was also different between genders. Finally, only women with extremely high titers of TPO antibodies at diagnosis and men with low or extremely high TPO antibody levels showed rhythmicity in MOB, with a pattern of MOB distribution different from that in controls. Conclusions: The different MOB seasonality in both GrH and HH points towards a similar maybe even common etiology with type 1 diabetes mellitus and multiple sclerosis, namely a seasonal viral infection as the initial trigger in the perinatal period, the clinical disease resulting from further specific damage over time.

scholarly journals Increased prevalence of thyroglobulin antibodies in Sri Lankan schoolgirls--is iodine the cause?

2000 ◽  
pp. 185-188 ◽  
Author(s):  
LD Premawardhana ◽  
AB Parkes ◽  
PP Smyth ◽  
CN Wijeyaratne ◽  
A Jayasinghe ◽  
...  
Keyword(s):  
Iodine Deficiency ◽  
Age Groups ◽  
Thyroid Volume ◽  
Thyroid Peroxidase ◽  
Sri Lankan ◽  
Free T4 ◽  
Thyroglobulin Antibodies ◽  
Age Related ◽  
High Prevalence ◽  
Urine Iodine

OBJECTIVE: Iodine deficiency was the likely cause of a high prevalence of goitre previously in Sri Lankan schoolchildren. Salt iodination was made compulsory in 1993 but there has been no recent study, using modern techniques, of its benefits or harmful effects. METHODS: Three hundred and sixty-seven schoolgirls between the ages of 11 and 16 years had ultrasound thyroid volume, free thyroxine (T4), free tri-iodothyronine (T3), thyrotrophin (TSH), anti-thyroglobulin (TgAb) and thyroid peroxidase (TPOAb) antibodies, and urine iodine concentrations measured. RESULTS: Median ultrasound thyroid volume ranged from 4.8 ml (11-year-old girls) to 8.6 ml (16-year-old girls) with an age-related increase. Median urine iodine concentrations ranged from 105 to 152 microg/l. Free T4 and free T3 were normal in all, but TSH was elevated in four subjects (5. 53-41.29 mU/l). However, the prevalence of TgAb was markedly raised, ranging between 14.3% (11-year-old girls) and 69.7% (16-year-old girls) (P<0.03). In contrast, the prevalence of TPOAb was 10% or less in all age groups. CONCLUSIONS: Normal median thyroid volumes, iodine concentrations and thyroid function would indicate that iodine deficiency is not a major problem in this group. The high prevalence of TgAb, hitherto unreported, most likely reflects excessive iodination of Tg resulting in increased immunogenicity. There is an urgent need to continuously monitor the adequacy and risks of iodination in this population.

scholarly journals Development of Graves' Disease After SARS-CoV-2 mRNA Vaccination: A Case Report and Literature Review

2021 ◽  
Vol 9 ◽  
Author(s):  
David Tak Wai Lui ◽  
Ka Kui Lee ◽  
Chi Ho Lee ◽  
Alan Chun Hong Lee ◽  
Ivan Fan Ngai Hung ◽  
...  
Keyword(s):  
Thyroid Dysfunction ◽  
Chinese Woman ◽  
Thyroid Peroxidase ◽  
Graves Disease ◽  
Immunoglobulin Level ◽  
Thyroglobulin Antibodies ◽  
Old Chinese ◽  
Autoimmune Thyroid ◽  
Diffuse Goiter ◽  
History Of

Background: Mounting evidence has revealed the interrelationship between thyroid and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to explain the thyroid dysfunction and autoimmune thyroid disorders observed after coronavirus disease 2019 (COVID-19). There are limited reports of thyroid dysfunction after SARS-CoV-2 vaccination.Methods: We report a case of a 40-year-old Chinese woman who developed Graves' disease after BNT162b2 mRNA vaccine. A search of PubMed and Embase databases from 1 September 2019 to 31 August 2021 was performed using the following keywords: “COVID,” “vaccine,” “thyroid,” “thyroiditis,” and “Graves.”Results: A 40-year-old Chinese woman who had 8-year history of hypothyroidism requiring thyroxine replacement. Her anti-thyroid peroxidase and anti-thyroglobulin antibodies were negative at diagnosis. She received her first and second doses of BNT162b2 mRNA vaccine on 6 April and 1 May 2021, respectively. She developed thyrotoxicosis and was diagnosed to have Graves' disease 5 weeks after the second dose of vaccine, with positive thyroid stimulating immunoglobulin level, diffuse goiter with hypervascularity on thyroid ultrasonography and diffusely increased thyroid uptake on technetium thyroid scan. Both anti-thyroid peroxidase and anti-thyroglobulin antibodies became positive. She was treated with carbimazole. Literature search revealed four cases of Graves' disease after SARS-CoV-2 vaccination, all after mRNA vaccines; and nine cases of subacute thyroiditis, after different types of SARS-CoV-2 vaccines.Conclusion: Our case represents the fifth in the literature of Graves' disease after SARS-CoV-2 vaccination, with an unusual presentation on a longstanding history of hypothyroidism. Clinicians should remain vigilant about potential thyroid dysfunction after SARS-CoV-2 vaccination in the current pandemic.

