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Thyroid function in patients with chronic thyroiditis (CT) varies depending on the clinical course. Serum antithyroglobulin antibody (TgAb) and antithyroid peroxidase antibody (TPOAb) levels may be used to predict hypothyroidism in CT. In this retrospective cohort study, patients with CT, defined as having a high TgAb or TPOAb value, were divided into a hypothyroid group (HG) and euthyroid group (EG), after a mean follow-up of 2.5 years. The definitions of the two groups was based on the maximum TSH value from the initial measurement to the most recent follow-up: HG was defined as TSH 10.0 µIU/mL or higher, and EG was defined as TSH < 10.0 µIU/mL. There were 20 and 113 patients in the HG and EG, respectively. There were no significant differences in age, sex, underlying diseases, or TgAb and TPOAb levels between the groups. Receiver operating characteristic curve analyses of TgAb and TPOAb values for predicting thyroid function showed areas under the curve of 0.714 and 0.757, respectively. The value with the highest diagnostic accuracy was 106 IU/mL for TgAb and 16 IU/mL for TPOAb. Thus, TgAb > 106 IU/mL and TPOAb > 16 IU/mL may predict hypothyroidism in children and young adults with CT.

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Objective: The purpose of this study was to predict elevated TSH levels by developing an effective machine learning model based on large-scale physical examination results. Methods: Subjects who underwent general physical examinations from January 2015 to December 2019 were enrolled in this study. A total of 21 clinical parameters were analyzed, including six demographic parameters (sex, age, etc.) and 15 laboratory parameters (thyroid peroxidase antibody (TPO-Ab), thyroglobulin antibody (TG-Ab), etc.). The risk factors for elevated TSH levels in the univariate and multivariate Logistic analyses were used to construct machine learning models. Four machine learning models were trained to predict the outcome of elevated TSH levels one year/two years after patient enrollment, including decision tree (DT), linear regression (LR), eXtreme Gradient boosting (XGBoost), and support vector machine (SVM). Feature importance was calculated in the machine learning models to show which parameter plays a vital role in predicting elevated TSH levels. Results: A total of 12,735 individuals were enrolled in this study. Univariate and multivariate Logistic regression analyses showed that elevated TSH levels were significantly correlated with gender, FT3/FT4, total cholesterol (TC), TPO-Ab, Tg-Ab, creatinine (Cr), and triglycerides (TG). Among the four machine learning models, XGBoost performed best in the one-year task of predicting elevated TSH levels (AUC (0.87(+/- 0.03))). The most critical feature in this model was FT3/FT4, followed by TPO-Ab and other clinical parameters. In the two-year task of predicting TSH levels, none of the four models performed well. Conclusions: In this study, we trained an effective XGBoost model for predicting elevated TSH levels one year after patient enrollment. The measurement of FT3 and FT4 could provide an early warning of elevated TSH levels to prevent relative thyroid diseases.

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INTRODUCTION: The role of autoimmunity and other preexisting risky conditions in hypersensitivity reactions (HSRs) to COVID-19 vaccines seems unclear. The aim of the study was to investigate the autoimmunity and preexisting risky conditions in HSRs to COVID-19 vaccines. METHODS: The patients aged ≥18 years with a history of HSR to CoronaVac or Pfizer-BioNTech COVID-19 vaccines within 24 h in 2 tertiary centers were assessed. The patients were divided according to the type of vaccine which they showed immediate-type (<4 h) HSR to (group A1 for CoronaVac and group B1 for Pfizer-BioNTech). Equal number of subjects who did not show HSR to two doses of either CoronaVac or Pfizer-BioNTech was recruited into the study as control groups (group A2 for CoronaVac and group B2 for Pfizer-BioNTech). The autologous serum skin test (ASST) was performed on patient and control groups. Later, the demographic, clinical, and laboratory features were compared between groups. RESULTS: A total number of 27 patients were included in the study. Subjects with chronic spontaneous urticaria (CSU) were more frequent in group B1 than in group B2 (p:0.041). In addition to CSU, the presence of HSRs to drugs was higher in group A1 than in A2 (both p:0.007). The presence of autoimmunity and autoimmune diseases, positivity of antithyroid peroxidase antibody, and ASST were less in group A2 than in A1 (p:0.015, p:0.048, p:0.048, and p:0.037). Additionally, COVID-19 infection history was less in group A2 than in A1 (p:0.037). DISCUSSION/CONCLUSION: Type IIb autoimmunity seems to play a role in immediate type HSRs to the CoronaVac vaccine as previously shown in autoimmune CSU and multidrug hypersensitivity.

