Increased incidence of autoimmune thyroiditis in patients with antipsychotic-induced hyperprolactinemia

Poyraz, Burç Çağrı; Aksoy, Cana; Balcıoğlu, İbrahim

doi:10.1016/j.euroneuro.2008.04.014

Cited by 39 publications

(14 citation statements)

References 34 publications

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“…analyzed a group of schizophrenic patients and observed that the prevalence of HPRL was significantly higher in patients positive for thyroid autoantibodies (81%), when compared with patients negative for them (49%). Serum levels of PRL were also significantly higher in patients with positivity for thyroid autoantibodies in that series (24). Despite the studies mentioned above, literature is still scarce with respect to primary thyroid disorders in patients with HPRL.…”

Section: Discussionmentioning

confidence: 89%

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Thyroid autoimmunity in patients with hyperprolactinemia: an observational study

Önal

Sağlam

Sacikara

et al. 2014

Arq Bras Endocrinol Metab

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Objective: To establish whether there is a relationship between hyperprolactinemia and primary thyroid disorders, focusing on patients with autoimmune features. Materials and methods: The medical records of 100 patients with hyperprolactinemia (HPRL) were retrospectively examined. Records of thyroid ultrasonography (USG), basal serum levels of thyroid stimulating hormone, circulating free thyroxine, free triiodothyronine, antithyroglobulin (anti-Tg), and antithyroperoxidase (anti-TPO) antibodies were analyzed. In 100 control subjects, matched by age and gender with HPRL patients, thyroid USG, thyroid function tests (TFTs), and autoantibody panel were obtained. Results:The median PRL in patients was 93 ng/mL (range: 37-470). Twenty-five patients (25%) and 22 controls (22%) had positive anti-Tg and/or anti-TPO titers (P = 0.739). The median serum PRL was 98 (37-470) ng/mL in patients with positive thyroid autoantibodies, and 92 (40-470) ng/mL in patients who were negative (P = 0.975). Among the individuals with autoantibody positivity TFTs abnormalities were more frequent in HPRL patients (60%, out of 25 patients, 14 with subclinical hypothyroidism and one with hyperthyroidism) than in controls (9.1%, out of 22 patients, 2 with subclinical hyperthyroidism) (P < 0.001). Twenty-seven patients with HPRL and 31 controls had goiter (27 vs. 31%, P = 0.437). Fortysix patients (46%) and 50 (50%) controls had one or more of the features of thyroid disorder, which were goiter, positive thyroid autoantibody, and thyroid function abnormality (P = 0.888). Conclusion:HPRL may be associated with more severe thyroid dysfunction in patients with thyroid autoimmunity.Arq Bras Endocrinol Metab. 2014;58(1):48-52 Keywords Hyperprolactinemia; thyroiditis; autoimmunity; goiter RESUMO Objetivo: Verificar se existe uma relação entre a hiperprolactinemia e distúrbios primários da tireoide, focando em pacientes com características autoimunes. Materiais e métodos: Os prontuários de 100 pacientes com hiperprolactinemia (HPRL) foram examinados retrospectivamente. Foram analisados registros de ultrassonografia da tireoide (USG), níveis séricos basais de hormônio tireoestimulante, tiroxina livre, triiodotironina livre e anticorpos antitireoglobulina (anti-Tg) e antitireoperoxidase (anti-TPO). Foram obtidos de 100 controles, pareados por idade e sexo com pacientes com HPRL, USG, testes de função da tireoide (TFTs) e painel de autoanticorpos. Resultados: A média de PRL em pacientes foi de 93 ng/mL (variação: 37-470). Vinte e cinco pacientes (25%) e 22 controles (22%) foram positivos para títulos de anti-Tg e/ou anti-TPO (P = 0,739). A mediana de PRL sérica foi de 98 (37-470) ng/mL em pacientes positivos para autoanticorpos tiroidianos e 92 (40-470) ng/mL em pacientes negativos (P = 0,975). Entre os indivíduos positivos para autoanticorpos, as anormalidades da TFTs foram mais frequentes em pacientes HPRL (60%; de 25 pacientes, 14 com hipotireoidismo subclínico e um com hipertireoidismo) do que nos controles (9,1%; de 22 pacientes, 2 com hip...

