title: Vestibular disorders in euthyroid patients with Hashimoto's thyroiditis: role of thyroid autoimmunity.
abstract: BACKGROUND
  A relationship between vestibular disorders and thyroid autoimmunity independently from thyroid function has been postulated.
  
  
  OBJECTIVE
  To shed more light on the actual relationship between vestibular lesions and Hashimoto's thyroiditis (HT) regardless of thyroid function.
  
  
  METHODS
  Forty-seven patients with HT (89·4% F; aged 48·3 ± 12·7 years), 21 with multinodular goitre (MNG; 57·1% F; 54·1 ± 9·8 years) and 30 healthy volunteers (56·7% F; 50·7 ± 13·9 years) were enrolled. Inclusion criteria were the presence of normal thyroid function tests and no clinical history of vestibular dysfunction. Each subject was submitted to complete vestibular evaluation [Caloric Test, Vestibular evoked myogenic potentials (VEMPs), Head Shaking Test (HST)].
  
  
  RESULTS
  52·2% of HT patients showed an alteration of VEMPs and 44·7% of caloric test (P < 0·0001 for both). None of the MNG patients showed any vestibular alteration, while one healthy control showed an altered caloric test. A correlation was found between vestibular alterations of HT patients and the degree of serum TPOAb level, not affected by age and serum TSH value. By logistic regression analysis, the absence of thyroid autoimmunity significantly reduced the risk of vestibular alterations: HR 0.19 (95%CI: 0·003-0.25, P = 0·0004) for caloric test; HR 0·07 (95%CI: 0·02-0·425, P < 0·0001) for VEMPs; and HR 0·22 (95%CI: 0·06-0·7, P = 0·01) for HST.
  
  
  CONCLUSIONS
  In euthyroid HT patients, a significant relationship between subclinical vestibular damage and the degree of TPOAb titre was documented. This finding suggests that circulating antithyroid autoantibodies may represent a risk factor for developing vestibular dysfunction. An accurate vestibular evaluation of HT patients with or without symptoms is therefore warranted.
authors.affiliation: Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, University of Catanzaro Magna Graecia, Catanzaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Chiarella
authors.forename: Sara
authors.initials: S
authors.lastname: Tognini
authors.forename: Andrea
authors.initials: A
authors.lastname: Nacci
authors.forename: Roberta
authors.initials: R
authors.lastname: Sieli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costante
authors.forename: Claudio
authors.initials: C
authors.lastname: Petrolo
authors.forename: Valentina
authors.initials: V
authors.lastname: Mancini
authors.forename: Pietro Hiram
authors.initials: PH
authors.lastname: Guzzi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pasqualetti
authors.forename: Ettore
authors.initials: E
authors.lastname: Cassandro
authors.forename: Bruno
authors.initials: B
authors.lastname: Fattori
authors.forename: Diego
authors.initials: D
authors.lastname: Russo
authors.forename: Fabio
authors.initials: F
authors.lastname: Monzani
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000378:metabolism; D005260:Female; D050031:Hashimoto Disease / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013961:Thyroid Gland / Q000378:metabolism / Q000473:pathology*; D013967:Thyroiditis, Autoimmune / Q000378:metabolism / Q000473:pathology*
chemical_list: D001323:Autoantibodies