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We aimed to investigate the relationship between rosacea and thyroid diseases by analyzing thyroid blood tests and ultrasound findings of our patients recently diagnosed with rosacea. This study was designed as a prospective, single-center study. Dermatological examination findings, lesion locations were recorded, and rosacea clinical scores were calculated for all study group patients. The control group consisted of completely healthy women presented to our hospital during the study period for check-up purposes. Serum-free thyroxine, free triiodothyronine, thyroid-stimulating hormone, antithyroglobulin antibody, antithyroid peroxidase antibody levels were measured, and thyroid ultrasound examinations were performed for all study participants. The entire study cohort consisted of 123 patients (63 cases and 60 controls). There was no significant difference between the groups in terms of mean patient age (P < .05). Cheek was the most common lesion location (96.8%). There was no difference between the groups in terms of thyroid-related laboratory parameters. However, anti-TPO levels differed significantly with increasing disease severity (ie, RCSs). There were significant relationships between cheek lesions and fT4 (P = .021), while nose and chin lesions were associated with fT3 (P = .01, P = .001). Thyroid ultrasound findings revealed that rosacea patients tended to have larger thyroid nodules and more heterogeneous thyroid parenchymas than controls. Our findings indicate that thyroid blood tests, including thyroid autoantibodies, should be tested and thyroid ultrasounds should be performed in patients diagnosed with rosacea. However, these findings need to be validated by prospective studies conducted in larger patient series with more extended follow-up periods.

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BACKGROUND AND AIMS: Intracranial stenosis (ICS), the common cause of ischemic stroke worldwide, is associated with a high risk of recurrent stroke. We aimed to investigate the relationship between arterial remodeling and antithyroid peroxidase-antibody (TPO-Ab) level in ICS and the effect of TPO-Ab level on the migration of vascular smooth muscle cells (VSMCs). METHODS: We analyzed data of mild-to-severe ICS patients with normal thyroid function who underwent high-resolution magnetic resonance imaging in our center. Vessel area (VA), lumen area, wall area and plaque size were assessed at the most narrowed lumen (MNL) and reference site, respectively. The remodeling index (RI) was defined as VAMNL/VAreference. Negative remodeling (NR) or non-NR was defined as RI ≤ 0.95 or > 0.95. A scratch-wound healing assay was also designed to analyze the impact of TPO-Ab level on migration of VSMCs, which were isolated from thoracic aorta segments of Sprague Dawley rats. RESULTS: A total of 88 patients were included. Patients with elevated TPO-Ab had smaller VA, wall area, plaque size and RI than those with normal level (p < 0.05). Elevated TPO-Ab was significantly associated with NR after adjusting for demographic and vascular risks (odds ratio 10.629, 95% confidence interval, 1.842-61.327, p = 0.008). The rate of VSMCs migration was significantly increased after culture with TPO-Ab (TPO-Ab 1 µg/ml vs. Mock, 29.8% vs. 12.0%, p < 0.01). CONCLUSIONS: Elevated TPO-Ab in ICS patients was related to NR. TPO-Ab could promote VSMCs migration, which might be involved in the NR of intracranial artery.

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PURPOSE: Selenium (Se), an essential trace element, has been implicated in pathogenesis of autoimmune thyroiditis (AIT). Most studies attributed the immune modulating effects of Se to its antioxidant properties. However, there is insufficient evidence to support the use of selenium supplementation or other antioxidants in patients with AIT. This clinical trial was designed to investigate the impact of Se and vitamin C supplementation on antithyroid peroxidase antibody (TPO-Ab) level in patients with AIT. METHODS: One hundred and two subjects aged 15-78 years were randomized into three groups. Group one (GI) (n = 38) was treated with 200 µg/day sodium selenite, group two (GII) (n = 36) received 500 mg vitamin C/day, and group three (GIII) (n = 28) received placebo over a 3-month period. Thyroid stimulating hormone (TSH), TPO-Ab, antithyroglobulin antibody (Tg-Ab) and Se concentrations were once measured before treatment and at the end of the study. RESULTS: After 3 months, TPO-Ab concentrations decreased within Se and vitamin C-treated groups, but did not change in the placebo subjects. In this regard, there was no significant difference between the groups. We also did not find any statistically significant difference in TSH and Tg-Ab levels within and between the groups. At the end of the study, Se level was significantly higher in GI compared with GII and GIII. CONCLUSION: Our findings supported the hypothesis of antioxidant beneficial effects of Se in AIT. However, it was not superior to vitamin C, regarding its effects on thyroid-specific antibodies.

