title: Prevalence and clinical significance of nonorgan specific antibodies in patients with autoimmune thyroiditis as predictor markers for rheumatic diseases.
abstract: Autoimmune diseases are considered the 3rd leading cause of morbidity and mortality in the industrialized countries. Autoimmune thyroid diseases (ATDs) are associated with high prevalence of nonorgan-specific autoantibodies, such as antinuclear antibodies (ANA), antidouble-stranded deoxyribonucleic acid (anti-dsDNA), antiextractable-nuclear antigens (anti-ENAs), rheumatoid factor (RF), and anticyclic-citrullinated peptides (anti-CCP) whose clinical significance is unknown.We aimed to assess the prevalence of various nonorgan-specific autoantibodies in patients with ATD, and to investigate the possible association between these autoantibodies and occurrence of rheumatic diseases and, if these autoantibodies could be considered as predictor markers for autoimmune rheumatic diseases in the future.This study had 2 phases: phase 1; in which 61 ATD patients free from rheumatic manifestations were assessed for the presence of these nonorgan-specific autoantibodies against healthy 61 control group, followed by 2nd phase longitudinal clinical follow-up in which cases are monitored systematically to establish occurrence and progression of any rheumatic disease in association to these autoantibodies with its influences and prognosis.Regarding ATD patients, ANA, anti-dsDNA, Anti-ENA, and RF were present in a percentage of (50.8%), (18%), (21.3%), and (34.4%), respectively, with statistically significance difference (P < 0.5) rather than controls. Nearly one third of the studied group (32.8%) developed the rheumatic diseases, over 2 years follow-up. It was obvious that those with positive anti-dsDNA had higher risk (2.45 times) to develop rheumatic diseases than those without. There was a statistically significant positive linear relationship between occurrence of disease in months and (age, anti-dsDNA, anti-CCP, RF, and duration of thyroiditis). Anti-dsDNA and RF are the most significant predictors (P < 0.0001).ATD is more associated with rheumatic diseases than previously thought. Anti-dsDNA, RF, and anti-CCP antibodies may be used as predictive screening markers of systemic lupus erythematosus and RA, with early referral to rheumatologists for close follow-up and early diagnoses for appropriate disease management of the disease, as early disease control will allow better quality of life.
authors.affiliation: Department of Physical Medicine and Rheumatology, Benha Faculty of Medicine, Benha University, Benha, Egypt Department of Rheumatology, Alhada Armed Forces Hospital, Taif, Saudi Arabia Department of Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt Department of Pediatrics, Alhada Armed Forces Hospital, Taif, Saudi Arabia Department of Public Health, Benha Faculty of Medicine, Benha University, Benha, Egypt Director of Armed Forces Hospitals, Taif, Saudi Arabia Departments of Pulmonology and Endocrinology, Al Hada Armed Forces Hospital, Taif, Saudi Arabia.
authors.forename: Basant M
authors.initials: BM
authors.lastname: Elnady
authors.forename: Naglaa M
authors.initials: NM
authors.lastname: Kamal
authors.forename: Raneyah H M
authors.initials: RHM
authors.lastname: Shaker
authors.forename: Amal F
authors.initials: AF
authors.lastname: Soliman
authors.forename: Waleed A
authors.initials: WA
authors.lastname: Hasan
authors.forename: Hamed A
authors.initials: HA
authors.lastname: Alghamdi
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Algethami
authors.forename: Mohamed Bilal
authors.initials: MB
authors.lastname: Jajah
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000974:Antibodies, Antinuclear / Q000097:blood*; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004247:DNA / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D010456:Peptides, Cyclic / Q000276:immunology; D015995:Prevalence; D012216:Rheumatic Diseases / Q000453:epidemiology / Q000209:etiology*; D012217:Rheumatoid Factor / Q000097:blood; D012307:Risk Factors; D013967:Thyroiditis, Autoimmune / Q000150:complications / Q000276:immunology*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D015415:Biomarkers; D010456:Peptides, Cyclic; C033055:anti-extractable nuclear antigen antibodies; C487763:cyclic citrullinated peptide; D004247:DNA; D012217:Rheumatoid Factor