Autoimmune polyglandular syndromes in the adults: the genetic and immunological diagnostic criteria

2014 ◽  
Vol 60 (3) ◽  
pp. 43-52 ◽  
Author(s):  
A A Larina ◽  
E A Troshina ◽  
O N Ivanova
Keyword(s):  
Adrenal Insufficiency ◽  
Thyroid Diseases ◽  
Primary Adrenal Insufficiency ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid ◽  
Aire Gene ◽  
Patients At Risk ◽  
Type 3 ◽  
Cortical Dysfunction

At present, four main types of autoimmune polyglandular syndromes (APS) are distinguished. Type 1 APS is associated with candidiasis, primary hypoparathyroidism, and primary adrenal insufficiency developing in the childhood as a result of mutations in the AIRE gene. Type 2 APS involves primary adrenal insufficiency in combination with autoimmune thyroid diseases and/or type 1 diabetes mellitus. Type 3 APS is characterized by the combination of autoimmune thyroid diseases with other endocrine and non-endocrine autoimmune pathologies in the absence of adrenal cortical dysfunction and hypoparathyriodism. Type 4 APS is presented by the combinations of autoimmune diseases other than the aforementioned ones. The above syndromes usually manifest themselves at the age between 20 and 60 years; they are of the polygenic type and associated with the genetic markers, such as HLAII-complex haplotypes, CTLA-4, PTPN22, FOXP3 genes, etc. In addition, the latent forms of APS have been described that occur in the populations much more frequently than the manifest disorders. These latent diseases can exert strong influence on the compensation and risk of complications of the underlying pathology. Of great importance in this context is the timely identification of the groups of patients at risk of developing clinical forms of APS among the subjects presenting with a single endocrine pathology.

Thyroid peroxidase antibodies are common in children with HLA-conferred susceptibility to type 1 diabetes, but are weakly associated with thyroid function

2020 ◽  
Vol 33 (8) ◽  
pp. 1027-1030
Author(s):  
Liisa Saare ◽  
Aleksandr Peet ◽  
Vallo Tillmann
Keyword(s):  
Type 1 Diabetes ◽  
Thyroid Function ◽  
Thyroid Autoimmunity ◽  
Risk Groups ◽  
Thyroid Peroxidase ◽  
Cross Sectional ◽  
Autoimmune Thyroid ◽  
Thyroid Peroxidase Antibodies ◽  
Hla Dq

AbstractObjectivesThe need for screening for autoimmune thyroid disease in children who have HLA-conferred susceptibility to type 1 diabetes (T1D), but have not yet been diagnosed with T1D, has not been thoroughly studied. The aim of this study was to describe the prevalence of positive thyroid peroxidase antibodies and its effect on thyroid function in children with genetic susceptibility to T1D as well as to describe the association between thyroid autoimmunity and HLA-DQ genotypes.MethodsCross-sectional study in 223 children (112 boys) aged 7.4–10.5 years with HLA-conferred susceptibility to T1D. TPOAb were measured in all children; thyroglobulin antibodies (TGAb) and thyroid function in TPOAb positive subjects.ResultsGirls had a significantly higher median TPOAb concentration than boys (12 vs 11 kU/L; p=0.001). Positive TPOAb occurred in 13.9% and positive TGAb in 4% of subjects. Only two children had mild changes in thyroid function. There was no association between HLA risk groups and the prevalence of TPOAb.ConclusionsTPOAb are common in children with HLA-conferred susceptibility to T1D, yet are weakly associated with thyroid function, suggesting limited value of thyroid screening in this cohort.

scholarly journals Pandora’s Box: Autoimmune Hypothyroidism Treatment During Pregnancy

2021 ◽  
Vol 28 (4) ◽  
pp. 401-405
Author(s):  
Florina-Paula PAULET ◽  
◽  
Claudia MEHEDINTU ◽  
Marina ANTONOVICI ◽  
Monica Mihaela CIRSTOIU ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Autoimmune Thyroid Disease ◽  
Descriptive Study ◽  
Thyroid Stimulating Hormone ◽  
Obstetrics And Gynecology ◽  
Thyroid Peroxidase ◽  
Thyroglobulin Antibodies ◽  
Autoimmune Thyroid ◽  
Autoimmune Hypothyroidism ◽  
Immunological Markers

