Antithyroid antibodies in antiphospholipid syndrome: prevalence and clinical associations

Abstract

Autoimmune thyroid disease has been associated with several systemic autoimmune disorders. However, limited data are available regarding the prevalence and clinical associations of thyroid autoimmunity in antiphospholipid syndrome (APS). Seventy-five patients with APS, 75 patients with systemic lupus erythematosus (SLE) and 75 healthy controls were tested for the presence of antithyroid antibodies (ATAs) (anti-thyroglobulin and anti-thyroid peroxidase [anti-TPO]) using commercial ELISA. Clinical data were also recorded. Although no significant differences in the prevalence of ATAs were detected among APS, SLE patient groups and healthy controls, a significant increase of anti-TPO antibodies in patients with APS-SLE was found. An increased prevalence of ATAs in APS population with ischemic central nervous system (CNS) clinical manifestations was also detected. We present novel associations between thyroid autoimmunity and ischemic CNS clinical manifestations in the setting of APS.

Keywords

antiphospholipid syndrome autoimmune thyroid disease CNS manifestations

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References

1 Dayan CM Daniels GH . Chronic autoimmune thyroiditis. N Engl J Med 1996; 335: 99–107.

2 Punzi L Betterle C . Chronic autoimmune thyroiditis and rheumatic manifestations. Joint Bone Spine 2004; 71: 275–283.

3 Mavragani CP Skopouli FN Moutsopoulos HM . Increased prevalence of antibodies to thyroid peroxidase in Dry eyes and mouth syndrome (DEMS) or sicca asthenia polyalgia syndrome (SAPS). J Rheum. (in press).

4 Mavragani CP Ioannidis JP Tzioufas AG Hantoumi IE Moutsopoulos HM . Recurrent pregnancy loss and autoantibody profile in autoimmune diseases. Rheumatology (Oxford) 1999; 38: 1228–1233.

5 Kothbauer-Margreiter I Sturzenegger M Komor J Baumgartner R Hess CW . Encephalopathy associated with Hashimoto thyroiditis: diagnosis and treatment. J Neurol 1996; 243: 585–593.

6 Mavragani CP Patronas N Dalakas M Moutsopoulos HM . Ill-defined neurological syndromes with autoimmune background: a diagnostic challenge. J Rheumatol 2007; 34: 341–345.

7 Petri M Karlson EW Cooper DS Ladenson PW . Autoantibody tests in autoimmune thyroid disease: a case-control study. J Rheumatol 1991; 18: 1529–1531.

8 Paggi A Caccavo D Ferri GM . Anti-cardiolipin antibodies in autoimmune thyroid diseases. Clin Endocrinol (Oxf) 1994; 40: 329–333.

9 Nabriski D Ellis M Ness-Abramof R Shapiro M Shenkman L . Autoimmune thyroid disease and antiphospholipid antibodies. Am J Hematol 2000; 64: 73–75.

10.

10 Innocencio RM Romaldini JH Ward LS . High prevalence of thyroid autoantibodies in systemic sclerosis and rheumatoid arthritis but not in the antiphospholipid syndrome. Clin Rheumatol 2003; 22: 494.

11.

11 Wilson WA Gharavi AE Koike T . International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum 1999; 42: 1309–1311.

12.

12 Tan EM Cohen AS Fries JF . The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 1271–1277.

13.

13 Brandt JT Triplett DA Alving B Scharrer I . Criteria for the diagnosis of lupus anticoagulants: an update. On behalf of the Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibody of the Scientific and Standardisation Committee of the ISTH. Thromb Haemost 1995; 74: 1185–1190.

14.

14 Nived O Sturfelt G Liang MH De Pablo P . The ACR nomenclature for CNS lupus revisited. Lupus 2003; 12: 872–876.

15.

15 Ochi H Horiuchi I Araki N . Proteomic analysis of human brain identifies alpha-enolase as a novel autoantigen in Hashimoto's encephalopathy. FEBS Lett 2002; 528: 197–202.

16.

16 Moodie FD Leaker B Cambridge G Totty NF Segal AW . Alpha-enolase: a novel cytosolic autoantigen in ANCA positive vasculitis. Kidney Int 1993; 43: 675–681.