Pattern of Thyroid Autoimmunity in Chinese Patients With Pernicious Anemia |
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| Authors: | Joyce Chee Wun Chan Herman Sung Yu Liu Bonnie Chi Shan Kho Thomas Kwan Hang Lau Vil Leung Li Florence Hoi Yan Chan In Son Leong Ho Kwong Pang Cheung Kei Lee Yu Shan Liang |
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| Affiliation: | 1. Division of Cardiology, Tzu-Chi General Hospital, Hualien, Taiwan;2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;3. Department of General Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;4. Department of Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan;5. Department of Medical Education and Research, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;6. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;7. Division of Cardiology, Sijhih Cathay General Hospital, New Taipei City, Taiwan;8. Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;9. School of medicine, National Yang-Ming University, Taipei, Taiwan;10. Division of Cardiology, Veterans General Hospital, Taipei, Taiwan;1. Department of Pediatric Surgery, University of Mannheim, Medical Faculty of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim;2. Department of Pediatrics, University of Mannheim, Medical Faculty of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim |
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| Abstract: | BackgroundAutoimmune thyroid disease (AITD) often coexists with pernicious anemia (PA) among whites. The study aimed to determine thyroid autoimmunity in Chinese patients with PAMethodsFrom the data of a hospital-based longitudinal study of Chinese PA patients (1994–2007), those with complete information of antibodies to thyroid peroxidase (TPO), thyroglobulin (Tg), and gastric parietal cell; serum thyroid-stimulating hormone and free thyroxine; gastric mucosal histology; and family history of AITD were analyzed.ResultsAmong 126 Chinese PA patients, 44% had TPO/Tg antibodies and 13.5% AITD. TPO/Tg antibodies occurred in 33% (16 of 49) of male and 52% (40 of 77) of female patients (P = 0.034). Graves disease (8 patients) tended to antedate PA and was associated with no or low titers of TPO/Tg antibodies. Primary hypothyroidism (9 patients) developed during follow-up and was associated with high TPO/Tg antibody titers. The TPO/Tg antibodies did not affect the clinical course of PA but was associated with an enhanced risk of developing AITD and vitiligo. Overall, AITD (before and after PA) occurred in 23% (13 of 56) and 5.7% (4 of 70) of PA patients with and without antibodies (P = 004). During follow-up (mean duration of 75.24 ± 46.39 months), 10 patients developed AITD—7 new onset of hypothyroidism and 3 progression/relapse of prior AITD. Logistic regression analysis of presenting features of PA revealed 2 independent factors for AITD development during follow-up—presence of thyroid antibodies (odds ratio 20.2, 95% confidence interval 1.8–223) and history of prior AITD (odds ratio 39.8, 95% confidence interval 2.3–679).ConclusionIt is recommended to screen thyroid antibodies and monitor thyroid function during follow-up. |
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