Prevalence of autoimmune thyroid disorders in a Spanish multiple sclerosis cohort.
The aim of the study was to determine the prevalence of thyroid autoimmune disorders in a cohort of untreated multiple sclerosis (MS) patients and compare it with a stratified sample of an adult population. We prospectively studied 93 untreated MS patients. The control group included 401 healthy subjects selected by stratified sampling in a non-iodine-deficient area. Antithyroid antibodies (ATA) (antibodies against peroxidase and thyroglobulin) were considered positive at titres > or =149 IU/ml. Antibodies were positive in 11 MS patients (11.8%; 95% CI 5.3-18.4%). This prevalence was five times higher (P = 0.0001) when compared with that in the control population. We found six cases with subclinical hypothyroidism (6.45%; 95% CI 11.4-1.5) in contrast to 2.24% in the control group. Comparing MS with positive and negative ATA, there was a non-significant, slightly higher frequency of low Expanded Disability Status Scale (EDSS) score in the ATA-positive group (81% vs. 73.2%). One year after start of interferon (IFN) treatment, only one patient developed subclinical thyroid dysfunction. MS patients have a higher prevalence of ATA compared with the general population. An initial ATA and thyroid-stimulating hormone (TSH) determination is recommended in all MS patients. A periodic assessment of thyroid function during IFN treatment only seems to be justified in those cases where positive ATA or dysfunction is present before treatment.
Munteis
E
E
Neurology Service, Hospital Universitari del Mar, IMAS, Barcelona, Spain. 91774@imas.imim.es
Cano
J F
JF
Flores
J A
JA
Martinez-Rodriguez
J E
JE
Miret
M
M
Roquer
J
J
D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D016017:Odds Ratio; D009195:Peroxidase / Q000276:immunology; D015995:Prevalence; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013954:Thyroglobulin / Q000276:immunology; D013959:Thyroid Diseases / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology / Q000473:pathology; D013961:Thyroid Gland / Q000503:physiopathology
D000906:Antibodies; D013954:Thyroglobulin; D009195:Peroxidase