The Prevalence of Elevated Serum C-Reactive Protein Levels in Inflammatory and Noninflammatory Thyroid Disease

Abstract

C-reactive protein (CRP) levels have not been routinely used to diagnose thyroid disease, although many thyroid conditions involve inflammation. This study was intended to determine whether CRP levels could differentiate between inflammatory and noninflammatory thyroid conditions, especially between type II inflammatory amiodarone-induced thyrotoxicosis (AIT) and type I iodine-induced AIT. Serum high-sensitivity CRP levels were measured in 100 euthyroid controls (7 taking amiodarone) and 353 patients with one of the following thyroid conditions: AIT, subacute thyroiditis, toxic diffuse goiter, nodular goiter, Hashimoto's thyroiditis, shortterm hypothyroidism, or postpartum thyroiditis. No patients with nontoxic multinodular goiter (n = 34), toxic nodular goiter (n = 23), or toxic diffuse goiter, either untreated (n = 49) or euthyroid while taking methimazole (n = 33), had positive CRP levels (>10 mg/L). The occurrence of positive CRP levels among patients with Hashimoto's thyroiditis (n = 35), short-term hypothyroidism (n = 38), and postpartum thyroiditis (n = 70) did not differ significantly from controls. The occurrence of positive CRP values did not differ significantly between patients with type I and type II AIT and controls. Six of 7 patients (86%) with untreated subacute thyroiditis had positive CRP levels (p < 0.00001). These results indicate that there is only a limited role for measurement of CRP levels in the diagnosis of thyroid diseases other than subacute thyroiditis.

Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace

“…[39][40][41][42][43][44] Conflicting results have been obtained in relation to hsCRP: three studies showed some correlation, [44][45][46] while another three did not show any association at all. 39,47,48 The positive studies tended to include patients with definitive thyroid disease, as opposed to asymptomatic patients who had been found through screening.…”

Thyroid hormone increases mannan-binding lectin levels

“…In parallel to MASP-2 and MBL, the levels of the acute phase reactant and inflammatory marker CRP tended to be increased by thyroid hormone, although this did not reach statistical significance. In other studies, CRP are reported to be increased in hypothyroidism (27,28), whereas others have found no evidence of elevated CRP levels in hyperthyroidism (29,30). Both Graves' disease and chronic autoimmune hypothyroidism are autoimmune diseases that share many immunologic features, including high serum concentrations of antibodies against thyroglobulin, thyroid peroxidase and possibly the sodium -iodide cotransporter in thyroid tissue (31).…”

Amiodaron i tarczyca

“…Thus, positivity of thyroid autoantibody tests does not always support diagnosis of the type 1 AI [35,44]. Other parameters, such as interleukin-6, C-reactive protein, and thyroglobulin, are not useful in clinical practice [45]. Radioiodine uptake (RAIU) is usually low in type 1 AIT, but can also be normal or raised because of avid uptake by autonomous thyroid tissue.…”

“…U pacjentów w eutyreozie, z utajonym autoimmunizacyjnym zapaleniem tarczycy, AMIO może wywołać proces rozpadu tarczycy, prowadząc do rozwoju typu 2 AIT [35,44]. Oznaczanie innych wskaźników, takich jak interleukina-6, białko C-reaktywne, tyreoglobulina nie jest użyteczne w praktyce klinicznej [45]. Wychwyt jodu (RAIU) zwykle jest niski w typie 1 AIT, ale może być prawidłowy lub podwyższony z powodu obecności autonomicznej tkanki tarczycowej.…”