SARS-CoV-2 and thyroid diseases

Staruszkiewicz, Małgorzata; Pituch-Noworolska, Anna; Skoczen, Szymon

doi:10.1016/j.jtauto.2023.100214

Cited by 6 publications

(9 citation statements)

References 40 publications

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“…As COVID-19 may induce changes in thyroid function, comparing liver transplant recipients included during the pandemic with controls included before the pandemic may potentially impact the results 33 , 34 . However, access to COVID-19 tests was free and unrestricted for the public in Denmark, and we had access to all test results.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of hyperthyroidism and hypothyroidism in liver transplant recipients and associated risk factors

Suarez-Zdunek,

Arentoft,

Krohn

et al. 2024

Sci Rep

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The prevalence of hyperthyroidism and hypothyroidism and associated risk factors are unknown in liver transplant recipients. We aimed to determine the prevalence of hyperthyroidism and hypothyroidism and associated risk factors in liver transplant recipients and to compare it with controls from the general population. As part of the Danish Comorbidity in Liver Transplant Recipients (DACOLT) Study, all Danish liver transplant recipients over the age of 20 were invited for measurements of concentrations of thyrotropin and thyroid hormones. The prevalence of hyperthyroidism and hypothyroidism was compared to age- and sex-matched controls from the Copenhagen General Population Study. Using logistic regression adjusted for age, sex, smoking, and body-mass index, we investigated potential risk factors. We recruited 489 liver transplant recipients and 1808 controls. Among liver transplant recipients, 14 (2.9%) had hyperthyroidism compared with 21 (1.2%) of controls (adjusted odds ratio [aOR] 2.24, 95% confidence interval [CI] 1.05–4.75, P = 0.04), while 42 (5.7%) had hypothyroidism compared with 139 (7.7%) of controls (aOR 0.68, 95% CI 0.43–1.08, P = 0.10). Female sex, and autoimmune hepatitis and primary sclerosing cholangitis as causes of transplantation were associated with hyperthyroidism after adjustments. Age, female sex, and autoimmune liver diseases as cause of transplantation were associated with hypothyroidism after adjustments. DACOLT is registered in ClinicalTrials.gov (NCT04777032).

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Section: Discussionmentioning

confidence: 99%

Prevalence of hyperthyroidism and hypothyroidism in liver transplant recipients and associated risk factors

Suarez-Zdunek,

Arentoft,

Krohn

et al. 2024

Sci Rep

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“…Increases in creatine kinase, prolactin, total cholesterol, triglycerides, and LDL cholesterol have been reported [11]. Although immune mechanisms are important in the pathogenesis of the disease, the existing therapy is based solely on the patient's thyroid status and function [16]. Patients with thyroiditis and transient hyperthyroidism, which usually leads to permanent hypothyroidism, are treated supportively [5].…”

Section: Clinical Presentation and Treatmentmentioning

confidence: 99%

“…In the case of overt hypothyroidism, levothyroxine therapy is required. The dose of levothyroxine depends on the patient's hormone levels, age, and body weight, and the time of year [16]; it typically ranges from 1.6 to 1.8 micrograms per kilogram of body weight [8]. Regular use of thyroid hormone has been shown to decrease Tfh cell activity and increase Treg cell numbers [16].…”

Section: Clinical Presentation and Treatmentmentioning

confidence: 99%

“…The dose of levothyroxine depends on the patient's hormone levels, age, and body weight, and the time of year [16]; it typically ranges from 1.6 to 1.8 micrograms per kilogram of body weight [8]. Regular use of thyroid hormone has been shown to decrease Tfh cell activity and increase Treg cell numbers [16]. In pregnant women, liquid levothyroxine treatment appears to be more beneficial [7].…”

Section: Clinical Presentation and Treatmentmentioning

confidence: 99%

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The Role of the Immune System in the Course of Hashimoto’s Thyroiditis: The Current State of Knowledge

Wrońska,

Hałasa,

Szczuko

2024

IJMS

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The process of thyroid autoimmunization develops against the background of genetic predispositions associated with class II human leukocyte antigens (HLA-DR), as well as cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), protein tyrosine phosphatase non-receptor type 22 (PTPN22), and forkhead transcription box protein P3 (FOXP3). Environmental factors, such as vitamin D deficiency, Zn, Se, and Mg, as well as infections, chronic stress, pregnancy, smoking, alcohol, medications, intestinal dysbiosis, and malnutrition, also play an important role. The first stage of autoimmunization involves the accumulation of macrophages and dendritic cells, as well as plasma cells. In the second stage, the mutual interactions of individual cells in the immune system lead to a decrease in the level of CD8+ in favor of CD4+, which intensifies the synthesis of T lymphocyte derivatives, especially Th1, Th17, Tfh, and Tc, reducing the level of Treg. Consequently, the number of the anti-inflammatory cytokines IL10 and IL2 decreases, and the synthesis of the pro-inflammatory cytokines IL-2, Il-12, Il-17, IL-21, IL-22, IFN-γ, and TNF-α increases. The latter two especially trigger the pyroptosis process involving the inflammasome. Activation of the inflammasome by IL-β and IL-18 produced by macrophages is one of the mechanisms of pyroptosis in the course of Hashimoto’s thyroiditis, involving Gram-negative bacteria and NLRC4. In the next step, the apoptosis of thyroid cells is initiated by the intensification of perforin, granzyme, and proteoglycan synthesis by Tc and NK cells. The current findings raise many possibilities regarding interventions related to the inhibition of pro-inflammatory cytokines and the stimulation of anti-inflammatory cytokines produced by both T and B lymphocytes. Furthermore, since there is currently no effective method for treating thyroid autoimmunity, a summary of the review may provide answers regarding the treatment of not only Hashimoto’s thyroiditis, but also other autoimmune diseases associated with autoimmunity.

