Hashimoto’s Thyroiditis and Membranous Nephropathy Developed in Progressive Systemic Sclerosis (PSS)

Akikusa, Bunshiro; Kondō, Yōichirō; Iemoto, Yoichi; Iesato, K; Wakashin, M

doi:10.1093/ajcp/81.2.260

Cited by 24 publications

(18 citation statements)

References 8 publications

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“…This wide range may be at least partially explained by application of steroids and immune suppressive drugs in SSc, and by the different gender and age composition (23) and iodine intake of SSc patients. In most of the older studies AbTg were more common than antimicrosomal antibodies (11,(16)(17)(18), while in the more recent ones a higher prevalence of AbTPO was found (12)(13)(14)(15). The results of our study demonstrate a significantly higher titer and prevalence of AbTPO, but not of AbTg, both in female and in male SSc than in controls.…”

Section: Discussionmentioning

confidence: 99%

Clinical and subclinical autoimmune thyroid disorders in systemic sclerosis

et al. 2007

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Objective: Several studies have reported the association of systemic sclerosis (SSc) with thyroid autoimmune disorders, but most of them have neither an appropriate control group nor include a complete thyroid work-up. Design: The aim of our study was to evaluate the prevalence of thyroid disorders in a large number of patients with SSc using a complete clinical evaluation. Methods: Thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroglobulin and antithyroid-peroxidase (AbTPO) autoantibodies, thyroid ultrasonography and blood flow and fine needle aspiration were performed in 202 SSc patients versus 404 gender-and age-matched controls from the general population, with similar iodine intake, to evaluate the prevalence of clinical and subclinical thyroid disorders. Results: Odds ratio (OR) for female SSc versus controls was: for subclinical hypothyroidism, 3.2 (95% CI)Z1.8-5.7); for clinical hypothyroidism, 14.5 (95% CIZ2.3-90.9); for AbTPO positivity, 2.7 (95% CIZ1.8-4.1); for hypoechoic pattern, 3.2 (95% CIZ2.2-4.7); for thyroid autoimmunity, 3.7 (95% CIZ2.6-5.4); for thyroid volume !6 ml, 1.8 (95% CIZ1.2-2.7). OR for thyroid autoimmunity in male SSc versus controls was 10.8 (95% CIZ2.2-52.4). Mean values of TSH in female SSc, and of AbTPO in female and male SSc were higher (P!0.01) than in controls. We observed three cases of Graves' disease in female SSc versus zero in controls (PZ0.0140), and two cases of papillary thyroid cancer in SSc patients. Conclusions: Thyroid function, AbTPO and ultrasonography should be tested as part of the clinical profile in SSc patients. Females, subjects with positive AbTPO and hypoechoic and small thyroid should have thyroid function follow-up and appropriate treatment in due course.

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Section: Discussionmentioning

confidence: 99%

Clinical and subclinical autoimmune thyroid disorders in systemic sclerosis

et al. 2007

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“…Both hypothyroidism (56) and hyperthyroidism (57,58) can coincide with different forms of glomerular disease. The more frequent form is membranous glomerulopathy associated with nephrotic syndrome (NS) (50,52,(55)(56)(57)59). Thyroid dysfunction has been reported to be associated with IgA glomerulonephritis (49,51,60), mesangiocapillary or membranoproliferative glomerulonephritis (47, 48,61), and minimal change glomerulonephritis (58,59,62,63).…”

Section: Glomerular Diseasementioning

confidence: 99%

Thyroid dysfunction and kidney disease

Iglesias

Díez

2009

European Journal of Endocrinology

375

352

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Thyroid hormones (TH) are essential for an adequate growth and development of the kidney. Conversely, the kidney is not only an organ for metabolism and elimination of TH, but also a target organ of some of the iodothyronines' actions. Thyroid dysfunction causes remarkable changes in glomerular and tubular functions and electrolyte and water homeostasis. Hypothyroidism is accompanied by a decrease in glomerular filtration, hyponatremia, and an alteration of the ability for water excretion. Excessive levels of TH generate an increase in glomerular filtration rate and renal plasma flow. Renal disease, in turn, leads to significant changes in thyroid function. The association of different types of glomerulopathies with both hyper-and hypofunction of the thyroid has been reported. Less frequently, tubulointerstitial disease has been associated with functional thyroid disorders. Nephrotic syndrome is accompanied by changes in the concentrations of TH due primarily to loss of protein in the urine. Acute kidney injury and chronic kidney disease are accompanied by notable effects on the hypothalamus-pituitary-thyroid axis. The secretion of pituitary thyrotropin (TSH) is impaired in uremia. Contrary to other non-thyroidal chronic disease, in uraemic patients it is not unusual to observe the sick euthyroid syndrome with low serum triodothyronine (T 3 ) without elevation of reverse T 3 (rT 3 ). Some authors have reported associations between thyroid cancer and kidney tumors and each of these organs can develop metastases into the other. Finally, data from recent research suggest that TH, especially T 3 , can be considered as a marker for survival in patients with kidney disease.

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“…Coexistence of autoimmune hypothyroidism has been described previously with various histological types of nephrotic syndrome, especially with membranous nephropathy. [14][15][16][17][18] In our study, four of 15 patients with membranous nephropathy had elevated anti-TPO antibodies.…”

Section: Resultsmentioning

confidence: 92%