ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

Frequency of Thyroid Antibodies at the Diagnosis of Subacute Thyroiditis
Subakut Tiroidit Hastalığında Tanı Sırasında Tiroid Antikor Sıklığı
Received Date : 12 Feb 2020
Accepted Date : 14 May 2020
Available Online : 20 May 2020
Doi: 10.25179/tjem.2020-74287 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24:144-148
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Although subacute thyroiditis (SAT) is not an autoimmune disease, the presence of antithyroid antibodies has been reported in this disease too. This study aims to determine the frequency of antithyroid antibodies at the time of diagnosis of SAT. Material and Methods: Quantitative measurements of antithyroid peroxidase antibody (anti-TPO), antithyroglobulin antibody (anti-Tg), and thyroid-stimulating hormone (TSH) receptor autoantibodies (TRAb) were made in 76 patients at the diagnosis of SAT. Cytopathological examination and iodine uptake test was performed to exclude Graves’ disease and Hashimoto’s disease in suspected patients. Multiple multinuclear giant cells and granulomatous formations, including epithelioid histiocytes, were the cytological findings employed to support the diagnosis of SAT in suspicious cases. Results: The median erythrocyte sedimentation rate and Creactive protein levels were found to be 49 mL/hour (21-130) and 54 mg/L (8-179), respectively. TSH, free T4, and free T3 levels were determined to be 0.01 mIU/L (0.003-5.2), 1.98 ng/dL (0.78-6.1) and 5.51 ng/L (3.07-14), respectively. During the initial presentation, 88% of the patients were hyperthyroid, and 9% of the patients were euthyroid. Anti-TPO and anti-Tg antibody levels were detected to be above the assay-specific cut-off in 11.8% and 10.5% of SAT patients, respectively, at the time of diagnosis. Elevated TRAb was detected in 6.6% of all SAT patients. The median anti-TPO, anti-Tg, and TRAb levels of antibody-positive patients were 55 IU/mL (38- 1.078), 163 IU/mL (5.5-876), 5 IU/L (1.9-23), respectively. Conclusion: Although uncommon, antibody positivity can also be observed in SAT disease. This study has proved that the previous studies claiming the absence of thyroid antibodies in SAT are flawed. SAT must be considered while assessing the differential diagnosis of Graves’ and Hashimoto’s disease.
ÖZET
Amaç: Subakut tiroidit (SAT) otoimmün bir hastalık olmamasına rağmen antitiroid antikorlarının pozitif olabileceği literatürde bildirilmiştir. Bu çalışmanın amacı, SAT’de tanı anında antitiroid antikorlarının sıklığını belirlemektir. Gereç ve Yöntemler: Toplam 76 SAT hastasının antitiroid peroksidaz antikoru (anti-TPO), antitiroglobulin antikoru (anti-Tg) ve TSH reseptörü otoantikorlarının [receptor autoantibodies (TRabs)] tanı anında kantitatif ölçümleri yapıldı. Tanısı şüpheli hastalarda Graves ve Hashimoto hastalığını dışlamak için radyoiyot uptake testi ve sitopatolojik inceleme yapıldı. Sitolojik incelemede çok çekirdekli dev hücrelerin ve epiteloid histiyosit içeren granülomatöz oluşumların saptanması şüpheli vakalarda SAT tanısını desteklemek için kullanıldı. Bulgular: Ortalama eritrosit sedimentasyon hızı ve C-reaktif protein düzeyleri sırasıyla 49 mL/saat (21-130) ve 54 mg/L (8-179) olarak saptandı. TSH, serbest T4 ve serbest T3 düzeyleri sırasıyla 0,01 mIU/L (0,003-5,2), 1,98 ng/dL (0,78- 6,1) ve 5,51 ng/L (3,07-14) olarak saptandı. İlk başvuru anında hastaların %88'i hipertiroidik, %9'u ötiroid idi. Tanı anında hastaların sırasıyla %11,8 ve %10,5’inde anti-TPO ve anti-Tg antikorlarının pozitif olduğu saptandı. Hastaların %6,6’sında TRAb pozitifliği saptandı. Antikor düzeyi pozitif olan hastaların medyan anti-TPO, anti-Tg ve TRAb seviyeleri sırasıyla 55 IU/mL (38-1.078), 163 IU/mL (5,5-876) ve 5 IU/L (1,9-23) olarak saptandı. Sonuç: Sık olmasa da antitiroid antikor pozitifliği SAT hastalarında da görülebilir. Bu çalışma, SAT'de tiroid antikorlarının saptanamayacağını iddia eden önceki çalışmaların hatalı olduğunu kanıtlamıştır. Bu nedenle SAT hastalığı, Graves ve Hashimoto hastalıklarının ayırıcı tanısında göz önünde bulundurulmalıdır.
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