Age-Related Prevalence of Platelet-Associated Immunoglobulins G in Nonthrombocytopenic Patients with Autoimmune Thyroid Disease and Autoimmune Polyglandular Syndrome

Abstract

Objective: The prevalence of platelet-associated IgG (paIgG) in nonthrombocytopenic patients with autoimmune thyroid disease (AITD) alone or associated with autoimmune polyglandular syndrome (APS) has been studied. Subjects: A total of 164 individuals were enrolled in this study: 81 patients with AITD alone, 33 patients with APS, and 50 healthy controls. Results: The presence of paIgG was recorded in 41 of 81 patients with AITD (51%) as compared with 2 of 50 control subjects (4%, p < 0.0001). The prevalence of paIgG in patients with APS was higher even when compared with patients with AITD alone (25/33, 76%; p = 0.02). The presence of paIgG was not related to the functional thyroid parameters. The prevalence of paIgG was higher in the older than in the younger patients (75 vs. 47%, p = 0.0037). Conclusions: The results indicate that the prevalence of paIgG in patients with AITD is higher than previously thought, namely in elderly patients and in patients with APS, and not related to the thyroid function.

Valproate-Induced Insulin Resistance and Obesity in Children

“…Apart from one study that showed that patients with generalized versus partial seizures tend to be at greater risk for weight increase [13], the literature does not differentiate the incidence of weight gain between generalized and partial epilepsy patients [8, 9, 11, 14, 17, 19, 28, 29]. Our experience confirms this lack of a difference [4].…”

“…It is possible that this gender difference could be related to leptin resistance or to the high frequency of carbohydrate craving observed in VPA-treated patients [19]. This higher percentage of weight gain in female patients is clearly reported by many authors [3, 5, 7, 9, 17, 19, 21]. In particular, a possible effect of gender on the extent of weight gain has been studied by El-Khatib et al [19], who compared the incidence and extent of weight gain associated with VPA monotherapy in male and female epileptic patients.…”

“…Increased appetite and excessive weight gain were reported in 23 boys and 21 girls; 31 of 66 patients with generalized epilepsy and 13 of 34 with partial epilepsy were affected in this way. In the following years, many studies [3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20] quantified the amount of weight gain. Also, in our experience we have found that the percentage of obesity in a group of 40 epileptic patients without mental retardation is significantly higher in VPA-treated patients (37.5%) than in a group of 40 epileptics treated with other anticonvulsant drugs (10%).…”

“…The increase in body weight appears to occur most frequently in post-pubertal girls taking VPA [3, 4, 6, 8, 9, 12, 15, 17, 19, 20,25,26,27], although VPA-induced weight gain has also been reported also in pre-pubertal patients [4,5,6,7, 10, 24, 26, 28]. Finally, a recent population-based study reported that increase in body weight is more common in patients treated with VPA during puberty if epilepsy and medication continue into adulthood [16].…”

Serum Insulin, Cortisol, Leptin, Neuropeptide Y, Galanin and Ghrelin Levels in Epileptic Children Receiving Valproate

“…In adults, the reported frequency of significant weight gain, commonly defined as 4 kg or more, is between 57 and 70% [5,31,32,33]. An open-label, 24-week, randomized study comparing lamotrigine, carbamazepine and VPA in patients newly diagnosed with epilepsy (n = 239) determined weight gain only in the VPA-treated patients, with a mean weight increase of 3.9 kg [34]. Privitera et al [35] reported that, as in adult patients, VPA causes a mean weight gain of between 2.0 and 5 kg in children.…”