Pattern of thyroid autoimmunity in chinese patients with pernicious anemia.
BACKGROUND
Autoimmune thyroid disease (AITD) often coexists with pernicious anemia (PA) among whites. The study aimed to determine thyroid autoimmunity in Chinese patients with PA.


METHODS
From the data of a hospital-based longitudinal study of Chinese PA patients (1994-2007), those with complete information of antibodies to thyroid peroxidase (TPO), thyroglobulin (Tg), and gastric parietal cell; serum thyroid-stimulating hormone and free thyroxine; gastric mucosal histology; and family history of AITD were analyzed.


RESULTS
Among 126 Chinese PA patients, 44% had TPO/Tg antibodies and 13.5% AITD. TPO/Tg antibodies occurred in 33% (16 of 49) of male and 52% (40 of 77) of female patients (P = 0.034). Graves disease (8 patients) tended to antedate PA and was associated with no or low titers of TPO/Tg antibodies. Primary hypothyroidism (9 patients) developed during follow-up and was associated with high TPO/Tg antibody titers. The TPO/Tg antibodies did not affect the clinical course of PA but was associated with an enhanced risk of developing AITD and vitiligo. Overall, AITD (before and after PA) occurred in 23% (13 of 56) and 5.7% (4 of 70) of PA patients with and without antibodies (P = 004). During follow-up (mean duration of 75.24 +/- 46.39 months), 10 patients developed AITD-7 new onset of hypothyroidism and 3 progression/relapse of prior AITD. Logistic regression analysis of presenting features of PA revealed 2 independent factors for AITD development during follow-up-presence of thyroid antibodies (odds ratio 20.2, 95% confidence interval 1.8-223) and history of prior AITD (odds ratio 39.8, 95% confidence interval 2.3-679).


CONCLUSIONS
It is recommended to screen thyroid antibodies and monitor thyroid function during follow-up.
Chan
Joyce Chee Wun
JC
Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China SAR. joycecwchan@hotmail.com
Liu
Herman Sung Yu
HS
Kho
Bonnie Chi Shan
BC
Lau
Thomas Kwan Hang
TK
Li
Vil Leung
VL
Chan
Florence Hoi Yan
FH
Leong
In Son
IS
Pang
Ho Kwong
HK
Lee
Cheung Kei
CK
Liang
Yu Shan
YS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000752:Anemia, Pernicious / Q000150:complications*; D001323:Autoantibodies / Q000097:blood; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013967:Thyroiditis, Autoimmune / Q000150:complications*
D001323:Autoantibodies