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Section: Discussionmentioning

confidence: 89%

“…Autoimmune diseases are often characterized by altered PRL levels, associated wtih both Th1 of Th2 dominance, which suggest an immunomodulatory role of PRL (21). There are several clinical studies that demonstrate a relationship between HPRL and autoimmune thyroid disease (15,(22)(23)(24). Giusti and cols.…”

Section: Discussionmentioning

confidence: 99%

Thyroid autoimmunity in patients with hyperprolactinemia: an observational study

Önal

Sağlam

Sacikara

et al. 2014

Arq Bras Endocrinol Metab

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“…Recent data suggest that there may be an association with autoimmune thyroiditis that is not unexpected. 62 There is a link between pituitary prolactin secreting tumours and an increased prevalence of thyroid autoantibodies, and in a case series of 75 schizophrenia patients the prevalence of hyperprolactinaemia was higher in patients with thyroid autoantibodies (P ¼ 0.045). 62 Relationship between serum prolactin concentration and adverse effects This is a complex question.…”

mentioning

confidence: 99%

“…62 There is a link between pituitary prolactin secreting tumours and an increased prevalence of thyroid autoantibodies, and in a case series of 75 schizophrenia patients the prevalence of hyperprolactinaemia was higher in patients with thyroid autoantibodies (P ¼ 0.045). 62 Relationship between serum prolactin concentration and adverse effects This is a complex question. Firstly if hyperprolactinaemia is associated with clinical symptoms then that prolactin concentration is relevant for the patient.…”

mentioning

confidence: 99%

A review of hyperprolactinaemia and severe mental illness: Are there implications for clinical biochemistry?

Bushe

Bradley

Pendlebury³

2010

Ann Clin Biochem

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Hyperprolactinaemia is a common adverse event reported in association with treatments used in schizophrenia and bipolar disorder. Recent data are suggestive that hyperprolactinaemia may have a range of significant short-and long-term clinical consequences. The objective of this review is to examine the causes, frequency and clinical consequences of hyperprolactinaemia in the severely mentally ill (SMI) with a focus on patients taking antipsychotic medications. A Medline search was carried out to identify relevant publications. Reference lists from previous review articles were also examined to search for additional data. Hyperprolactinaemia may be one of the most common adverse events associated with some antipsychotic medications. Precise rates with individual drugs had however until recently been poorly categorized. The relationship between hyperprolactinaemia and adverse outcomes in the SMI population appears similar to that in the general population. Adverse outcomes (such as sexual dysfunction) can occur acutely and in the longer term (bone fractures and possibly breast cancer), but the precise link between degree and length of hyperprolactinaemia and adverse outcome remains to be established. In conclusion, hyperprolactinaemia is a common treatment-emergent adverse event of some antipsychotic medications and may have clinical consequences. Physicians must balance the benefits and risks of treatment when determining appropriate therapy for individual patients.

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“…The multiple actions of prolactin and relative lack of research into hyperprolactinaemia suggest that additional potential long-term effects may be discovered potentially in glands such as the thyroid. Recent data suggest there may be an association with autoimmune thyroiditis and in 75 schizophrenia patients, the prevalence of hyperprolactinaemia was higher in patients with thyroid autoantibodies (p=0.045) (Poyraz et al, 2008). …”

Section: Possible Association With Cancermentioning

confidence: 99%

Prolactin and Schizophrenia, an Evolving Relationship

Bushe¹,

Pendlebury²

2011

Health Management - Different Approaches and Solutions

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Increased incidence of autoimmune thyroiditis in patients with antipsychotic-induced hyperprolactinemia

Cited by 39 publications

References 34 publications

Thyroid autoimmunity in patients with hyperprolactinemia: an observational study

Thyroid autoimmunity in patients with hyperprolactinemia: an observational study

A review of hyperprolactinaemia and severe mental illness: Are there implications for clinical biochemistry?

Prolactin and Schizophrenia, an Evolving Relationship

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