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.

The Antibody Response in Human Autoimmune Thyroid Disease

1997 ◽  
Vol 92 (6) ◽  
pp. 529-541 ◽  
Author(s):  
Richard S. McIntosh ◽  
M. Suhail Asghar ◽  
Anthony P. Weetman
Keyword(s):  
Antibody Response ◽  
Thyroid Disease ◽  
Hormone Receptor ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
Thyroid Autoantigens ◽  
Reactive Antibody ◽  
Stimulating Hormone

1. The analysis of the antibody response in autoimmune thyroid disease has followed several historical trends. It was the investigation of thyroid-reactive antibody that allowed the initial characterization of the three principle thyroid autoantigens, thyroglobulin, thyroid peroxidase and the thyroid stimulating hormone receptor. 2. Analysis can be grouped under two broad areas: analysis of the physiological and pathological effects of the antibody, and analysis of the structure of the antibodies themselves. This review will focus on the latter. 3. Within recent years there has been a great increase in knowledge of thyroid-reactive antibody structure, principally through the adoption of phage display combinatorial library methodologies. While this latter technique has established some general principles for antibodies to thyroglobin and especially thyroid peroxidase, there is still a substantial gap in our knowledge of the antibody response to the thyroid stimulating hormone receptor. 4. Thyroid peroxidase antibodies have a relatively restricted V-region usage, and there is a correlation between the V-regions used and the epitope on thyroid peroxidase bound. In particular the Vκ light chain, Vκl(O12), is associated with reactivity to one epitope. 5. The purpose of this review is to bring together the latest results concerning the molecular analysis of the antibody response in autoimmune thyroid disease, to highlight areas of ignorance and conflict, and to discuss the methods adopted to circumvent the problems associated with analysis of the antibody response.

Comparison of Autoimmune Thyroid Disease in Patients With Progressive and Stable Vitiligo

2015 ◽  
Vol 20 (2) ◽  
pp. 135-138 ◽  
Author(s):  
Mohammad Javad Yazdanpanah ◽  
Seyed Ali Seyedi Noghabi ◽  
Morteza Taghavi ◽  
Monavar Afzal Aghaee ◽  
Naghmeh Zabolinejad
Keyword(s):  
Physical Examination ◽  
Selection Criteria ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
Patient Selection Criteria ◽  
Antibody Levels ◽  
Tsh Levels

Background and Objective: Activity of vitiligo has not been considered as a patient selection criteria in previous studies; we decided to compare the presence of elevated thyroid auto-antibodies in patients with progressive and stable vitiligo. Methods: Seventy-two patients with vitiligo were examined for thyroid problems and were divided into 2 groups of stable and progressive vitiligo according to their history and physical examination. Anti-thyroid peroxidase antibodies (anti-TPO antibodies), thyroxine (T4), and thyroid stimulating hormone (TSH) levels were assessed for all patients. Results: Elevated levels of anti-TPO antibodies were observed in 43.7% of the patients with stable vitiligo and in 37.5% of patients with progressive vitiligo, which was not statistically significant ( P = .315). Conclusion: This study not only confirmed thyroid dysfunction in patients with vitiligo but also showed that there was no difference in thyroid dysfunction and anti-TPO antibody levels in the subgroups of patients with stable or progressive vitiligo.

scholarly journals Relationship Between Thyroid Hormonal Status in Patients with a Hypothyroid Form of Hashimoto’s Thyroiditis and Iodine Concentrations in Drinking Water

2021 ◽  
Author(s):  
Olha Kasiyan ◽  
Halyna Tkachenko ◽  
Natalia Kurhaluk ◽  
Svitlana Yurchenko ◽  
Alek Manenko
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Thyroid Stimulating Hormone ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Supply Network ◽  
Thyroid Status ◽  
Thyroglobulin Antibodies ◽  
Regressive Analysis

