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Association between thyroid function tests and anti-thyroid peroxidase (TPO) antibodies in pregnancy

Loh TP, Tee JC, Tee NW, Cheng WL, Thevarajah M, Sabir N, et al.

Endocrine, 2016 Sep;53(3):865-7.
PMID: 26725315 DOI: 10.1007/s12020-015-0844-y
Matched MeSH terms: Iodide Peroxidase/immunology*
Fulltext Metastatic Follicular Thyroid Carcinoma as a Cause of Low Serum Thyroxine with a Normal Thyroid Stimulating Hormone Level

Loh LT, Lim V

J ASEAN Fed Endocr Soc, 2017;32(1):57-59.
PMID: 33442087 DOI: 10.15605/jafes.032.01.11

Thyroid function is usually normal in differentiated thyroid carcinoma. We describe a case of a female patient who had metastatic follicular thyroid carcinoma (FTC) to the spine and lungs, who was clinically euthyroid but had very low free tetraiodothyronine (fT4) and normal thyroid stimulating hormone (TSH). Free triiodothyronine (fT3) and total T3 (TT3) were normal. Levothyroxine treatment increased fT4 marginally but caused a two- to three-fold rise in fT3 and TT3 along with suppressed TSH. This is likely due to hyperconversion of T4 to T3 from elevation in D2 deiodinase activity in the tumor. This phenomenon has been reported to occur in about 20% of metastatic FTC.

Matched MeSH terms: Iodide Peroxidase
A study of haemolytic streptococci isolated from outpatients in dermatological clinics

Murai T, Inazumi Y, Nishiwaki M, Noda Y, Hino H

Kansenshogaku Zasshi, 1991 Aug;65(8):960-9.
PMID: 1919131

A total of 44 patients suspected of streptococcal infections were studied in outpatient clinics in Tokyo during the one year from December 1988 to December 1989. Employing bacteriological culturing and serodiagnosis, the following results were obtained. 1) There were 9 cases of impetigo and 15 cases of erysipelas with typical clinical manifestations and age distributions. 2) It seemed that some of the skin infections were caused by group A streptococci whose M-types were different from those of upper respiratory infections typically occurring in Japan. 3) The type distribution of group A streptococci found were quite similar to those isolated in Thailand or Malaysia. 4) There were found group A streptococci exhibiting unique combinations of T- and M-types, such as T11 and M9, T11 and M62 or T13-49 and MOD8 (Provisional type). 5) As for serodiagnostic method, ADNB (anti-deoxyribonuclease B) titer reflected infection by group A streptococcus only, while ASK (anti-streptokinase) and ASO (anti-streptolysin O) reflected not only group A streptococcal infections but group G infections as well.

Matched MeSH terms: Iodide Peroxidase*
Fulltext High prevalence of thyroid antibodies in urban population of Peninsular Malaysia

MA, Shahar, Ahmad Marzuki Omar, N, AB Wahab, N, Sukor, NA, Kamaruddin

IIUM Medical Journal Malaysia, 2020;19(2):3-12.
MyJurnal

INTRODUCTION: Thyroid antibodies are closely related to autoimmune thyroid disorders. To date, there
are no data on the prevalence of these antibodies among the Malaysian population. This study aimed to
determine the prevalence of thyroid antibodies; and the factors associated with thyroid antibodies in the
Malaysian adult population. MATERIALS AND METHODS: A cross-sectional study was performed in 5 preassigned regions in Peninsular Malaysia. Participants’ sociodemographic profile and medical history were
recorded. Physical examinations were done looking for abnormalities of the thyroid gland and signs of thyroid
dysfunctions. Fifteen mils of blood were withdrawn and analysed for thyroid function, anti-thyroperoxidase
(anti-TPO) and anti-thyroglobulin (anti-TG) antibodies at a central laboratory. RESULTS: Among the total of
2190 respondents, the overall prevalence of positive anti-TPO and anti-TG antibodies were 12.2% and 12.1%,
respectively; mainly found in urban and coastal areas. Only 7% to 9% of those with positive anti-TPO or antiTG antibodies had either hypo- or hyperthyroidism. The predictors for positive anti-TPO antibody were
female [adjusted OR 1.7 (95%CI: 1.2–2.4); p=0.001], Indian [adjusted OR 1.9 (95%CI: 1.1–3.1); p=0.020], and
having a goitre [adjusted OR 1.8 (95%CI: 1.2–2.8), p=0.004]. The predictors of positive anti-TG antibody was
female [adjusted OR 2.3 (95%CI: 1.6–3.3); p

Matched MeSH terms: Iodide Peroxidase
Fulltext Subclinical hypothyroidism among patients with depressive disorders

Siti Yazmin Zahari Sham, Nor Aini Umar, Zarida Hambali, Rosdinom Razali, Mohd Rizal Abdul Manaf

Malaysian Journal of Medicine and Health Sciences, 2014;10(2):71-78.
MyJurnal

Subclinical hypothyroidism (SHT) is a biochemical diagnosis, defined as an elevated Thyroid Stimulating Hormone (TSH) with normal free thyroxine (FT4). It affects 4-10% of the adult population and is more prevalent in elderly women. Its commonest cause is autoimmune thyroiditis, detected by anti- thyroid peroxidase antibody (TPO-Ab). About 2-5% of SHT patients progress to overt hypothyroidism annually. The SHT prevalence among depressed patients ranges between 3% and 17%. This study aimed to determine the prevalence of SHT and TPO-Ab positivity among patients diagnosed with depressive disorders. It was a cross-sectional study carried out in the Universiti Kebangsaan Malaysia Medical Centre over a 12 months period. Serum TSH, FT4 and TPO-Ab were measured. Results showed that 82% of depressed patients were euthyroid, 4% had SHT, 11% had subclinical hyperthyroidism and 2% had discordant thyroid function. TPO-Ab positivity among the subjects was 7%, one of whom had SHT. In conclusion, the prevalence of SHT and TPO-Ab positivity in the study population, at 4% and 7%, respectively, were comparable to previous findings.

