Evaluation of the structure, autoimmunity, and functions of the thyroid gland in familial Mediterranean fever patients

ABSTRACT Objective Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder that is frequently seen in the eastern Mediterranean region. The thyroid gland can be affected in FMF patients through autoimmunity or amyloidosis. Here, we aimed to evaluate the structure and functions of the thyroid gland in addition to possible autoimmunity in FMF patients. Subjects and methods The study was conducted by the Endocrinology and Metabolism and Internal Medicine Departments. Thirty FMF patients and 30 age and gender-matched healthy controls were enrolled in the study. Free thyroxin (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (anti-TPO) autoantibodies were investigated. Detailed thyroid grayscale and Doppler Ultrasonography examinations and shear-wave elastosonography (SWE) were performed in the patient and control groups. Results Anti-TPO was detected in 24% (n = 7) of the patients. On the grayscale US, mean thyroid volumes were similar between the FMF and the control groups (p > 0.05). By Doppler US, thyroid vascularity observed was detected in 10.3% (n = 3) of the patients. SWE revealed that the mean velocity value of right vs. left lobe in the patient group was 1.77 ± 0.45 m/s and 1.95 ± 0.51 m/s, respectively. Compared to the control group, the mean velocity values were significantly higher in the right (p = 0.004) and left (p = 0.01) lobes of the patient group. The mean stiffness value in the patient group was also significantly higher in the right and left lobes [10.13 ± 5.65 kPa (p = 0.005) and 12.24 ± 6.17 kPa (p = 0.02), respectively]. Conclusion Recognizing the complications of FMF early in the course of the disease is as important as the early diagnosis of the disorder. Based on this, thyroid functions and changes in its structure should be evaluated carefully for early diagnosis of a possible coexisting thyroid disorder. Arch Endocrinol Metab. 2020;64(1):66-70

Tireoidite de Hashimoto com aumento inesperado de triiodotironina: anticorpo anti-triiodotironina / Unexpected increase of triiodothyronine in a case of Hashimoto thyroiditis: anti-triiodothyronine antibody

A presença de anticorpos anti-tiroxina (T4) e antiotriiodotironina (T3) tem sido relatada, sendo que a sua prevalência aumenta em indivíduos com alteraçöes tireoidiana. Descrevemos o caso de uma paciente que se apresentava em hipotireoidismo laboritorial com aumento inesperado de T3 total. O anticorpo anti-tiroperoxidase (anti-TPO) positivo confirmou o diagnóstico de tireoidite de Hashimoto. O aumento de T3 total sugere a presença de anticorpos anti-T3. Realizamos entäo, um ensaio de T3 marcado e posterior precipitaçäo com polietilenoglicol para comprovar a existência deste anticorpo. A paciente apresentou alta porcentagem de ligaçäo de seu anticorpo anti-T3 marcado, confirmando a existência de anticorpo anti-T3. A associaçäo de tireoidite de Hashimoto e anticorpos anti-T3, apesar e rara, deve ser lembrada nas situaçöes em que os hormônios tireoidianos estäo discordantes em relaçäo à clínica

Detection of autoantibodies against 3,5,3'-triiodothyronine in a hyperthyroid patient (a case report).

A 35-year-old female patient was evaluated for thyroid function and was found to be hyperthyroid clinically and by laboratory tests. During the course of treatment with neomercazole, she developed a bizarre picture with consistently low T3 levels irrespective of her clinical thyroid status and other laboratory tests like serum T4 and TSH levels. The serum of the patient when analysed for the presence of autoantibodies was positive for those against T3. The presence of T3 autoantibodies was confirmed by other laboratory techniques like assessment of blank values in radioimmunoassay, binding of T3-125I to isolated gamma globulin and starch gel electrophoresis. Autoantibodies were found to be present only against T3 and not against. T4 The affinity constant of T3 antibodies was 4 x 10(9) lit. mol-1 as determined by Scatchard plot analysis while total binding capacity was 23 x 10(-11) mol/L.