AbstractThe current study aimed to identify correlative and regressive dependencies between the water iodine concentration and the levels of TSH (thyroid-stimulating hormone), thyroglobulin antibodies (TgAbs), and thyroid peroxidase (TPOAb) in the serum of 168 in patients (34 men and 134 women) with a hypothyroid form of Hashimoto’s thyroiditis who use water from the supply network and individual wells. Based on the water iodine concentration, low and moderate degrees of iodine endemia in the location of the patients were determined. In the groups of men and women using water from different water supply sources, there were direct correlations between the water iodine concentrations and the TgAbs and TPOAb titers as well as an inverse dependence between iodine and TSH levels. Multivariate regressive analysis indicated that TgAb and TSH in the group of women using water from a supply network and TPOAb titers in the group of women using well water were independent factors associated with water iodine concentrations. Statistically significant correlations and regressive dependencies between the water iodine concentrations and the biomarkers of the thyroid status of the patients indicate the risk of Hashimoto’s thyroiditis progression, especially among women with additional iodine intake.

Autoimmune thyroid disease in diabetic children and adolescents: a single center study from south Punjab

2021 ◽  
Vol 71 (7) ◽  
pp. 1804-1807
Author(s):  
Waqas Imran Khan ◽  
Erum Afzal ◽  
Sajjad Hussain
Keyword(s):  
Children And Adolescents ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Glycosylated Hemoglobin ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Pediatric Endocrinology ◽  
Autoimmune Thyroid ◽  
Thyroid Peroxidase Antibody ◽  
Diabetic Children

Objective: To evaluate the prevalence of autoimmune thyroid disease (AITD) in diabetic children in south Punjab. Methods: This was an observational cross sectional study from Jan 2019 to Dec 2019 in the outpatient diabetic clinic of the department of pediatric endocrinology at Children Hospital and The Institute of Child Health Multan. A total of 161 consecutive patients of both genders with TIDM were enrolled in this study after taking informed consent. Blood samples for Thyroid functions testes including thyroid stimulating hormone (TSH), free thyroxin (fT4), Thyroid peroxidase antibody (TPO-Ab), thyroglobulin antibody (TG-Ab) and glycosylated hemoglobin (HbA1C) level were sent. Results: Among diabetic children males were 83 (51.6%). Age range was 2-15 years. Mean age and standard deviation was 9.7± 4.3. TPO-Ab was positive in 34 patients (21.1%) and TG-Ab in 27 patients (16.7%), whereas both antibodies were positive in 17 patients (10.5%). Six patients (3.7%) had evidence of subclinical hypothyroidism, 8 patients (4.9%) had overt hypothyroidism and 1 patient (0.62%) had hyperthyroidism Conclusion: The prevalence of AITD among children and adolescents with type 1 diabetes mellitus was 21.1% in our study. Hypothyroidism was more prevalent in these children compared to hyperthyroidism. All diabetic children should be screened for AITD. Thyroid functions should be checked where TPO antibody is positive. Keywords: Autoimmune thyroid disease, anti thyroid peroxidase antibody, anti thyroglobulin Continuous...

Deliberate self-harm in a patient with hyperthyroidism with acute psychosis

2021 ◽  
Vol 14 (10) ◽  
pp. e242333
Author(s):  
Haw Huo Wong ◽  
Nicholas Tze Ping Pang
Keyword(s):  
Autoimmune Thyroid Disease ◽  
Radioactive Iodine ◽  
External Genitalia ◽  
Thyroid Stimulating Hormone ◽  
Symphysis Pubis ◽  
Auditory Hallucinations ◽  
Autoimmune Thyroid ◽  
Self Harm ◽  
Iodine Treatment

A woman in her 30s with underlying Graves’ disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient’s own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible.

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 Frequent detection of thyroid peroxidase-specific IgG+ memory B cells in blood of patients with autoimmune thyroid disease

2002 ◽  
Vol 32 (11) ◽  
pp. 3126-3132 ◽  
Author(s):  
Heike Leyendeckers ◽  
Eberhard Voth ◽  
Harald Schicha ◽  
Nicolas Hunzelmann ◽  
Paul Banga ◽  
...  
Keyword(s):  
B Cells ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Memory B Cells ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
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