RESUMO
BACKGROUND AND OBJECTIVES: Our aim was to evaluate the prevalence of parietal cell antibodies (PCA) in patients with autoimmune thyroid disease (ATD). MATERIAL AND METHODS: We performed a descriptive, cross-sectional study of patients with ATD. The presence of PCA was determined. Elevated antithyroid antibodies (ATAs) were defined as those higher than the 75th percentile of distribution. Multivariate logistic regression models were built to assess the independent contribution of the following variables to PCA positivity: age, sex, hemoglobin, medium corpuscular volume (MCV), dose/Kg of levothyroxine (LT4), disease duration and elevated ATA levels. RESULTS: A total of 148 patients were included (137 females). The mean age was 45.7 (SD 15) years and disease duration was 4.5 (SD 4) years. Forty-three patients (29%) with Graves' disease and 105 (71%) with primary hypothyroidism were included. The 75th percentile of distribution was 420U/ml for anti-peroxidase antibodies and 200U/ml for anti-thyroglobulin antibodies. PCA positivity was found in 30 patients, with an overall prevalence of 20.3%. PCA positivity with titers higher than 1/640 was found in 19 patients (12.8%). The only independent predictive factor of PCA positivity was the presence of elevated levels of ATAs (odds ratio (OR)=3; 95% confidence interval (CI): 1.1-8.6; p=0.04). The only independent predictive factor of PCA positivity at titers >/=1/640 was also the presence of elevated levels of ATAS (OR=7.3; 95% CI: 1.6-32.7; p=0.009). CONCLUSIONS: The prevalence of PCA positivity in patients with ATD was 20%. Elevated levels of ATAs increase the risk of PCA positivity.
Assuntos
Autoanticorpos/sangue , Doenças Autoimunes/imunologia , Gastrite Atrófica/imunologia , Doença de Graves/imunologia , Células Parietais Gástricas/imunologia , Tireoidite Autoimune/imunologia , Adulto , Idoso , Especificidade de Anticorpos , Autoanticorpos/imunologia , Autoantígenos/imunologia , Doenças Autoimunes/complicações , Doenças Autoimunes/diagnóstico , Estudos Transversais , Feminino , Gastrite Atrófica/complicações , Gastrite Atrófica/diagnóstico , Doença de Graves/sangue , Doença de Graves/complicações , Humanos , Hipotireoidismo/sangue , Hipotireoidismo/complicações , Hipotireoidismo/imunologia , Iodeto Peroxidase/imunologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Tireoglobulina/imunologia , Tireoidite Autoimune/sangue , Tireoidite Autoimune/complicaçõesRESUMO
Introducción Evaluar la prevalencia de anticuerpos frente a las células parietales gástricas (ACP) en pacientes con enfermedad tiroidea autoinmune (ETI). Material y métodos Estudio descriptivo transversal con inclusión de pacientes con ETI. Se determinó la presencia de ACP. Se definieron como títulos elevados de anticuerpos antitiroideos (ATAS) niveles de anticuerpos antiperoxidasa o antitiroglobulina superiores al percentil 75. Mediante modelo de regresión logística se evaluó la contribución independiente de las siguientes variables a la presencia de ACP positivos: edad, sexo, hemoglobina, volumen corpuscular medio (VCM), dosis/k de levotiroxina (LT4), duración de la ETI y títulos elevados de ATAS. Resultados Se incluyeron 148 pacientes (137 mujeres) con edad de 45,7 (DE 15) años y duración de la enfermedad de 4,5 (DE 4) años. De ellos, 43 (29%) tenían enfermedad de Graves y 105 (71%) hipotiroidismo primario. El percentil 75 fue para anticuerpos anti-peroxidasa 420U/ml y para anticuerpos antitiroglobulina 200U/ml. Los ACP fueron positivos en 30 pacientes, con una prevalencia global del 20,3%. Títulos iguales o superiores a 1/640 aparecieron en 19 pacientes (12,8%). El único factor predictivo independiente de ACP positivos fue la presencia de títulos elevados de ATAS (Odds Ratio [OR]=3; intervalo de confianza [IC] 95%: 1,18,6; p=0,04). El único factor predictivo independiente de ACP positivos a títulos iguales o superiores a 1/640 fue también la presencia de títulos elevados de ATAS (OR=7,3; IC 95% 1,632,7; p=0,009). Conclusiones La prevalencia de ACP positivos en pacientes con ETI fue del 20%. La presencia de títulos elevados de ATAS incrementa el riesgo de aparición de ACP positivos (AU)
Background and objectives Our aim was to evaluate the prevalence of parietal cell antibodies (PCA) in patients with autoimmune thyroid disease (ATD). Material and Methods We performed a descriptive, cross-sectional study of patients with ATD. The presence of PCA was determined. Elevated antithyroid antibodies (ATAs) were defined as those higher than the 75th percentile of distribution. Multivariate logistic regression models were built to assess the independent contribution of the following variables to PCA positivity: age, sex, hemoglobin, medium corpuscular volume (MCV), dose/Kg of levothyroxine (LT4), disease duration and elevated ATA levels.
