American Journal of Clinical and Experimental Medicine

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Thyroid Functions and Thyroid Auto-Antibodies in Pediatric Systemic Lupus Erythematosus Patients: A Study from Bangladesh

Received: 29 July 2015    Accepted: 12 August 2015    Published: 21 August 2015
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Abstract

Background: Thyroid dysfunction may be associated in pediatric SLE cases and may present as euthyroid, subclinical hypothyroid, hypothyroid or hyperthyroid states. Aim of this study was to assess thyroid functions (serum T3, T4, TSH) and thyroid antibodies (anti-thyroid Peroxidase and anti-thyroglobulin) in pediatric SLE patients. Methods: It was a cross sectional study. Pediatric SLE (pSLE) patients who fulfilled the American College of Rheumatology 1997 revised classification criteria for SLE were enrolled in this study. Sixteen apparently healthy children were enrolled in the study as reference group. Disease activity was measured by systemic lupus erythematosus disease activity index (SLEDAI). Serum T3, T4, TSH and auto-antibodies including, anti-thyroid peroxidase (anti-TPO) and anti- thyroglobulin (anti-TG) were measured by radio-immuno assay (RIA) method in the National Institute of Nuclear Medicine & Allied Sciences, BSMMU, Dhaka. Data were analyzed by SPSS for window version 16 which included descriptive statistics, Man-Whitney test and Fisher exact test. Results: Among a total number of 50 pSLE cases, 41 (82%) cases had euthyroid state, 4 had subclinical hypothyroidism, 3 had hypothyroidism and 2 patients had euthyroid sick syndrome. All the cases of reference group were in euthyroid state. Anti-thyroid peroxidase (TPO) antibody was positive in 24 pSLE cases and anti-thyroglobulin (TG) antibody was positive in 16 patients. Thyroid disorder was present in 9 cases and 7 of them had positive anti-TPO antibody. Conclusion: Thyroid disorders and presence of thyroid auto antibodies were common in pSLE patients. Anti-TPO positivity was more common than Anti-TG positivity

DOI 10.11648/j.ajcem.20150305.12
Published in American Journal of Clinical and Experimental Medicine (Volume 3, Issue 5, September 2015)
Page(s) 207-212
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pediatric SLE, Triidothyronine, Thyroxine, TSH, Anti- thyroid Peroxidase, Anti- thyroglobulin

