Comparison of Thyroid Gland Sonography Index with Serum Antithyroid Peroxidase, Antithyroglobulin, and Thyroid Function Tests in Patients with Hashimoto Thyroiditis
Comparison of Thyroid Gland Sonography Index in Patients with Hashimoto Thyroiditis
DOI:
https://doi.org/10.31661/gmj.v13i.3309Keywords:
Hashimoto’s Thyroiditis; Anti-Thyroid Antibody; Thyroid UltrasoundAbstract
Background: Ultrasound examination of the thyroid has emerged as a useful diagnostic and prognostic tool, along with measuring serum titers of anti-thyroid peroxidase (TPO), anti-thyroglobulin (Tg), and thyroid hormones, in patients with Hashimoto's thyroiditis. So, we aimed at considering correlations of ultrasonographic, antibodies, and thyroid hormone levels. Materials and Methods: A total of 149 patients (118 females, 31 males; aged 18–60 years; mean age: 38.60 ± 8.03 years) who were diagnosed with Hashimoto's thyroiditis were enrolled in the study. The blood sample was taken to measure serum titers of free T3 (FT3) and T4 (FT4), TSH, anti-TPO, and anti-Tg antibody titers. The thyroid sonography of each patient was classified into one of the five grades by real-time ultrasound (US) based on echogenicity, thyroid size, and thyroid pattern. We evaluated whether there was a correlation between thyroid characteristics observed via ultrasound and serum levels of thyroid hormones, anti-TPO antibodies, and anti-Tg antibodies. Results: Nodular structures were detected in 54 (36.2%) patients (38 micro-nodular and 16 macro-nodular). Echogenicity was recorded as isoechoic in 15(10.07%) and hypoechoic in 119 (79.87%) subjects. Euthyroid subjects had significantly thicker isthmus than overt and subclinical hypothyroid patients (P=0.018). Mean serum TSH, anti-Tg, and anti-TPO antibody titers showed a significant increase in patients with macro-nodules compared to those with micro-nodules and individuals without nodules (P<0.05). The thickness of the isthmus had a significant negative correlation with FT4 (P=0.046; r=0.11) and FT3 (P=0.017; r=0.15), respectively. Thyroid autoantibodies had positive significant correlations with different parameters of thyroid volume (P<0.05). Conclusions: Thyroid US findings, in addition to serum anti-Tg and anti-TPO antibody titers, might be correlated with the severity and extent of Hashimoto's thyroiditis, but further evaluations are needed.
References
Kalantar K, Khansalar S, Eshkevar Vakili M, Ghasemi D, Dabbaghmanesh MH, Amirghofran Z. Association of Foxp3 gene variants with risk of Hashimoto’s thyroiditis and correlation with anti-tpo antibody levels. Acta Endocrinol (Copenh). 2019;15:423–9.
Ashouri E, Dabbaghmanesh MH, Ranjbar Omrani G. Presence of more activating KIR genes is associated with Hashimoto’s thyroiditis. Endocrine. 2014;46:519–25.
Seyyedi N, Dehbidi GR, Karimi M, Asgari A, Esmaeili B, Zare F, et al. Human herpesvirus 6A active infection in patients with autoimmune Hashimoto’s thyroiditis. Brazilian J Infect Dis. 2019;23:435–40.
Rostamzadeh D, Dabbaghmanesh MH, Shabani M, Hosseini A, Amirghofran Z. Expression Profile of Human Fc Receptor-Like 1, 2, and 4 Molecules in Peripheral Blood Mononuclear Cells of Patients with Hashimoto’s Thyroiditis and Graves' Disease. Horm Metab Res. 2015;47:693–8.
Fröhlich E, Wahl R. Thyroid autoimmunity: Role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases. Frontiers in Immunology. 2017;8 MAY.
Kosiak W, Piskunowicz M, Świętoń D, Batko T, Kaszubowski M. An additional ultrasonographic sign of Hashimoto’s lymphocytic thyroiditis in children. J Ultrason. 2015;15:349–57.
Guan H, De Morais NS, Stuart J, Ahmadi S, Marqusee E, Kim MI, et al. Discordance of serological and sonographic markers for Hashimoto’s thyroiditis with gold standard histopathology. Eur J Endocrinol. 2019;181:539–44.
