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. 2000 Jun;76(896):345–349. doi: 10.1136/pmj.76.896.345

Status of antithyroid antibodies in Bangladesh

M Hasanat 1, M Rumi 1, M Alam 1, K Hasan 1, M Salimullah 1, M Salam 1, M Fariduddin 1, H Mahtab 1, A Khan 1
PMCID: PMC1741600  PMID: 10824048

Abstract

To study autoimmunity among thyroid diseases, 397 thyroid patients (age 30 (13) years; M/F 75/322) from two referral centres in Bangladesh and 94 healthy controls (age 30 (13) years; M/F 24/70) were studied for antimicrosomal and antithyroglobulin antibodies. Thyroid patients were clinically grouped as suspected autoimmune thyroid disease (AITD), non-autoimmune, or indeterminate groups (where no decision could be reached). Antimicrosomal antibody was strongly positive in 19.4% and weakly positive in 7.3% of patients but only 4.3% and 2.1% respectively in the controls (χ2 = 17.852; p = 0.000) whereas strong and weak positivity were 27.2% and 6.8% in patients compared with 8.5% and 4.3% respectively in the controls (χ2 = 16.916; p = 0.000) for antithyroglobulin antibody. Antibodies were positive in 63.0% with Hashimoto's thyroiditis, 36.4% with Graves' disease, and 44.7% with atrophic thyroiditis among the autoimmune group. In the non-autoimmune group antibodies were positive in 100% with multinodular hypothyroidism, 46.7% with subacute thyroiditis, 40.0% with suspected iodine deficiency goitre, 31.3% with toxic multinodular goitre, 30.8% with non-toxic solitary nodules, and 19.4% with simple diffuse goitre. None was positive for antimicrosomal antibody without being positive for antithyroglobulin antibody. The two antibodies strongly correlated in both patients (r = 0.977, p = 0.000) and controls (r = 0.986, p = 0.000). About 9% (36/397) of patients were mismatched with the final diagnosis on antibody measurement; most of them had Hashimoto's thyroiditis (33/36). Prevalence of AITD among thyroid patients was 48.36%. Specificity of antimicrosomal and antithyroglobulin antibodies were 93% and 87%. It was concluded that AITD is not uncommon in Bangladesh; antimicrosomal antibody is a useful marker for AITD and unless antibodies are checked, an appreciable number of patients with AITDs will remain undetected.


