L-thyroxine Stabilizes Autoimmune Inflammatory Process in Euthyroid Nongoitrous Children with Hashimoto’s Thyroiditis and Type 1 Diabetes Mellitus

Abstract

Objective: To investigate if L-thyroxine (T4) treatment may influence the clinical course of autoimmune thyroiditis (AIT) or prevent progression to subclinical or overt hypothyroidism in euthyroid nongoitrous pediatric patients with type 1 diabetes mellitus (T1DM) and AIT.Methods: The study was performed in four Polish pediatric diabetes centers. Of 330 children with T1DM and AIT followed between 2008 and 2012, 101 received L-T4 and 160 underwent clinical observation for 24 months. Thyroid stimulating hormone (TSH), free T4 (fT4), anti thyroid peroxidase antibody (anti-TPO), anti thyroglobulin antibody (anti-TG), glycosylated hemoglobin (HbA1c) levels, and lipid profile were assessed in all patients. Ultrasonographic evaluation was also performed in all children at each examination.Results: Patients treated with thyroid hormones had higher TSH levels (3.99; interquantile 3.5 to 4.52 vs. 2.09 mIU/L; interquantile 1.55 to 3.06; p<0.0001). A fall in TSH level (0.87 mIU/L 95% CI 0.43-1.30; p<0.0001) was documented after the first year of treatment. FT4 level did not differ between the groups at baseline (p=0.7434), but rose in the treatment group and fell in the control group [mean difference 0.78 95% CI-0.22-1.53 pmol/L (p=0.02) after 12 months and 0.98 95% CI 0.04-1.76 (p=0.005) after 24 months]. Higher levels of anti-TPO were initially found in the treated patients (p<0.0001) and significantly decreased over the 24-month period (p<0.0001). Children in the treatment group had higher anti-TG levels (p<0.0001), which showed a borderline decrease (p=0.08) in time. In the control group, anti-TG levels rose marginally (p=0.06) during the study.Conclusions: The data demonstrate that treatment with L-T4 in euthyroid pediatric patients with T1DM and AIT stabilizes autoimmune inflammation in the thyroid gland and is to be recommended as soon as the diagnosis is established.Conflict of interest:None declared.

Impact of Vitamin D on Immunopathology of Hashimoto’s Thyroiditis: From Theory to Practice

“…According to the authors, the lower TNF-α and IL-17 levels, which correlated with low vitamin D status, could be explained by the control of cytotoxicity by long-time treatment of HT. As stated by Korzeniowska et al [ 91 ], levothyroxine may contribute to stabilizing the inflammatory process in HT. In a study by Wencai Ke et al [ 92 ], serum 25(OH)D levels were not associated with IL-4, IL-17, and TNF-α in newly diagnosed or treated patients with HT.…”

Determination of trace uranium by a photo-catalytic resonance fluorescence method coupled with dual cloud point extraction

“…In general, the optimum equilibration temperature of CPE was 15 to 20 C higher than the cloud point temperature of the surfactant. 14 Considering the low cloud point temperature (22 to 30 C) of TX-114, we tested the effect of the equilibration temperature in the range from 40 to 80 C. The extraction efficiency increased with increasing the temperature in the range from 40 to 68 C and then decreased above 68 C (Fig. 6).…”

“…12 A novel double cloud point extraction (dCPE) was developed recently that has played important roles in the eld of environment science and is becoming increasingly popular due to the simplicity of operation, rapidity of extraction, low cost, environmental friendliness, and high enrichment factors. 13,14 To the best of our knowledge, no study to date has been reported on the determination of uranyl based on the dCPE technique. In this investigation, we integrate the advantages of photo-catalytic RF and dCPE technology for detecting trace amounts of uranyl.…”