Autoimmune thyroid disease and antiphospholipid antibodies

Abstract

Objective: Autoimmune thyroid disease (ATD) is associated with circulating autoantibodies reactive with epitopes on thyroid tissue and that are thought to be pathogenic in the development of these diseases. Antiphospholipid antibodies (APLA) are a family of immunoglobulins that recognize a variety of plasma proteins in association with anionic phospholipids. These antibodies may lead to a number of clinical syndromes including venous and arterial thromboses, thrombocytopaenia, and recurrent fetal loss. We have studied the prevalence of APLA in patients with ATD and have determined the prevalence of the APLA syndrome among APLA-positive patients. Design: The study was a retrospective survey of patients with autoimmune thyroid disease attending the endocrinology clinic of a tertiary care academic hospital. Patients and Measurements: One hundred and thirty patients with autoimmune thyroid disease from the endocrinology clinic at our hospital were studied. 84% had chronic thyroiditis and 16% had Graves' disease. Free T4 and thyroid stimulating hormone (TSH) levels, antimicrosomal and antithyroglobulin antibodies, and an antiphospholipid antibody test were performed on all subjects. Results: 43% of patients with chronic thyroiditis and 43% of patients with Graves' disease were APLA positive, with an overall rate of 43% APLA positivity among patients with ATD. Of the 56 patients that were APLA positive, forty-eight (86%) had APLA of the IgG subtype, four (7%) had IgM antibodies, and nine (16%) had both IgG and IgM antibodies. None of the patients had clinical evidence of the APLA syndrome. Conclusions: We conclude that the prevalence of APLA in ATD is increased compared to healthy individuals but that this is likely to be an epiphenomenon, However, prolonged follow up is necessary in order to determine the true clinical significance of these antibodies in ATD patients. Am. J. Hematol. 64:73-75, 2000.

Increased Risk of Stroke in Patients With Bullous Pemphigoid

“…aPLs are a heterogeneous group of antibodies, including lupus anticoagulant, anticardiolipin antibody, and anti-␤2 glycoprotein I antibody. 37 These antibodies frequently appear in systemic lupus erythematosus 38 but have also been detected in organ-specific autoimmune diseases such as insulin-dependent diabetes mellitus, 39 myasthenia gravis, 40 autoimmune thyroid diseases, 41 and inflammatory bowel disease. 42 A recent study shows that aPLs were detected in 10 of 20 patients with autoimmune blistering disease, including 2 of 4 patients with BP.…”

Antiphospholipid antibodies in patients with autoimmune blistering disease

“…However, recent studies indicate that aPLs have also been detected in organ-specific autoimmune diseases, such as insulin dependent diabetes mellitus (34%) 9, 10 , myasthenia gravis (22%) 11 , autoimmune thyroid diseases (43~55%) 12,13 , inflammatory bowel disease (16~18%) 14,15 , and localized scleroderma (46%) 16 . Nevertheless, aPL positive patients with these diseases infrequently show clinical signs of thromboembolism 9,[11][12][13][14][15][16] .…”

“…aPLs are frequently found in patients with systemic autoimmune diseases, especially in systemic lupus erythematosus (SLE). They are also found in patients with organ-specific autoimmune diseases [9][10][11][12][13][14][15][16] , however the frequency of aPL in ABD remains unknown. In this study, we investigated whether aPLs were detected in patients with ABD, and whether these Abs correlated with the clinical symptoms of APS.…”

Novel antiphospholipid antibodies in autoimmune bullous diseases

“…The occurrence of the antiphospholipid antibodies have been detected in several organ-specific autoimmune diseases, such as insulin-dependent diabetes mellitus (34%), myasthenia gravis (22%), autoimmune thyroid diseases (43%-5%), inflammatory bowel disease (16%-18%), rheumatoid arthritis (33%) and localized scleroderma (46%) [7][8][9]. We demonstrated the presence of two non-classic antiphospholipid antibodies, aPS-β2GPI and aPT-PT, among ABD patients.…”