Matched MeSH terms: Iodide Peroxidase
Fulltext Functional analyses of C.2268dup in thyroid peroxidase gene associated with goitrous congenital hypothyroidism

Lee CC, Harun F, Jalaludin MY, Lim CY, Ng KL, Mat Junit S

Biomed Res Int, 2014;2014:370538.
PMID: 24745015 DOI: 10.1155/2014/370538

The c.2268dup mutation in thyroid peroxidase (TPO) gene was reported to be a founder mutation in Taiwanese patients with dyshormonogenetic congenital hypothyroidism (CH). The functional impact of the mutation is not well documented. In this study, homozygous c.2268dup mutation was detected in two Malaysian-Chinese sisters with goitrous CH. Normal and alternatively spliced TPO mRNA transcripts were present in thyroid tissues of the two sisters. The abnormal transcript contained 34 nucleotides originating from intron 12. The c.2268dup is predicted to generate a premature termination codon (PTC) at position 757 (p.Glu757X). Instead of restoring the normal reading frame, the alternatively spliced transcript has led to another stop codon at position 740 (p.Asp739ValfsX740). The two PTCs are located at 116 and 201 nucleotides upstream of the exons 13/14 junction fulfilling the requirement for a nonsense-mediated mRNA decay (NMD). Quantitative RT-PCR revealed an abundance of unidentified transcripts believed to be associated with the NMD. TPO enzyme activity was not detected in both patients, even though a faint TPO band of about 80 kD was present. In conclusion, the c.2268dup mutation leads to the formation of normal and alternatively spliced TPO mRNA transcripts with a consequential loss of TPO enzymatic activity in Malaysian-Chinese patients with goitrous CH.

Matched MeSH terms: Iodide Peroxidase/genetics*
Fulltext Prevalence of c.2268dup and detection of two novel alterations, c.670_672del and c.1186C>T, in the TPO gene in a cohort of Malaysian-Chinese with thyroid dyshormonogenesis

Lee CC, Harun F, Jalaludin MY, Heh CH, Othman R, Junit SM

BMJ Open, 2015 Jan 05;5(1):e006121.
PMID: 25564141 DOI: 10.1136/bmjopen-2014-006121

OBJECTIVES: The c.2268dup mutation in the thyroid peroxidase (TPO) gene is the most common TPO alteration reported in Taiwanese patients with thyroid dyshormonogenesis. The ancestors of these patients are believed to originate from the southern province of China. Our previous study showed that this mutation leads to reduced abundance of the TPO protein and loss of TPO enzyme activity in a Malaysian-Chinese family with goitrous hypothyroidism. The aim of our study was to provide further data on the incidence of the c.2268dup mutation in a cohort of Malaysian-Chinese and its possible phenotypic effects.
SETTING: Cohort study.
PARTICIPANTS: Twelve biologically unrelated Malaysian-Chinese patients with congenital hypothyroidism were recruited in this study. All patients showed high thyrotropin and low free thyroxine levels at the time of diagnosis with proven presence of a thyroid gland.
PRIMARY OUTCOME MEASURE: Screening of the c.2268dup mutation in the TPO gene in all patients was carried out using a PCR-direct DNA sequencing method.
SECONDARY OUTCOME MEASURE: Further screening for mutations in other exonic regions of the TPO gene was carried out if the patient was a carrier of the c.2268dup mutation.
RESULTS: The c.2268dup mutation was detected in 4 of the 12 patients. Apart from the c.2268dup and a previously documented mutation (c.2647C>T), two novel TPO alterations, c.670_672del and c.1186C>T, were also detected in our patients. In silico analyses predicted that the novel alterations affect the structure/function of the TPO protein.
CONCLUSIONS: The c.2268dup mutation was detected in approximately one-third of the Malaysian-Chinese patients with thyroid dyshormonogenesis. The detection of the novel c.670_672del and c.1186C>T alterations expand the mutation spectrum of TPO associated with thyroid dyshormonogenesis.

Matched MeSH terms: Iodide Peroxidase/genetics*
Thyroid autoantibodies and associated complications during pregnancy

Nor Azlin MI, Bakin YD, Mustafa N, Wahab NA, Johari MJ, Kamarudin NA, et al.

J Obstet Gynaecol, 2010;30(7):675-8.
PMID: 20925608 DOI: 10.3109/01443615.2010.503908

This study was undertaken to determine the presence of thyroid autoantibodies and associated pregnancy complications from 49 pregnant women with thyroid disease. There were 31 (63%) women with Graves' disease (GD) and 18 (37%) with primary hypothyroidism (PHT). A total of 26 (53.1%) women, 19 (61%) with GD and seven (39%) with PHT, had positive antibodies. Six had thyroid peroxidase antibodies (TPO), one with thyroglobulin antibody (TG) and eight had TSH receptor antibodies (TR). Two had a mixture of antibodies involving TG/TPO (one GD vs one PHT), four with TG/TPO/TR (all had GD) and five with TPO/TR (four with GD vs one with PHT). There were associations in women with positive thyroid antibodies and pre-eclampsia (15.4%), abruptio placenta (4%), caesarean deliveries (31%), postpartum thyroiditis (19.2%) and abnormal neonatal thyroid function (15.4%). Women with positive thyroid antibodies in pregnancy need close care during and after pregnancy, as they can develop complications affecting both mother and fetus.

Matched MeSH terms: Iodide Peroxidase/immunology