Sostre S, Reyes MM. Sonographic diagnosis and grading of Hashimoto’s thyroiditis. J Endocrinol Invest. 1991;14:115–21.
Dabbaghmanesh MH, Sadegholvaad A, Zarei F, Omrani G. Zinc status and relation to thyroid hormone profile in Iranian schoolchildren. J Trop Pediatr. 2008;54:58–61.
Koohi Hosseinabadi O, Behnam MA, Khoradmehr A, Emami F, Sobhani Z, Dehghanian AR, et al. Benign prostatic hyperplasia treatment using plasmonic nanoparticles irradiated by laser in a rat model. Biomed Pharmacother. 2020;127.
Zhang Y, Jia DD, Zhang YF, Cheng MD, Zhu WX, Li PF, et al. The emerging function and clinical significance of circrnas in thyroid cancer and autoimmune thyroid diseases. International Journal of Biological Sciences. 2021;17:1731–41.
Talattof Z, Dabbaghmanesh MH, Parvizi Y, Esnaashari N, Azad A. The Association between Burning Mouth Syndrome and Level of Thyroid Hormones in Hashimotos Thyroiditis in Public Hospitals in Shiraz, 2016. J Dent. 2019;20:42–7.
Trimboli P. Ultrasound: The extension of our hands to improve the management of thyroid patients. Cancers. 2021;13:1–2.
Jeong SH, Hong HS, Lee JY. The association between thyroid echogenicity and thyroid function in pediatric and adolescent Hashimoto’s thyroiditis. Medicine (Baltimore). 2019;98:e15055.
Mittal K, Rafiq MA, Rafiullah R, Harripaul R, Ali H, Ayaz M, et al. Mutations in the genes for thyroglobulin and thyroid peroxidase cause thyroid dyshormonogenesis and autosomal-recessive intellectual disability. J Hum Genet. 2016;61:867–72.
De Morais NS, Stuart J, Guan H, Wang Z, Cibas ES, Frates MC, et al. The impact of hashimoto thyroiditis on thyroid nodule cytology and risk of thyroid cancer. J Endocr Soc. 2019;3:791–800.
Schiemann U, Avenhaus W, Konturek J, Gellner R, Hengst K, Gross M. Relationship of clinical features and laboratory parameters to thyroid echogenicity measured by standardized grey scale ultrasonography in patients with Hashimoto’s thyroiditis. Med Sci Monit. 2003;9.
Mazziotti G, Sorvillo F, Iorio S, Carbone A, Romeo A, Piscopo M, et al. Grey-scale analysis allows a quantitative evaluation of thyroid echogenicity in the patients with Hashimoto’s thyroiditis. Clin Endocrinol (Oxf). 2003;59:223–9.
Słowińska-Klencka D, Wojtaszek-Nowicka M, Klencki M, Wysocka-Konieczna K, Popowicz B. The Presence of Hypoechoic Micronodules in Patients with Hashimoto′s Thyroiditis Increases the Risk of an Alarming Cytological Outcome. J Clin Med. 2021;10:638. doi:10.3390/jcm10040638.
Smith TJ. Insulin-like Growth Factor Pathway and the Thyroid. Front Endocrinol (Lausanne). 2021;12. doi:10.3389/fendo.2021.653627.
Ahn J, Moyers J, Wong J, Hsueh CT. Thyroid dysfunction from inhibitor of fibroblast growth factor receptor. Exp Hematol Oncol. 2019;8.
Papadopoulou AM, Bakogiannis N, Skrapari I, Moris D, Bakoyiannis C. Thyroid Dysfunction and Atherosclerosis: A Systematic Review. In Vivo. 2020;34:3127–36.
Weetman AP. An update on the pathogenesis of Hashimoto’s thyroiditis. Journal of Endocrinological Investigation. 2021;44:883–90.
Eftekharian F, Ranjbar Omrani GH, Dabbaghmanesh M, Sahraei R, Bakhshayeshkaram M, Dabbaghmanesh MM, Behnam MA. Comparison of the sonography index of thyroid gland with serum level of Anti-thyroid peroxidase, Anti-thyroglobulin and thyroid function test in patients with Hashimoto thyroiditis. "Research Square" 2021; This is a preprint; it has not been peer reviewed by a journal.
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