title: Thyrotropin receptor autoantibodies and early miscarriages in patients with Hashimoto thyroiditis: a case-control study.
abstract: We have previously hypothesized that early miscarriage in women with Hashimoto thyroiditis might be the result of a cross-reactivity process, in which blocking autoantibodies against thyrotropin receptor (TSHr-Ab) antagonize hCG action on its receptor on the corpus luteum. To test this hypothesis from the clinical perspective, we investigated the presence of TSHr-Ab in Hashimoto thyroiditis patients with apparently unexplained, first-trimester recurrent miscarriages compared to that in Hashimoto thyroiditis patients with documented normal fertility. A total of 86 subjects (43 cases and 43 age-matched controls) were finally included in a case-control study. No difference in the prevalence of TSHr-Ab positivity was detected between cases and controls (Fisher's exact test, p value = 1.00). In patients with recurrent miscarriages, TSHr-Ab concentrations did not predict the number of miscarriages (univariate linear regression, p value = 0.08). These results were robust in sensitivity analyses, including only cases with full investigation or those with three or more miscarriages. We conclude that no role could be advocated for TSHr-Ab in the aetiology of recurrent miscarriages in women with Hashimoto thyroiditis.
authors.affiliation: Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki (AUTH), Greece. touliskos@gmail.com
authors.forename: Konstantinos A
authors.initials: KA
authors.lastname: Toulis
authors.forename: Dimitrios G
authors.initials: DG
authors.lastname: Goulis
authors.forename: Konstantina
authors.initials: K
authors.lastname: Tsolakidou
authors.forename: Ilias
authors.initials: I
authors.lastname: Hilidis
authors.forename: Marios
authors.initials: M
authors.lastname: Fragkos
authors.forename: Stergios A
authors.initials: SA
authors.lastname: Polyzos
authors.forename: Antonios
authors.initials: A
authors.lastname: Gerofotis
authors.forename: Marina
authors.initials: M
authors.lastname: Kita
authors.forename: Helen
authors.initials: H
authors.lastname: Bili
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vavilis
authors.forename: Michail
authors.initials: M
authors.lastname: Daniilidis
authors.forename: Basil C
authors.initials: BC
authors.lastname: Tarlatzis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papadimas
mesh_terms: D000022:Abortion, Spontaneous / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D050031:Hashimoto Disease / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011989:Receptors, Thyrotropin / Q000276:immunology*; D012307:Risk Factors; D016036:Seroepidemiologic Studies
chemical_list: D001323:Autoantibodies; D011989:Receptors, Thyrotropin