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“…Recently, the COVID-19 pandemic has placed numerous multidisciplinary conditions in relationship with a new cause, namely, the viral infection itself [150,151]. Some reports showed an exacerbation of LP following coronavirus-associated diseases or even the vaccination against the virus [152][153][154][155], while others highlighted similar data on ATD exacerbation (apart from subacute thyroiditis which is a direct, viral consequence) [156][157][158]. Of note, coronavirus infection might trigger thyroid eye disease in GD or exacerbate TH in previously diagnosed (endocrine) patients, since the virus might interfere with the immune and autoimmune systems as well as the hormonal panel [159][160][161].…”

Section: Infectious Diseasesmentioning

confidence: 99%

Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies

Radu,

Carsote,

Nistor

et al. 2023

Biomedicines

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In this narrative review, we aimed to overview the interplay between lichen planus (LP) and thyroid conditions (TCs) from a dual perspective (dermatologic and endocrine), since a current gap in understanding LP-TC connections is found so far and the topic is still a matter of debate. We searched PubMed from Inception to October 2023 by using the key terms “lichen planus” and “thyroid”, (alternatively, “endocrine” or “hormone”). We included original clinical studies in humans according to three sections: LP and TC in terms of dysfunction, autoimmunity, and neoplasia. Six studies confirmed an association between the thyroid dysfunction (exclusively hypothyroidism) and LP/OL (oral LP); of note, only one study addressed cutaneous LP. The sample size of LP/OLP groups varied from 12–14 to 1500 individuals. Hypothyroidism prevalence in OLP was of 30–50%. A higher rate of levothyroxine replacement was identified among OLP patients, at 10% versus 2.5% in controls. The highest OR (odd ratio) of treated hypothyroidism amid OLP was of 2.99 (p < 0.005). Hypothyroidism was confirmed to be associated with a milder OLP phenotype in two studies. A single cohort revealed a similar prevalence of hypothyroidism in LP versus non-LP. Non-confirmatory studies (only on OLP, not cutaneous LP) included five cohorts: a similar prevalence of hypothyroidism among OLP versus controls, and a single cohort showed that the subjects with OLP actually had a lower prevalence of hypothyroidism versus controls (1% versus 4%). Positive autoimmunity in LP/OLP was confirmed in eight studies; the size of the cohorts varied, for instance, with 619 persons with LP and with 76, 92, 105, 108, 192, 247, and 585 patients (a total of 1405) with OLP, respectively; notably, the largest control group was of 10,441 individuals. Four clusters of approaches with respect to the autoimmunity in LP/OLP were found: an analysis of HT/ATD (Hashimoto’s thyroiditis/autoimmune thyroid diseases) prevalence; considerations over the specific antibody levels; sex-related features since females are more prone to autoimmunity; and associations (if any) with the clinical aspects of LP/OLP. HT prevalence in OLP versus controls was statistically significantly higher, as follows: 19% versus 5%; 12% versus 6%; and 20% versus 9.8%. A single study addressing LP found a 12% rate of ATDs. One study did not confirm a correlation between OLP-associated clinical elements (and OLP severity) and antibody values against the thyroid, and another showed that positive TPOAb (anti-thyroperoxidase antibodies) was more often found in erosive than non-erosive OLP (68% versus 33%). Just the reverse, one cohort found that OLP subjects had a statistically significantly lower rate of positive TPOAb versus controls (9% versus 15%). Five case-control studies addressed the issue of levothyroxine replacement for prior hypothyroidism in patients that were diagnosed with OLP (no study on LP was identified); three of them confirmed a higher rate of this treatment in OLP (at 8.9%, 9.7%, and 10.6%) versus controls. In conclusion, with regard to LP/OLP-TC, we note several main aspects as practical points for multidisciplinary practitioners: OLP rather than LP requires thyroid awareness; when it comes to the type of thyroid dysfunction, mostly, hypothyroidism should be expected; female patients are more prone to be associated with ATDs; a potential higher ratio of OLP subjects taking levothyroxine was found, thus a good collaboration with an endocrinology team is mandatory; and so far, OLP individuals have not been confirmed to be associated with a higher risk of thyroid nodules/cancer.

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SARS-CoV-2 and thyroid diseases

Cited by 6 publications

References 40 publications

Prevalence of hyperthyroidism and hypothyroidism in liver transplant recipients and associated risk factors

Prevalence of hyperthyroidism and hypothyroidism in liver transplant recipients and associated risk factors

The Role of the Immune System in the Course of Hashimoto’s Thyroiditis: The Current State of Knowledge

Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies

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