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Thyroid dysfunction (TD) induced by immune checkpoint inhibitors is not sufficiently understood. The purpose of this retrospective observational study was to identify risk factors and the clinical course of TD induced by nivolumab. Patients with advanced solid tumors who were treated with nivolumab from March 2009 through to March 2016 at the National Cancer Center Hospital (Tokyo, Japan) were included. Thyroid function and antithyroid Abs from serum samples among all patients were evaluated at baseline and during nivolumab treatment. Overt hypothyroidism was defined as low serum-free T4 together with elevated thyroid-stimulating hormone (TSH) >10 µIU/mL. Thyrotoxicosis was defined as low TSH with elevated free T4 and/or free T3. We defined thyroid autoimmunity as the presence of antithyroid Abs at baseline, including antithyroid peroxidase Abs and antithyroglobulin Abs (TgAb). Twenty-three (14%) of a total of 168 patients developed TD, including 17 cases of hypothyroidism and 20 of thyrotoxicosis. Thyrotoxicosis followed by hypothyroidism occurred in 14 cases. Fourteen of 35 patients (40%) with thyroid autoimmunity developed TD vs 9 of 133 (7%) without (odds ratio 9.19; 95% confidence interval [CI], 3.53-23.9). In multivariate analysis, elevated TSH and TgAb at baseline were significantly associated with the development of TD, with odds ratio of 7.36 (95% CI, 1.66-32.7) and 26.5 (95% CI, 8.18-85.8), respectively. Association between TD and elevated antithyroid peroxidase Abs at baseline was not significant. These results suggest that patients with pre-existing TgAb and elevated TSH at baseline are at high risk of TD.

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OBJECTIVE: To find the prevalence of thyroid autoimmunity in PCOS women of reproductive age group. METHODS: Study design: Observational study was done at ESIMC and PGIMSR K.K. Nagar March 2013-Feb 2014. Ninety cases of women with PCOS based on Rotterdam's criteria and an equal number of age-matched controls (women without PCOS) were included in the study. Thyroid profile, antithyroid peroxidase titre, serum progesterone, testosterone and fasting blood sugar were estimated using standardised techniques. RESULTS: Menstrual irregularity (oligomenorrhoea and amenorrhoea) was the most common abnormality found in patients with PCOS compared with non-PCOS (p < 0.0001). Hyperandrogenism was the second most common manifestation present in PCOS of our study group. Hirsutism was the striking hyperandrogenic feature that was present in study group. PCOS patients had higher BMI compared to controls (p < 0.0001). The prevalence of thyroid dysfunction was not significantly different in both the groups (p < 0.80). Anti-TPO titre was higher in PCOS patients (25.8 ± 2.9 IU/ml) compared to the controls (14.5 ± 2.3 IU/ml) (p < 0.009). CONCLUSION: The present study shows that PCOS was associated with increased anti-TPO titres, thus emphasising the importance of screening all PCOS patients for anti-TPO along with routine thyroid profile.

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BACKGROUND AND PURPOSE: Antinuclear antibody-positive multiple sclerosis (MS) patients have shorter disease duration and lower Expanded Disability Status Scale (EDSS) scores. The aim of this study was to compare clinical and laboratory features between MS and neuromyelitis optica (NMO) patients with and without autoantibodies and to investigate the prognosis of NMO in patients with and without autoantibodies. METHODS: The frequencies of antinuclear, anti-Sjögren's syndrome A (SSA)/Ro, anti-Sjögren's syndrome B (SSB)/La and anti-thyroid peroxidase (TPO) antibodies in the sera of 75 NMO patients and 131 MS patients were compared. Clinical and laboratory profiles were also compared between NMO patients with and without autoantibodies, including annual relapse rate and time from onset of NMO to EDSS scores of 4.0 (limited walking but without aid) and 6.0 (walking with unilateral aid). RESULTS: More NMO than MS patients had antinuclear and anti-SSA/Ro antibodies (31% vs. 10%, P < 0.001, and 21% vs. 3%, P < 0.001, respectively). Antinuclear antibody-positive NMO patients had a lower annual relapse rate from disease onset to serum sampling compared with antinuclear antibody-negative NMO patients, independent of treatment regimen. Antinuclear antibody-negative NMO patients reached an EDSS score of 6.0 earlier than antinuclear antibody-positive NMO patients (P = 0.026). Cerebrospinal fluid cell counts were higher in anti-SSA/Ro-positive than in anti-SSA/Ro-negative NMO patients. More anti-TPO antibody-positive than anti-TPO antibody-negative NMO patients had oligoclonal immunoglobulin G bands (60% vs. 11%, P = 0.048). CONCLUSIONS: Autoantibodies possibly modulate the pathophysiology of NMO. Antinuclear antibody may be associated with less severe disease activity or less disability in NMO.

