Anti-nuclear autoantibodies in Graves’ disease and Graves’ orbitopathy

Abstract

Objective A relationship between thyroid and non-organ-specific autoimmunity could be relevant for Graves’ orbitopathy (GO), which affects connective tissue. We investigated the association between GO and anti-nuclear antibodies (ANAs). Methods Retrospective investigation was conducted in 265 patients with Graves’ disease (GD), 158 with and 107 without GO. Primary outcome was: prevalence of ANAs in GO vs no-GO. Secondary outcomes were: (1) relationship between ANAs and GO features; (2) prevalence of ANAs in GD compared with non-autoimmune hyperthyroidism [(78 patients with toxic nodular goiter (TNG)]; (3) distribution of ANA patterns. Results ANAs were detected in 212 (80%) GD patients, but prevalence did not differ between GO (79.7%) and no-GO (80.3%). Higher ANA titers (1:160) were more common in GO (51.5 vs 38.3%), but only nearly significantly (OR 0.5; 95% CI: 0.3–1; P = 0.059). Proptosis was lower in ANA-positive patients (mean difference: − 1.4 mm; 95% CI from − 2.5 to − 0.3; P = 0.011), in whom nearly significantly lower CAS (Mann–Whitney U: 1.5; P = 0.077) and eyelid aperture (mean difference: − 0.9 mm; 95% CI from − 2 to 0; P = 0.062) were observed. Prevalence of ANAs in GD was lower than in TNG (80 vs 91%; OR 0.3; 95% CI: 0.1–0.9; P = 0.028), but nuclear speckled pattern was more frequent (OR 22.9; 95% CI 1.3–381.3; P = 0.028). Conclusions Although ANAs are not more frequent in GO, they seem to exert a protective role on its severity and on development of GD. A switch of T cell population in ANA-positive patients, resulting in a different phenotype, may be responsible. Further studies are needed to investigate the mechanisms.

Association between thyroid autoimmunity and antinuclear antibody prevalence among pregnant women: a cross-sectional study in Qingdao, China

“…ANA positivity is a risk factor for thyroid autoimmunity. However, as shown by G. Lanzolla et al., being ANA positive protected against the development of Graves’ disease and reduced its severity ( 29 ). The study of ANA patterns is of tremendous interest in the fields of immunology and rheumatology since distinct patterns may have diverse clinical, diagnostic, and prognostic implications.…”

Graves’ disease and systemic lupus erythematosus: a Mendelian randomization study

“…indicated that the presence of antinuclear antibodies was observed in around 80% of patients diagnosed with GD. This finding suggested that GD may potentially influence the development of SLE through the autoantibody pathway ( 40 ). Furthermore, a shared immunological pathway in the development of SLE and GD is suggested by the overlapping presence of specific chemokines and cytokines.…”

Relationship between autoimmune thyroid antibodies and anti-nuclear antibodies in general patients

“…An Italy retrospective investigation was conducted the ANA positivity rate arrived 80% in 265 patients with GD ( 25 ). Another Italy research assessed the prevalence of ANA in 96 pediatric patients with AITD, in which 86 children with chronic lymphocytic thyroiditis and 7 with GD, the ANA positivity was 71% ( 26 ).…”