You are here

HaşhimotoTiroiditli Olguların Klinik ve Laboratuvar Bulgularının Değerlendirilmesi

Evaluation of clinical and laboratory findings in patients with Hashimoto thyroiditis

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Hashimoto thyroiditis (HT) is a common autoimmune thyroid disorder with a high prevalence in our region. In our article, we presented the clinical and laboratory results of patients with Hasthimoto thyroidits. There were 211 patients diagnosed with HT among internal medicine outpatients from April 2015-January 2016. Clinical, laboratory and thyroid ultrasonography characteristics of these patients were evaluated. Patients were divided into three groups according to their thyoid function: euthyroid(n=169), hypothyroid(n=32) and hyperthyroid(n=10) . Laboratory and several clinical characteristics were compared among groups. Statistical significance was accepted as P< 0.05. HT diagnosis was made in 211 patients. Mean age was 39.31 ± 11.44. Women comprised 92% of the patients. Most patients(72%) had diffuse guatre whereas 16% had nodular and 12% had multinodular pattern. 93.4% of the patients had vitamin D deficiency whereas B12 deficiency was detected in 51(24.1%) patients. Anti-TPO and anti TG antiboies were significantly higher in hypothyroid patients compared to euthyroid and hyperthyroid ones(P<0.001 and P =0.030, respectively). One patient in the hyperthyroid group was co-diagnosed with Graves disease. Most of the patients with HT were euthyroid women. Vitamin D and B12 deficiency were common and this may be due to autoimmune etiology. Hypothyroid patients had higher thyroid antibody levels which might have clinical consequences in this patient group. HT and Graves disease might co-exist and we suggest that differential dignosis must be made carefully between Graves disease and HT in thyotoxic stage.
Abstract (Original Language): 
Haşimototiroiditi (HT) bölgemizde yüksek prevalansa sahip yaygın bir otoimmüntiroid hastalığıdır. Bu çalışmada HT tanısı konan hastaların klinik ve laboratuvar sonuçlarını sunduk. Çalışmada İç hastalıkları polikliniklerinde Nisan 2015-Ocak 2016 HT’i tanısı konmuş 211 hasta vardı. Bu hastaların klinik, laboratuvar ve tiroid ultrasonografi verileri değerlendirildi. Hastalar tiroid fonksiyonlarına göre ötiroid(n=169), hipotiroid(n=32) ve hipertiroid(n=10) olarak üç gruba ayrıldı. P< 0.05 olan veriler istatiksel olarak anlamlı kabul edildi. Haşimototiroiditli hastalarımızın (n=211) yaş ortalaması 39.31 ± 11.44 idi. Hastaların %92’sini kadınlardan oluşmaktadır. %72’sinin diffüzguvatırı varken, %16’sının nodüler, %12’sinin multinodülerguvatırı vardı. %93.4’ünde D vitamini(25- OHD3) eksikliği varken, 51(%24.1) olguda B12 vitamin eksikliği vardı. Ortalama değerler incelendiğinde hipotiroidik hastalarda hem anti TPO hem anti TG hiper ve ötiroidlere göre anlamlı derecede yüksekti(sırasıyla P<0.001 ve P=0.030). Hipertiroid gruptaki bir hasta Graves Hastalığı ile beraberdi.HT’li hastaların çoğu ötiroid kadındı. Vitamin D ve B12 eksikliği yaygındı ve bu otoimmün etiyolojiye bağlı olabilir. Hipotiroidik hastalar daha yüksek tiroid antikor seviyesine sahipti. HT ve Graves Hastalığı birlikte olabilir ve tirotoksikoz döneminde HT ve Graves Hastalığı ile ayırıcı tanısı dikkatli bir şekilde yapılması önerilir.

REFERENCES

References: 

