M Fiducia1, R Lauretta, R Lunghi, S Kyanvash, S Pallotti. 1. Dipartimento di Fisiopatologia Medica, Policlinico Umberto I, Università degli Studi di Roma, La Sapienza, Roma, Italy. manuela.fiducia@tele2.it
Abstract
AIM: Aim of the study is a prospective evaluation of the simultaneous presence of antinuclear antibodies (ANA) in patients with Hashimoto's thyroiditis as a sign of a possible occurrence of another autoimmune disease. METHODS: Thirty two patients with Hashimoto's thyroiditis have been selected. No other immunological parameters have been used for the selection. All the patients have been submitted to ANA research and to thyroid colour-Doppler ultrasonography. Moreover, subgroups of patients have been submitted to the research of other autoimmunity parameters: 25 patients to AMA (anti-mitochondrial antibodies), ASMA (anti-smooth muscle antibodies), ENA (extractable nuclear antigens) and anti-double stranded-DNA; 7 patients to anti-gastric mucosa; 8 patients to ACA (anti-cardiolipin antibodies) IgM and IgG; 12 patients to rheuma-screen. Twenty five patients were under L-thyroxine therapy at the time of the samples. RESULTS: Forty-seven percent of the patients were ANA positive. Of them 60% showed a title of 1:40. The most frequent sonography picture was pseudo-nodular (66%) with predominance in ANA negative subgroups (71%) than in ANA positive one (60%). On the basis of all the autoimmune parameters evaluated in every subgroups, 72% of our patients were positive to at least one autoimmunity parameter and/or have an autoimmune disease besides Hashimoto's thyroiditis. CONCLUSION: The conclusion is drawn that the patient with Hashimoto's thyroiditis should be considered as an autoimmune patient. Thus, it is necessary to carry out an autoimmune screening with ANA in every new diagnosed patients and to study in depth the familiar and phatological history. Periodical checking of the autoimmune parameters should not be underestimated in these patients.
AIM: Aim of the study is a prospective evaluation of the simultaneous presence of antinuclear antibodies (ANA) in patients with Hashimoto's thyroiditis as a sign of a possible occurrence of another autoimmune disease. METHODS: Thirty two patients with Hashimoto's thyroiditis have been selected. No other immunological parameters have been used for the selection. All the patients have been submitted to ANA research and to thyroid colour-Doppler ultrasonography. Moreover, subgroups of patients have been submitted to the research of other autoimmunity parameters: 25 patients to AMA (anti-mitochondrial antibodies), ASMA (anti-smooth muscle antibodies), ENA (extractable nuclear antigens) and anti-double stranded-DNA; 7 patients to anti-gastric mucosa; 8 patients to ACA (anti-cardiolipin antibodies) IgM and IgG; 12 patients to rheuma-screen. Twenty five patients were under L-thyroxine therapy at the time of the samples. RESULTS: Forty-seven percent of the patients were ANA positive. Of them 60% showed a title of 1:40. The most frequent sonography picture was pseudo-nodular (66%) with predominance in ANA negative subgroups (71%) than in ANA positive one (60%). On the basis of all the autoimmune parameters evaluated in every subgroups, 72% of our patients were positive to at least one autoimmunity parameter and/or have an autoimmune disease besides Hashimoto's thyroiditis. CONCLUSION: The conclusion is drawn that the patient with Hashimoto's thyroiditis should be considered as an autoimmune patient. Thus, it is necessary to carry out an autoimmune screening with ANA in every new diagnosed patients and to study in depth the familiar and phatological history. Periodical checking of the autoimmune parameters should not be underestimated in these patients.