There are international protocols for the management of hypothyroidism induced by autoimmune thyroid disease during pregnancy. In this descriptive study, we analyzed the implementation of international protocols regarding these pathologies, in local clinical practice. Analyzing the cases admitted to the Obstetrics and Gynecology department of Bucharest University Emergency Hospital on a period of 55 months, we identified the pregnancies with autoimmune hypothyroidism treated with Levothyroxine (LT4). We determined the prevalence of specific immunological markers for autoimmune hypothyroidism in pregnant women, we analyzed whether they are associated with distinct clinical phenotypes and ultrasound characteristics, and also, we evaluated the treatment of choice. Measurement of thyroglobulin antibodies, thyroid peroxidase antibodies, Thyroid-Stimulating Hormone, free fractions of Triiodothyronine and Thyroxine with substitute treatment instituted early (in the first 2 weeks postnatal) determine the normalization of cognitive development, especially in areas known for iodine deficiency, including Romania.

scholarly journals Evaluation of serum anti-Mullerian hormone levels in women with Hashimoto thyroiditis in the reproductive age

2020 ◽  
Author(s):  
Ilknur Ozturk Unsal ◽  
Sema Hepsen ◽  
Pinar Akhanli ◽  
Murat Calapkulu ◽  
Muhammed Erkam Sencar ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Thyroid Autoimmunity ◽  
Premenopausal Women ◽  
Hashimoto Thyroiditis ◽  
Reproductive Age ◽  
Control Group ◽  
Autoimmune Thyroid ◽  
High Prevalence ◽  
Healthy Control ◽  
Antibody Levels

Abstract Background Autoimmune thyroid disease in women is associated with subfertility and early pregnancy loss, and patients with primary ovarian insufficiency have a high prevalence of thyroid autoimmune disorders. The aim of this study was to investigate the association between Hashimoto thyroiditis and ovarian reserve. Methods Levels of serum thyroid stimulating hormones, thyroid autoantibodies, and anti-Mullerian hormone (AMH) were measured in women with Hashimoto thyroiditis (HT) and a healthy control group between 2018 and 2019. Result Evaluation was made of 108 premenopausal women with Hashimoto thyroiditis. A control group was formed of 172 healthy female subjects with normal anti-thyroid antibody levels and thyroid function. Serum AMH levels were determined to be significantly lower in the HT group compared to the control group. Conclusion Ovarian reserve evaluated by serum AMH concentration is affected by thyroid autoimmunity independently of anti-thyroid antibodies type or titers.

scholarly journals Predicting difficulty of thyroidectomy preoperatively

2017 ◽  
Vol 4 (5) ◽  
pp. 1605
Author(s):  
Alex Oommen ◽  
Vaisagh Remin
Keyword(s):  
Statistical Analysis ◽  
High Volume ◽  
Thyroid Peroxidase ◽  
Postoperative Hypocalcemia ◽  
Thyroglobulin Antibodies ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody ◽  
Duration Of Surgery ◽  
Difficulty Scale ◽  
Common Operation

Background: Today, thyroidectomy is a common operation used to treat various thyroid disorders. Nowadays, many high-volume thyroid surgeons are discharging patients on the same day of thyroidectomy. The incidence of complications following thyroidectomy is directly linked to the difficulty of the procedure. So, if we can predict the difficulty of thyroidectomy preoperatively, we can anticipate complications and decide on which patients will require in-patient care.Methods: A thyroidectomy difficulty scale was developed by Schneider and colleagues. This scale was used in our study to classify patients in to difficult thyroidectomy group and non-difficult thyroidectomy group. The association between preoperative variables and difficulty of thyroidectomy was studied.Results: Statistical analysis revealed that there was a significant association between hyperthyroidism and difficult thyroidectomy. Similarly, there was a significant association between positive anti-thyroid peroxidase antibody (which defines Hashimoto’s thyroiditis) and difficult thyroidectomy. Also, there was a significant association between positive anti-thyroglobulin antibody and difficult thyroidectomy. Difficult thyroidectomy was found to have a significant association with postoperative hypocalcemia. Statistical analysis also showed duration of surgery to have a significant association with difficulty of thyroidectomyConclusions: Patients with hyperthyroidism, positive anti-thyroid peroxidase antibodies, positive anti-thyroglobulin antibodies have a high probability of a difficult thyroidectomy, associated with longer operative times and increased complications. This information can improve preoperative risk counseling and lead to more efficient scheduling of the operating room.

Sign in / Sign up

Export Citation Format

Share Document