1. Chistiakov DA. Immunogenetics of Hashimoto’sthyroiditis. J AutoimmuneDis 2005;2: 1.
2. Wiersinga WM. Clinical Relevance of Environmental Factors in the Pathogenesis
of Autoimmune Thyroid Disease. EndocrinolMetab (Seoul). 2016 May 13. [Epubahead of print ] Review. PMID:27184015.
3. Volpe R. Autoimmunethyoiditis. In: Braverman LE, Utiger RD, editors. WernerandIngbar’sthethyroid, 5th ed. Philadelphia: JB Lippincott, 1991: S. 921. 4. Zahorec R. Ratio of neutrophil to lymphocyte counts rapid and simple parameter of systemic inflammation and stress incritically ill. BratislLekListy. 2001;102:5-14. 5. Tomer Y, Davies TF. Infection, thyroid disease and autoimmunity.Endocr Rev 1993;14:107-20.
6. Bindra A, Braunstein G.D, 2006. Thyroiditis. Am. Fam. Physician. 73,1769-1776.
7. Pearce E.N, Farwell A.P, Braverman L.E, 2003. Thyroiditis. New Engl. J. Med. 348, 2646-2655.
8. Slatosky J, Shipton B, Wahba H, 2000. Thyroiditis: differential diagnosisand management. Am. Fam. Physician. 61,1047-1052
9. Safit HF. Thyroiddisorders. İn Fitzgerald PAed. Handbook of Clinical Endocrinology, 2nd ed. Appletonand Lange Publ.,1992, p:156-2264.
10. Greenspan FS. Thethyroidgoland. İn GreenspanandBaxter ed. Basic and Clinical Endocrinology, Fourth Ed, Appletonand Lange Publ.1994, page 160-226.11. Amino N, Tada H. Autoimmune Thyroid Disease Thyroiditis in Leslie J, De Groot ed. Endocrinology, Third Ed, 1995, p: 726-740. 12. World Health Organization. Preventionand management of the global epidemic of the global epidemic of obesity. Report of the WHO Concultation on Obesity. Geneva WHO; 112:2735. 13. Larsen PR, Ingbar SH. The Thyroid Gland in Wilson JD, Foster DW ed. Villiams Textbook of Endocrinology. WB Saunders Company. 8th ed, 1992, p: 357-487.
14. D Çorapoğlu, Uysal A.R, Çetinarslan B at al. Haşhimototiroiditli olgularımızın klinik ve laboratuvar değerlendirilmesi. Ankara Üniversitesi Tıp Fakültesi mecmuası cilt 49, sayı 1,33-37, 1996.
15. Amino N, Yabu Y, Miyai K, et al. Differantiation of thyrotoxicosis induced by thyroidde struction from Graves Disease. Lancet 12: 344-346, 1978. 16. Castoro C, Le Moli R, Arpi ML, Tavarelli M, Sapuppo G, Frittitta L, Squatrito S, Pellegriti. G. Association of autoimmunethyroid diseases, chronicatrophic gastritis and gastric carcinoid: experience from a single institution J Endocrinol Invest. 2016 Feb 29. [Epubahead of print] PMID:26928404 17. Ness-Abramof R, Nabriski DA, Braverman LE at all. Prevalenceandevaluation of B 12 deficiency in patients with autoimmunethyroid disease. Am J Med Sci.2006 Sep;332(3):119-22. 18. Mansournia N, Mansournia MA, Saeedi S, Dehghan J. The association between serum 25OHD levels and hypothyroid Hashimotosthyroiditis. J Endocrinol Invest. 2014; 37 (5): 473-6. 19. Tamer G, Arik S, Tamer I, Coksert D. Relative vitamin D insufficiency in Hashimoto’sthyroiditis. Thyroid 2011; 21:891–896. 20. Arslan MS, Topaloglu O, Ucan B, Karakose M, Karbek B, Tutal E, Caliskan M, Ginis Z, Cakal E, Sahin M, Ozbek M, Delibasi T. Isolated vitamin D deficiency is not associated with nonthyroidal illnesssyndrome, but with thyroid autoimmunity. Scientific World Journal 2015 Jan 12;2015:239815. 21. Ehlers M, Thiel A, Bernecker C, et al. Evidence of a combined cytotoxic thyroglobulinand thyroperoxidaseepitope-specific cellular immunity in Hashimoto' sthyroiditis. J Clin Endocrinol Metab 2012;97:1347-54. PMID: 22259066 22. Kocer D, Karakukcu C, Karaman H, et al. May theneutrophil/ lymphocyteratio be a predictor in thedifferentiation of differentthyroiddisorders? AsianPac J CancerPrev 2015;16:3875-9. PMID: 25987053 23. Sun C, Li Q, Hu Z, et al. Treatment and prognosis of anaplasticthyroidcarcinoma: experiencefrom a singleinstitution in China. PLoSOne 2013 Nov 5;8(11):e80011. PMID: 24224029 24. Platonova NM, Sviridonova MA, Troshina EA. [Thyroiddys function and the hemostatic system]. Ter Arkh 2014;86:92-6. PMID: 25509900. 25. Cordiano I, Betterle C, Spadaccino CA, Soini B, Girolami A, Fabris F Autoimmunethrombocytopenia (AITP) and thyroidautoimmune disease (TAD): overlapping syndromes? Clin Exp Immunol 1998;113:373-8. PMID: 9737665 26. Aktas G, Sit M, Dikbas O, Tekce BK, et al. Couldredcelldistributionwidth be a marker in Hashimoto' sthyroiditis? Exp Clin Endocrinol Diabetes 2014;122:572-4. PMID: 2538054 27. Bilge M, Adas M, Helvaci A. Neutrophil/LymphocyteRatio (NLR) and Platelet/LymphocyteRatio (PLR) in Patients with Hashimoto' s Thyroiditis and Their Relationship with Thyroid Autoimmunity. EndocrineSociety 2015 https://endo.confex.com/endo/ 2015endo/webprogram/Paper20422.html

Thank you for copying data from http://www.arastirmax.com