References
[1] Ardoin SP, Schanberg LE. Systemic Lupus Erythematosus. In: Kliegman RM, Stanton BF, St.Game JW, Schor NF, Behrman RE, editors. Nelson Textbook of pediatrics. 19th edition Philadelphia: Elsevier Saunders; 2012. P. 841-46.
[2] Silverman E, Eddy A. Systemic lupus erythematosus. In: Cassidy JM, Petty RE, Laxer RM, Lindaley CB editors. Textbook of Pediatric Rheumatology. Philadelphia: Elsevier Saunders; 2011. P. 315-343.
[3] Klein-Gitelman MS, Miller ML. Systemic lupus erythematosus. In: Behrman RE, Kleigman RM Jenson HB, Stanton BF, editors. Nelson Textbook of Pediatrics. 18th edition. Philadelphia: Elsevier Saunders; 2007. p. 809-813.
[4] Goh KL, Wang F. Thyroid disorders in systemic lupus erythematosus. Annals of the Rheumatic Diseases 1986; 45: 579-583.
[5] Kakehasi AM, Dias VN, Duarte JE, Lanna CCD, Carvalho MAP. Thyroid abnormalities in systemic lupus erythematous: a study in 100 Brazilian patients. Rev Bras Reumatol 2006; 46: 375-379.
[6] Porkodi R, Ramesh S, Mahesh A, Kanakarani P, Rajendran C. Thyroid function and auto-antibodies in Egyptian patient with systemic lupus erythematosus and rheumatoid arthritis. J. Indian Rheumatol Assoc 2004; 12: 88-92.
[7] Weetman AP. Chronic autoimmune thyroiditis. In: Breverman LE, Utiger RD editors. The thyroid: A fundamental and clinical text. Philadelphia, Lippincott Williams and wilkins; 2000. P. 721-732.
[8] Chu JW, Crapo LM. Should mild subclinical hypothyroidism be treated? Am J Med 2002; 112: 422-3.
[9] Kahaly GJ. Cardiovascular and atherogenic aspects of subclinical hypothyroidism. Thyroid 2000; 10: 665-79.
[10] Brunner HI, Feldman BM, Bombardier C, Silverman ED. Sensitivity of the Systemic lupus erythematosus disease activity index, British Isles lupus assessment group index, and Systemic lupus activity measure in the evaluation of clinical change in childhood onset Systemic lupus erythematosus. Arthritis Rheum 1999; 42: 1354-60.
[11] Mousa AA, Ghonem M, Hegazy A, El-Baoemy AA, El-daisty A. Thyroid function and auto-antibodies in Egyptian patients with systemic lupus erythematosus and rheumatoid arthritis. Trends in Medical Reasearch 2012; 7: 25-33.
[12] Baloch Z, Carayon P, Conte-Devolex B, Demer LM, Feldt-Rasmussen U, Henry JF, et al. Guidelines Committee, National Academy of Clinical Biochemistry (NACB). Laboratory medicine practice guidelines (LMPG): Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid 2003; 13( 1): 3-126.
[13] Oppenheimer JH. Role of plasma protein in the binding, distribution and metabolism of thyroid hormone. New England Journal of Med 1968; 278: 1153-62. Waite KY, Mabery GF, Ma G, Estam CJ. Immunoradiometric assay with use of magnetizableparticles. Clin chem 1986; 32,10: 1966-8.
[14] Waite KY, Mabery GF, Ma G, Estam CJ. Immunoradiometric assay with use of magnetizable particles: Measurement of thyrotropin in blood spot to serum for neonatal hypothyroidism. Clin chem 1986; 32(10): 1966-8.
[15] Weetman AP. Non-thyroid autoantibodies in autoimmune thyroid disease. Best pract Res clin Endocrinal metab. 2005; 19: 17-32.
[16] Karmaker CK, Toruinho TF, Castro WP. Association between systemic lupus erythematosus, rheumatoid arthritis, hyperprolactenemia and thyroid antibodies. Arch med res 2005; 36: 54-58.
[17] Tsai RT, Chang TC, Wang CR, Chuang CY, Chen CY. Thyroid disorder in Chinese patients with systemic lupus erythematosu. Rheumatol Internatioanl 1993; 13: 9-13.
[18] Park DJ, Cho CS, Lee SH, Park SH, Kim, HY. Thyroid disorder in Korean patients with systemic lupus erythematosus. Scan J. Rheumatol 1995; 24: 13-17.
[19] Miller FW, Moore GF, Weintraub BD and Steinberg AD. Prevalence of thyroid disease and abnormal thyroid function test results in patients with systemic lupus erythematosus. Arthritis Rheumatism 1987; 30: 1124-1131.
[20] Pyne D, Isenberg DA. Autoimmune thyroid disease in systemic lupus erythematosus. Ann Rheum Dis. 2002; 1: 70-2.
[21] Engler H, Staub JJ, Althaus B, Ryff-de Leche A, Gerber, H. Assessment of antithyroglobulin and anti-microsomal autoantibodies in patients with autoimmune thyroid disease: comparison of haemagglutination assay, enzyme-linked immunoassay and radioligand assay. Clin Chim Acta. 1989; 179 (3): 251-263.
[22] Chan AT, Al-Saffar Z, Buknail RC. Thyroid disease in systemic lupus erythematosus and rheumatoid arthritis. Rheumatology 2001; 40(3): 353-354.
[23] El-Sherif WT, El-Gendi SS, Ashmawy MM, Ahmed HM, Salma MM. Thyroid disorder and auto-antibodies in systemic lupus erythematosus and rheumatoid arthritis. Egypt J Immunol 2004; 11: 81-90.
[24] Al-Saleh J, Jassim V, El-Sayed M, Saleh N, Harb D. Clinical and immunological manifestations in 151 SLE patients living in Dubai. Lupus 2008; 17: 62–66.
[25] O’Leary PC, Edema PH, Micheeli VP, Leedman PJ, Chew GT, et al. Investigations of thyroid hormones and antibodies based on a community health survey: the Busselton thyroid study. Clinical endocrinology 2006; 64: 97-104.
[26] Al-Awadhi AM, Olusi S, Hasan EA, Abdullah A. Frequency of abnormal thyroid function in Kuwaiti Arabs autoimmune disease. Med Princ Pract 2008; 17: 61-65.
[27] Al-Jabri AA, Al-Belushi MS, Nsanze H. Frequency and levels of autoantibodies in healthy adult Omanis. Ann Saudi Med 2003; 23(6): 372-6.
[28] El-Ghoneimy DH, Awad KS, Soliman AD, El-wahab RMA. Subclinical hypothyroidism among Egyptian children with systemic lupus erythematosus. Egypt J Pediatr Allergy Immunol 2011; 9( 2): 87-92.
[29] Weetman AP, Walport MJ. Association of autoimmune thyroiditis with systemic lupus erythromatosus. Br. J Rheumatol 1987; 26: 359-61.
[30] El-Hadidi KT, Mansour MA, El-Wakd MM, El-Emary AE. Thyroid dysfunction and anti-thyroid antibodies in Egyptian patients with systemic lupus erythematosus: Correlation with clinical musculoskeletal manifestations. The Egyptian Rheumatologist 2014; 36: 173-178.
[31] Kumar K, Kole AK, Karmakar PS, Ghosh A. The spectrum of thyroid disorders in systemic lupus erythematosus. Rheumatol Int 2010; 32 (1): 73-78.
[32] Boey WL, Fong PH, Lee JS, Nag WY, Thaia AC. Autoimmune thyroid disorder in Singapore lupus. Lupus 1993; 2: 51-54.
[33] Mina R, Brunner HI. Pediatric lupus - Are there differences in presentation, genetics, response to therapy, damage accrual compared to adult lupus ? Rheum Dis Clin N Am 2010; 36(1): 53-80.
Author Information
  • Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

  • Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

  • Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

  • Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

  • Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

  • National Institute of Nuclear Medicine & Allied Sciences (NINMAS), Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

  • National Institute of Nuclear Medicine & Allied Sciences (NINMAS), Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

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    Satya Narayan Chaudhary, Shahana Akther Rahman, Mohammad Imnul Islam, Suraiya Begum, Manik Kumar Talukdar, et al. (2015). Thyroid Functions and Thyroid Auto-Antibodies in Pediatric Systemic Lupus Erythematosus Patients: A Study from Bangladesh. American Journal of Clinical and Experimental Medicine, 3(5), 207-212. https://doi.org/10.11648/j.ajcem.20150305.12

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    ACS Style

    Satya Narayan Chaudhary; Shahana Akther Rahman; Mohammad Imnul Islam; Suraiya Begum; Manik Kumar Talukdar, et al. Thyroid Functions and Thyroid Auto-Antibodies in Pediatric Systemic Lupus Erythematosus Patients: A Study from Bangladesh. Am. J. Clin. Exp. Med. 2015, 3(5), 207-212. doi: 10.11648/j.ajcem.20150305.12

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    AMA Style

    Satya Narayan Chaudhary, Shahana Akther Rahman, Mohammad Imnul Islam, Suraiya Begum, Manik Kumar Talukdar, et al. Thyroid Functions and Thyroid Auto-Antibodies in Pediatric Systemic Lupus Erythematosus Patients: A Study from Bangladesh. Am J Clin Exp Med. 2015;3(5):207-212. doi: 10.11648/j.ajcem.20150305.12