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BACKGROUND AND OBJECTIVES: Autoimmune thyroiditis (AIT) is a form of thyroiditis associated with autoimmune antibodies. Few studies have measured thyroid volume in Asians. This study was undertaken to determine the distribution of thyroid volume and to explore possible correlations between thyroid volume and other factors in a Korean cohort. MATERIALS AND METHODS: Two hundred eleven patients who underwent (99m)Tc-pertechnetate thyroid scintigraphy between 2009 and 2011 were recruited and their thyroid volume was measured. AIT was defined as having thyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) positivity and TRAb negativity, regardless of thyroid function. RESULTS: The mean thyroid volume was 32.1 mL in AIT patients. The distribution of thyroid volume was normal after log transformation. Thyroid volume was larger in patients with both autoantibodies than in patients with only one antibody (p<0.001). The first quartile of patients grouped according to thyroid volume were older (52.1 years, p=0.037) than the patients in other quartile groups. Thyroid volume correlated independently with TPOAb titer, and TgAb titer adjusted for other factors in a multivariate analysis. CONCLUSION: Thyroid volume in Korean AIT patients had an unimodal distribution and correlated with autoantibody titer.

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BACKGROUND AND OBJECTIVES: Autoimmune thyroiditis (AIT) is a form of thyroiditis associated with autoimmune antibodies. Few studies have measured thyroid volume in Asians. This study was undertaken to determine the distribution of thyroid volume and to explore possible correlations between thyroid volume and other factors in a Korean cohort. MATERIALS AND METHODS: Two hundred eleven patients who underwent (99m)Tc-pertechnetate thyroid scintigraphy between 2009 and 2011 were recruited and their thyroid volume was measured. AIT was defined as having thyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) positivity and TRAb negativity, regardless of thyroid function. RESULTS: The mean thyroid volume was 32.1 mL in AIT patients. The distribution of thyroid volume was normal after log transformation. Thyroid volume was larger in patients with both autoantibodies than in patients with only one antibody (p<0.001). The first quartile of patients grouped according to thyroid volume were older (52.1 years, p=0.037) than the patients in other quartile groups. Thyroid volume correlated independently with TPOAb titer, and TgAb titer adjusted for other factors in a multivariate analysis. CONCLUSION: Thyroid volume in Korean AIT patients had an unimodal distribution and correlated with autoantibody titer.

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Autoimmune thyroid disorders (AITD) are characterized by the impairment of the thyroid gland as a result of systemic or organ-specific autoimmune disorders, and the presence of antithyroid autoantibodies, such as antithyroglobulin antibody (AbTg) and antithyroid peroxidase antibody (AbTPO). Several studies have reported the association of AITD with systemic sclerosis (SSc). However, none of those studies analyzed the association between AITD and skin sclerosis in SSc patients. The aim of this study was to examine the demographic and clinical features of SSc patients with AITD treated in our department. Of a total of 210 SSc patients, we identified 30 with AITD (14.3%), including 29 with Hashimoto's disease (13.8%) and one patient with Graves' disease (0.5%), indicating that hypothyroidism was more common among SSc patients with AITD. All patients with AITD were female, and anticentromere antibody positivity, the complication of Sjögren's syndrome, severe facial skin sclerosis and atrophy of the thyroid gland were significantly prevalent in SSc patients with AITD. SSc patients with such clinical features may be at high risk of AITD and require regular follow up of thyroid function including ultrasonography and the examination of serum hormone levels to start an early treatment.

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ObjectiveTo investigate the positive rate of thyroid peroxidase antibody(TPO-Ab) in the diabetic in-patients. MethodsThe positive rates of thyroid peroxidase antibody ( TPO-Ab ) was measured in 1884 subjects, including 1508 type 2 diabetes mellitus ( T2DM ), 76 classic typetype 1 diabeties( T1 DM ), 44 latent autoimmune diabetes in adults (LADA) and 256 "untype" diabetics ( NTDM ). Clinical data were registered and analyzed. Results( 1 )The positive rates of TPO-Ab were 14. 59％ in T2DM(220/1508) ,42. 11％ in T1DM (32/76) ,31.25％ in NTDM ( 80/256 ), 63.64％ in LADA group ( 28/44 ), respectively. The positive rate of T2DM was significantly lower than that of LADA ( P ＜ 0. 05 ), but no significant difference was found in the coparison between T1 DM and NTDM ( P ＞ 0. 05 ). ( 2 ) There were no significant differences between LADA and NTDM groups in the comparison of age, course of disease and BMI ( Ps ＞ 0. 05 ). Conclusion①The positive rate of TPO-Ab in NTDM was significantly higher than that of T2DM, whereas significantly lower than that of T1 DM and LADA.②The positive rate of TPO-Ab was highest in LADA, which indicate that LADA and AIT might have the common etiological mechanisms. ③There is a consisted increasing trend in the positive rate of TPO-Ab from T2DM ,NTDM,and classic T1DM to LADA.