Anti-TPO levels and its relationship with the activity of systemic lupus erythematosus in outpatient patients
Abstract
Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs and can be associated with other autoimmune pathologies such as autoimmune thyroid disease (ATD). Hypothyroidism is the most common disorder within the thyroid disease spectrum.
Objective: To determine the presence and serum levels of anti-TPO antibodies in patients with SLE and to establish whether high concentrations of anti-TPO antibodies are related to a higher score of disease activity measured by SLEDAI.
Methodology: Observational, cross-sectional, descriptive study with an analytical component. Consecutive sampling was used to select patients. The target population was patients with or without known thyroid disease. Patients of both sexes, over 18 years of age, who satisfied ACR/EULAR classification criteria for SLE, with a disease duration greater than 12 months were included.
Results: A total of 54 patients with SLE were included, with a mean age of 37.4±12.86 years. We found a 20.37% prevalence of anti-TPO antibody positivity. Mean anti-TPO level in patients who tested positive was 58.9 mIU/L. In relation to anti-TPO positive patients’ thyroid profile, 55% had elevated TSH with a mean serum level of 27.48±4.4 mIU/L. Out of 11 patients with positive anti-TPO levels, 45.45% had thyroid hormone levels compatible with hypothyroidism.
Conclusion: This study found a prevalence of ATD in SLE of 38.8%. Most of these patients had a thyroid profile compatible with hypothyroidism. No relationship was found between positive anti-TPO antibodies and SLE activity, as well as with other SLE disease activity markers.
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References
(1) Rivas-Larrauri F, Yamazaki-Nakashimada MA. Lupus eritematoso sistémico: ¿es una sola enfermedad? Reumatol Clínica [Internet]. 2016;12(5):274–81. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1699258X16000103
(2) Acosta Colmán I, Avila G, Acosta ME, Aquino A, Centurión O, Duarte M. Clinical and laboratory manifstations in Systemic Lupus Erythematosus. Memorias del Inst Investig en Ciencias la Salud. 2016 May 10;14(1):94–104.
(3) Rua-Figueroa Fernandez de Larrinoa I. Lo mejor del año en lupus eritematoso sistémico. Vol. 11, Reumatologia Clinica. 2015. p. 27–32.
(4) López-longo FJ, Calvo-alén J, Galindo-izquierdo M, Loza E, García MJ, Yebenes D. Registro nacional de pacientes con lupus eritematoso sistémico de la Sociedad de Reumatología : objetivos y metodología Espa nola. Reumatol Clin. 2014;10(1):17–24.
(5) Izmirly PM, Wan I, Sahl S, Buyon JP, Belmont HM, Salmon JE, et al. The Incidence and Prevalence of Systemic Lupus Erythematosus in New York County (Manhattan), New York: The Manhattan Lupus Surveillance Program. Arthritis Rheumatol. 2017;69(10):2006–17.
(6) Rees F, Doherty M, Grainge M, Davenport G, Lanyon P, Zhang W. The incidence and prevalence of systemic lupus erythematosus in the UK, 1999-2012. Ann Rheum Dis. 2016;75(1).
(7) Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-goldman R, et al. 2019 European League Against Rheumatism / American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019;71(9):1400–12.
(8) Anaya JM, Castiblanco J, Rojas-Villarraga A, Pineda-Tamayo R, Levy RA, Gómez-Puerta J, et al. The multiple autoimmune syndromes. A clue for the autoimmune tautology. Clin Rev Allergy Immunol. 2012;43(3):256–64.
(9) Barragán-Garfias JA, Zárateb A. Relación entre las enfermedades tiroideas autoinmunes y las del tejido conectivo. Rev Med Inst Mex Seguro Soc [Internet]. 2013;51(2):e1-5. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=89291623&lang=es&site=ehost-live
(10) Pérez de Alejo Rodríguez M, Martínez Delgado JF, Silverio Martínez E. Alteraciones de la tiroides en el lupus eritematoso sistémico. Acta Médica del Cent [Internet]. 2010;4(4):9–13. Available from: http://www.actamedica.sld.cu/r4_10/tiroides.htm
(11) Alcázar C, Juan DS, Real C. cartas al director Lupus eritematoso sistémico e hipotiroidismo central cartas al director. 2011;763–4.
(12) Ramírez Pulgarín S ; Martínez Sánchez L ; Jaramillo Jaramillo L. Enfermedad tiroidea: Una aproximación clínica y genética. Arch Med Manizales. 2016;57(70):359–72.
(13) Miniño M. Índice De Actividad Lúpica Y Tratamiento Del Lupus Eritematoso En Dermatología. Dermatologia Rev Mex. 2008;52(1):20–8.
(14) Antonelli A, Ferrari SM, Corrado A, Di Domenicantonio A, Fallahi P. Autoimmune thyroid disorders. Autoimmun Rev [Internet]. 2015;14(2):174–80. Available from: http://dx.doi.org/10.1016/j.autrev.2014.10.016
(15) Franco JS, Amaya-Amaya J, Molano-González N, Caro-Moreno J, Rodríguez-Jiménez M, Acosta-Ampudia Y, et al. Autoimmune thyroid disease in Colombian patients with systemic lupus erythematosus. Clin Endocrinol (Oxf). 2015;83(6):943–50.
(16) Pan X-F, Gu J-Q, Shan Z-Y. Patients with Systemic Lupus Erythematosus Have Higher Prevalence of Thyroid Autoantibodies: A Systematic Review and Meta-Analysis. PLoS One [Internet]. 2015;10(4):1–12. Available from: http://dx.plos.org/10.1371/journal.pone.0123291
(17) Alessandro A;, Fallahi P, Mosca M, Martina SF, Rufinelli Ilaria, Corti A, et al. Prevalence of thyroid dysfunctions in systemic lupus erythematosus. Metabolism. 2010;59(6):896–900.
(18) Ferrari SM, Elia G, Virili C, Centanni M, Antonelli A, Fallahi P. Systemic lupus erythematosus and thyroid autoimmunity [Internet]. Vol. 8, Frontiers in Endocrinology. 2017. p. 1–6. Available from: http://journal.frontiersin.org/article/10.3389/fendo.2017.00138/full
(19) Kumar K, Kole AK, Karmakar PS, Ghosh A. The spectrum of thyroid disorders in systemic lupus erythematosus. Rheumatol Int. 2012;32(1):73–8.
(20) Pomata CD. Frecuencia de Patologías Tiroideas con Tratamiento Quirúrgico Frequency of Thyroid Diseases with Surgical Treatmen. Rev Salud Pública Parag [Internet]. 2015;5 no(Enero-Junio 2015):9–17. Available from: http://www.ins.gov.py/revistas/index.php/rspp/article/viewFile/317/251
(21) Domingues S L; Torres Gonçalves F; Mendonça M L; Pereira J ; Limongi J E ; Ranza R ; Jorge P T. High Prevalence of Hyrotioidism in Systemic Lupus Eritematosus Patients Without an Increase in Circulatiing Anti-Thyroid Antibodies. Endocr Pract. 2017;23(11):1304–11.
(22) Mader R, Mishail S, Adawi M, Lavi I, Luboshitzky R. Thyroid dysfunction in patients with systemic lupus erythematosus (SLE): Relation to disease activity. Clin Rheumatol. 2007;26(11):1891–4.
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