One-Year Prophylactic Treatment of Euthyroid Hashimoto's Thyroiditis Patients with Levothyroxine: Is There a Benefit?

Padberg, Stephanie; Heller, Klaus; Usadel, K. H.; Schumm-Draeger, P.-M.

doi:10.1089/105072501750159651

Cited by 79 publications

(77 citation statements)

References 29 publications

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“…Furthermore, elevated anti-TPO antibodies seemed to be more specific for thyroid disorder than elevated anti-TG, because they were associated with higher TSH levels. This confirms recent findings by Padberg et al (12). TSH elevations were also found in a group of patients without thyroid autoimmunity.…”

Section: Resultssupporting

confidence: 93%

Thyroid Autoimmunity in Children and Adolescents With Type 1 Diabetes

Kordonouri

Klinghammer²,

Lang³

et al. 2002

Diabetes Care

267

160

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OBJECTIVE -To investigate thyroid autoimmunity in a very large nationwide cohort of children and adolescents with type 1 diabetes.RESEARCH DESIGN AND METHODS -Data were analyzed from 17,749 patients with type 1 diabetes aged 0.1-20 years who were treated in 118 pediatric diabetes centers in Germany and Austria. Antibodies to thyroglobulin (anti-TG) and thyroperoxidase (anti-TPO) were measured and documented at least once in 7,097 patients. A total of 49.5% of these patients were boys, the mean age was 12.4 years (range 0.3-20.0 years), and the mean duration of diabetes was 4.5 years (range 0.0 -19.5 years). A titer exceeding 100 units/ml or 1:100 was considered significantly elevated.RESULTS -In 1,530 patients, thyroid antibody levels were elevated on at least one occasion, whereas 5,567 were antibody-negative during the observation period. Patients with thyroid antibodies were significantly older (P Ͻ 0.001), had a longer duration of diabetes (P Ͻ 0.001), and developed diabetes later in life (P Ͻ 0.001) than those without antibodies. A total of 63% of patients with positive antibodies were girls, compared with 45% of patients without antibodies (P Ͻ 0.001). The prevalence of significant thyroid antibody titers increased with increasing age; the highest prevalence was in the 15-to 20-year age group (anti-TPO: 16.9%, P Ͻ 0.001; anti-TG: 12.8%, P Ͻ 0.001). Thyroid-stimulating hormone (TSH) levels were higher in patients with thyroid autoimmunity (3.34 U/ml, range 0.0 -615.0 U/ml) than in control subjects (1.84 U/ml, range 0.0 -149.0 U/ml) (P Ͻ 0.001). Even higher TSH levels were observed in patients with both anti-TPO and anti-TG (4.55 U/ml, range 0.0 -197.0 U/ml).CONCLUSIONS -Thyroid autoimmunity seems to be particularly common in girls with diabetes during the second decade of life and may be associated with elevated TSH levels, indicating subclinical hypothyroidism.

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Section: Resultssupporting

confidence: 93%

Thyroid Autoimmunity in Children and Adolescents With Type 1 Diabetes

Kordonouri

Klinghammer²,

Lang³

et al. 2002

Diabetes Care

267

160

View full text Add to dashboard Cite

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“…The prophylactic usage of LT4 in euthyroid patients may suppress the serum concentrations of autoantibodies mildly because of a possible decline in antigenic stimulus (due to the rest) of the thyrocytes, not by direct suppression of antibodies (Padberg et al 2001). Neither corticosteroids nor nonsteroid anti-inflammatory drugs are indicated to inhibit chronic cellular destruction.…”

Section: Introductionmentioning

confidence: 99%

Selenium treatment in autoimmune thyroiditis: 9-month follow-up with variable doses