Keywords: thyroid autoimmunity; diagnostic dilemma

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Selected References

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  1. Aust G., Lehmann I., Laue S., Scherbaum W. A. Activated and interferon-gamma producing thyroid-derived T cells are detected in Graves' disease, thyroid autonomy as well as in non-toxic multinodular goiter. Eur J Endocrinol. 1996 Jul;135(1):60–68. doi: 10.1530/eje.0.1350060. [DOI] [PubMed] [Google Scholar]
  2. Brown R. S., Jackson I. M., Pohl S. L., Reichlin S. Do thyroid-stimulating immunoglobulins cause non-toxic and toxic multinodular goitre? Lancet. 1978 Apr 29;1(8070):904–906. doi: 10.1016/s0140-6736(78)90682-7. [DOI] [PubMed] [Google Scholar]
  3. Chiovato L., Bassi P., Santini F., Mammoli C., Lapi P., Carayon P., Pinchera A. Antibodies producing complement-mediated thyroid cytotoxicity in patients with atrophic or goitrous autoimmune thyroiditis. J Clin Endocrinol Metab. 1993 Dec;77(6):1700–1705. doi: 10.1210/jcem.77.6.7903315. [DOI] [PubMed] [Google Scholar]
  4. Corrales J. J., Orfao A., Miralles J. M., López-Berges M. C., García L. C., González M., Mories M. T., San Miguel J. Immunological features of sporadic multinodular goiter. Clin Investig. 1993 Jul;71(7):552–558. doi: 10.1007/BF00208480. [DOI] [PubMed] [Google Scholar]
  5. Corrales J. J., Orfao A., Miralles J. M., San Miguel J. The relationship between hyperthyroidism and the distribution of peripheral blood T, NK and B-lymphocytes in multinodular goiter. Horm Metab Res. 1994 Feb;26(2):104–108. doi: 10.1055/s-2007-1000783. [DOI] [PubMed] [Google Scholar]
  6. Das A. B., Alam M. N., Haq S. A., Ansari M. A., Rahman A. N., Hasan M., Yasmeen S., Haque M. M., Tahir M., Karim M. A. Solitary thyroid nodule: a study of 100 cases. Bangladesh Med Res Counc Bull. 1996 Apr;22(1):12–18. [PubMed] [Google Scholar]
  7. Dayan C. M., Daniels G. H. Chronic autoimmune thyroiditis. N Engl J Med. 1996 Jul 11;335(2):99–107. doi: 10.1056/NEJM199607113350206. [DOI] [PubMed] [Google Scholar]
  8. Drexhage H. A. Autoimmunity and thyroid growth. Where do we stand? Eur J Endocrinol. 1996 Jul;135(1):39–45. doi: 10.1530/eje.0.1350039. [DOI] [PubMed] [Google Scholar]
  9. Feldt-Rasmussen U. Analytical and clinical performance goals for testing autoantibodies to thyroperoxidase, thyroglobulin, and thyrotropin receptor. Clin Chem. 1996 Jan;42(1):160–163. [PubMed] [Google Scholar]
  10. Harach H. R., Escalante D. A., Onativia A., Lederer Outes J., Saravia Day E., Williams E. D. Thyroid carcinoma and thyroiditis in an endemic goitre region before and after iodine prophylaxis. Acta Endocrinol (Copenh) 1985 Jan;108(1):55–60. doi: 10.1530/acta.0.1080055. [DOI] [PubMed] [Google Scholar]
  11. Knobel M., Barca M. F., Pedrinola F., Medeiros-Neto G. Prevalence of anti-thyroid peroxidase antibodies in autoimmune and nonautoimmune thyroid disorders in a relatively low-iodine environment. J Endocrinol Invest. 1994 Dec;17(11):837–842. doi: 10.1007/BF03347788. [DOI] [PubMed] [Google Scholar]
  12. Ladenson P. W. Optimal laboratory testing for diagnosis and monitoring of thyroid nodules, goiter, and thyroid cancer. Clin Chem. 1996 Jan;42(1):183–187. [PubMed] [Google Scholar]
  13. Laurberg P. Iodine intake--what are we aiming at? J Clin Endocrinol Metab. 1994 Jul;79(1):17–19. doi: 10.1210/jcem.79.1.8027222. [DOI] [PubMed] [Google Scholar]
  14. Mariotti S., Caturegli P., Piccolo P., Barbesino G., Pinchera A. Antithyroid peroxidase autoantibodies in thyroid diseases. J Clin Endocrinol Metab. 1990 Sep;71(3):661–669. doi: 10.1210/jcem-71-3-661. [DOI] [PubMed] [Google Scholar]
  15. Soliman M., Kaplan E., Fisfalen M. E., Okamoto Y., DeGroot L. J. T-cell reactivity to recombinant human thyrotropin receptor extracellular domain and thyroglobulin in patients with autoimmune and nonautoimmune thyroid diseases. J Clin Endocrinol Metab. 1995 Jan;80(1):206–213. doi: 10.1210/jcem.80.1.7829613. [DOI] [PubMed] [Google Scholar]
  16. Toldy E., Lócsei Z., Kalmár I., Varga L., Kovács L. G. A pajzsmirigy elleni autoantitestek diagnosztikus értéke. Orv Hetil. 1996 Sep 22;137(38):2075–2080. [PubMed] [Google Scholar]
  17. Vadivelu N., Stephen D. C., Kanagasabapathy A. S., Seshadri M. S. Thyroid stimulating hormone receptor antibody in thyroid diseases. Indian J Med Res. 1990 Aug;92:220–223. [PubMed] [Google Scholar]
  18. Weetman A. P. Is endemic goiter an autoimmune disease? J Clin Endocrinol Metab. 1994 May;78(5):1017–1019. doi: 10.1210/jcem.78.5.7909815. [DOI] [PubMed] [Google Scholar]
  19. Weetman A. P., McGregor A. M. Autoimmune thyroid disease: further developments in our understanding. Endocr Rev. 1994 Dec;15(6):788–830. doi: 10.1210/edrv-15-6-788. [DOI] [PubMed] [Google Scholar]

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