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  • @article{10.11648/j.ajcem.20150305.12,
      author = {Satya Narayan Chaudhary and Shahana Akther Rahman and Mohammad Imnul Islam and Suraiya Begum and Manik Kumar Talukdar and Md Israque Hossain Ansari and Mizanul Hasan},
      title = {Thyroid Functions and Thyroid Auto-Antibodies in Pediatric Systemic Lupus Erythematosus Patients: A Study from Bangladesh},
      journal = {American Journal of Clinical and Experimental Medicine},
      volume = {3},
      number = {5},
      pages = {207-212},
      doi = {10.11648/j.ajcem.20150305.12},
      url = {https://doi.org/10.11648/j.ajcem.20150305.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajcem.20150305.12},
      abstract = {Background: Thyroid dysfunction may be associated in pediatric SLE cases and may present as euthyroid, subclinical hypothyroid, hypothyroid or hyperthyroid states. Aim of this study was to assess thyroid functions (serum T3, T4, TSH) and thyroid antibodies (anti-thyroid Peroxidase and anti-thyroglobulin) in pediatric SLE patients. Methods: It was a cross sectional study. Pediatric SLE (pSLE) patients who fulfilled the American College of Rheumatology 1997 revised classification criteria for SLE were enrolled in this study. Sixteen apparently healthy children were enrolled in the study as reference group. Disease activity was measured by systemic lupus erythematosus disease activity index (SLEDAI). Serum T3, T4, TSH and auto-antibodies including, anti-thyroid peroxidase (anti-TPO) and anti- thyroglobulin (anti-TG) were measured by radio-immuno assay (RIA) method in the National Institute of Nuclear Medicine & Allied Sciences, BSMMU, Dhaka. Data were analyzed by SPSS for window version 16 which included descriptive statistics, Man-Whitney test and Fisher exact test. Results: Among a total number of 50 pSLE cases, 41 (82%) cases had euthyroid state, 4 had subclinical hypothyroidism, 3 had hypothyroidism and 2 patients had euthyroid sick syndrome. All the cases of reference group were in euthyroid state. Anti-thyroid peroxidase (TPO) antibody was positive in 24 pSLE cases and anti-thyroglobulin (TG) antibody was positive in 16 patients. Thyroid disorder was present in 9 cases and 7 of them had positive anti-TPO antibody. Conclusion: Thyroid disorders and presence of thyroid auto antibodies were common in pSLE patients. Anti-TPO positivity was more common than Anti-TG positivity},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Thyroid Functions and Thyroid Auto-Antibodies in Pediatric Systemic Lupus Erythematosus Patients: A Study from Bangladesh
    AU  - Satya Narayan Chaudhary
    AU  - Shahana Akther Rahman
    AU  - Mohammad Imnul Islam
    AU  - Suraiya Begum
    AU  - Manik Kumar Talukdar
    AU  - Md Israque Hossain Ansari
    AU  - Mizanul Hasan
    Y1  - 2015/08/21
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ajcem.20150305.12
    DO  - 10.11648/j.ajcem.20150305.12
    T2  - American Journal of Clinical and Experimental Medicine
    JF  - American Journal of Clinical and Experimental Medicine
    JO  - American Journal of Clinical and Experimental Medicine
    SP  - 207
    EP  - 212
    PB  - Science Publishing Group
    SN  - 2330-8133
    UR  - https://doi.org/10.11648/j.ajcem.20150305.12
    AB  - Background: Thyroid dysfunction may be associated in pediatric SLE cases and may present as euthyroid, subclinical hypothyroid, hypothyroid or hyperthyroid states. Aim of this study was to assess thyroid functions (serum T3, T4, TSH) and thyroid antibodies (anti-thyroid Peroxidase and anti-thyroglobulin) in pediatric SLE patients. Methods: It was a cross sectional study. Pediatric SLE (pSLE) patients who fulfilled the American College of Rheumatology 1997 revised classification criteria for SLE were enrolled in this study. Sixteen apparently healthy children were enrolled in the study as reference group. Disease activity was measured by systemic lupus erythematosus disease activity index (SLEDAI). Serum T3, T4, TSH and auto-antibodies including, anti-thyroid peroxidase (anti-TPO) and anti- thyroglobulin (anti-TG) were measured by radio-immuno assay (RIA) method in the National Institute of Nuclear Medicine & Allied Sciences, BSMMU, Dhaka. Data were analyzed by SPSS for window version 16 which included descriptive statistics, Man-Whitney test and Fisher exact test. Results: Among a total number of 50 pSLE cases, 41 (82%) cases had euthyroid state, 4 had subclinical hypothyroidism, 3 had hypothyroidism and 2 patients had euthyroid sick syndrome. All the cases of reference group were in euthyroid state. Anti-thyroid peroxidase (TPO) antibody was positive in 24 pSLE cases and anti-thyroglobulin (TG) antibody was positive in 16 patients. Thyroid disorder was present in 9 cases and 7 of them had positive anti-TPO antibody. Conclusion: Thyroid disorders and presence of thyroid auto antibodies were common in pSLE patients. Anti-TPO positivity was more common than Anti-TG positivity
    VL  - 3
    IS  - 5
    ER  - 

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