Türker¹,

Kumanlıoğlu²,

Karapolat³

et al. 2006

Journal of Endocrinology

133

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The aim of this study is to investigate the long-term (9 months) effects of variable doses (200/100 mg/day) of L-selenomethionine on autoimmune thyroiditis (AIT) and the parameters affecting the success rate of this therapy. The present study was designed in three steps: (1) 88 female patients with AIT (mean ageZ40$1G13$3 years) were randomized into two groups according to their initial serum TSH, thyroid peroxidase antibody (TPOAb) concentrations, and age. All the patients were receiving L-thyroxine to keep serum TSH%2 mIU/l. Group S2 (nZ48, mean TPOAbZ803$9G483$8 IU/ml) received 200 mg L-selenomethionine per day, orally for 3 months, and group C (nZ40, mean TPOAbZ770$3G 406$2 IU/ml) received placebo. (2) 40 volunteers of group S2 were randomized into two age-and TPOAb-matched groups. Group S22 (nZ20) went on taking L-selenomethionine 200 mg/day, while others (group S21) lowered the dose to 100 mg/day. (3) 12 patients of group S22 (group S222) went on taking L-selenomethionine 200 mg/day, while 12 patients of group S21 (S212) increased the dose to 200 mg/day. Serum titers of TPOAb decreased significantly in group S2 (26$2%, P!0$001), group S22 (23$7%, P!0$01) and group S212 (30$3%, P!0$01). There were no significant changes in group C and group S222 (PO0$05). TPOAb titers increased significantly in group S21 (38$1%, P!0$01). A significant decrease in thyroglobulin antibody titers was only noted in group S2 (5$2%, P!0$01). L-selenomethionine substitution suppresses serum concentrations of TPOAb in patients with AIT, but suppression requires doses higher than 100 mg/day which is sufficient to maximize glutathione peroxidase activities. The suppression rate decreases with time.

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“…Padberg et al (2001) have reported reduction in anti-TPO antibodies and B lymphocyte counts in adults with eHT in response to levothyroxine prophylaxis.…”

Section: Discussionmentioning

confidence: 97%

Cardiac Autonomic Regulation Is Disturbed in Children with Euthyroid Hashimoto Thyroiditis

Kilic¹,

Gülgün²,

Tascilar³

et al. 2012

Tohoku J. Exp. Med.

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Hashimoto thyroiditis (chronic autoimmune thyroiditis) is the most common form of thyroiditis in childhood. Previous studies have found autonomic dysfunction of varying magnitude in patients with autoimmune diseases, which is considered a cardiovascular risk factor. We aimed to evaluate the heart rate variability (HRV), a measure of cardiac autonomic modulation, in children with euthyroid Hashimoto thyroiditis (eHT). The study included 32 patients with eHT (27 girls and 5 boys; mean age 11 ± 4.1 years, range 8-16; body mass index 0.47 ± 0.69 kg/m 2 ), as judged by normal or minimally elevated serum TSH levels (normal range: 0.34-5.6 mIU/l) and normal levels of free thyroid hormones (FT4 and FT3) and 38 euthyroid age-matched controls. Patients with eHT and control subjects underwent physical examination and 24-hour ambulatory ECG monitoring. Time-domain parameters of HRV were evaluated for cardiac autonomic functions. Children with eHT displayed significantly lower values of time-domain parameters of SDANN (standard deviation of the averages of NN intervals), RMSSD (square root of the mean of the sum of the squares of differences between adjacent NN intervals), NN50 counts (number of pairs of adjacent NN intervals differing by more than 50 ms) and PNN50 (NN50 count divided by the total number of all NN intervals) for each 5-min interval, compared to healthy controls ( p < 0.05 for each), indicating the decreased beat-to-beat variation of heart rate. In conclusion, eHT is associated with disturbed autonomic regulation of heart rate. Hence, the children with eHT are at higher risk for developing cardiovascular diseases.

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One-Year Prophylactic Treatment of Euthyroid Hashimoto's Thyroiditis Patients with Levothyroxine: Is There a Benefit?

Cited by 79 publications

References 29 publications

Thyroid Autoimmunity in Children and Adolescents With Type 1 Diabetes

Thyroid Autoimmunity in Children and Adolescents With Type 1 Diabetes

Selenium treatment in autoimmune thyroiditis: 9-month follow-up with variable doses

Cardiac Autonomic Regulation Is Disturbed in Children with Euthyroid Hashimoto Thyroiditis

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