title: Pattern of thyroid autoimmunity in chinese patients with pernicious anemia.
abstract: 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.
authors.affiliation: Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China SAR. joycecwchan@hotmail.com
authors.forename: Joyce Chee Wun
authors.initials: JC
authors.lastname: Chan
authors.forename: Herman Sung Yu
authors.initials: HS
authors.lastname: Liu
authors.forename: Bonnie Chi Shan
authors.initials: BC
authors.lastname: Kho
authors.forename: Thomas Kwan Hang
authors.initials: TK
authors.lastname: Lau
authors.forename: Vil Leung
authors.initials: VL
authors.lastname: Li
authors.forename: Florence Hoi Yan
authors.initials: FH
authors.lastname: Chan
authors.forename: In Son
authors.initials: IS
authors.lastname: Leong
authors.forename: Ho Kwong
authors.initials: HK
authors.lastname: Pang
authors.forename: Cheung Kei
authors.initials: CK
authors.lastname: Lee
authors.forename: Yu Shan
authors.initials: YS
authors.lastname: Liang
mesh_terms: 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*
chemical_list: D001323:Autoantibodies