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Fröhlich E, Wahl R. Pars Distalis and Pars Tuberalis Thyroid-Stimulating Hormones and Their Roles in Macro-Thyroid-Stimulating Hormone Formation. Int J Mol Sci 2023; 24:11699. [PMID: 37511458 PMCID: PMC10380753 DOI: 10.3390/ijms241411699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Thyroid-stimulating hormone (TSH) and thyroid hormone levels are standard parameters in blood analysis. However, the immunoassays employed may lead to false-positive or false-negative results when the sample contains certain materials that interfere with the assay. Macro-TSH, a complex of TSH with immunoglobulin or albumin, may cause apparently increased TSH concentrations. TSH is produced in the pars tuberalis (PT) of the pituitary gland and by thyrotrophs of the pars distalis (PD). It was found that variable glycosylation can render the molecule more strongly bound to antibodies or albumin in the blood, leading to the hypothesis that macro-TSH consists mainly of PT-TSH. Although less known than PD-TSH, PT-TSH plays an important role in the central regulation of thyroid metabolism. The present review summarizes the physiological function of human PT-TSH and its role in macro-TSH formation. The prevalence of macro-hyperthyrotropinemia, the structure of PT-TSH and macro-TSH, problems in the measurement of TSH, and the action of PT-TSH in animals with seasonal breeding are discussed. Despite the absence of a specific function of macro-TSH in the organism, the identification of macro-TSH is important for avoiding unnecessary treatment based on a falsified readout of increased TSH concentrations as numerous individual case reports describe.
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Affiliation(s)
- Eleonore Fröhlich
- Center for Medical Research, Medical University of Graz, 8010 Graz, Austria
| | - Richard Wahl
- Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, 72076 Tübingen, Germany
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Elenkova A, Racheva P, Kirilov G, Zacharieva S. Clinical course of autoimmune thyroid diseases in women with prolactinomas: Results from a prospective study in a single tertiary centre. ENDOCRINOL DIAB NUTR 2023; 70 Suppl 2:27-34. [PMID: 37268355 DOI: 10.1016/j.endien.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/23/2022] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Several retrospective and cross-sectional studies have revealed a higher prevalence of autoimmune thyroid diseases (AITD) with a predominance of autoimmune hypothyroidism in prolactinoma patients compared to the general population. To date, we have no data on the clinical course of AITD in these patients. The aim of this prospective study was to assess the clinical course of AITD in female patients with prolactinomas compared to an age- and thyroid-risk factors-matched control group. MATERIALS AND METHODS The study population consisted of 144 females (71 patients/73 controls) who underwent approximately a 6-year follow-up. Physical examination, thyroid ultrasound and laboratory testing (measurement of antibodies to thyroglobulin, thyroid peroxidase, TSH-receptor; serum TSH and FT4 levels) were performed twice - at the baseline and at the follow-up visits. RESULTS AITD were diagnosed in 26.8% (n=19) of the patients and 9.6% (n=7) of the controls (p=0.007) at baseline visit. At the end of the follow-up (FU), these percentages increased to 33.8% (n=24) among the patients versus 12.3% (n=9) in the control group (p=0.002). Hypothyroidism was significantly more frequent in prolactinoma patients than in controls at the end of the study (19.7% vs. 4.1%; p=0.003). Two prolactinoma patients had hyperthyroidism at the baseline visit and restored euthyroid state with negative TSH-receptor antibodies during the follow-up. We did not observe hyperthyroidism in the control group. Among the hypothyroid subsets, the average daily levothyroxine dose at FU visit varied from 25 to 200mcg in the prolactinoma group compared to 25 to 50mcg in the control group. CONCLUSIONS Female patients with prolactinomas seem to be prone to autoimmune hypothyroidism. As a pathogenetic mechanism, we could suggest the selective immunomodulatory action of PRL predominantly on cell autoimmunity, complement activation and antibody-dependent cytotoxicity, resulting in earlier and more rapid progression of Hashimoto's thyroiditis towards hypothyroid state in genetically predisposed individuals.
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Affiliation(s)
- Atanaska Elenkova
- USHATE "Acad. Ivan Penchev", Department of Endocrinology, Medical University Sofia, Bulgaria.
| | - Petya Racheva
- USHATE "Acad. Ivan Penchev", Department of Endocrinology, Medical University Sofia, Bulgaria
| | - Georgi Kirilov
- USHATE "Acad. Ivan Penchev", Department of Endocrinology, Medical University Sofia, Bulgaria
| | - Sabina Zacharieva
- USHATE "Acad. Ivan Penchev", Department of Endocrinology, Medical University Sofia, Bulgaria
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Laway BA, Sahu D, Bhat MH, Baba MS, Viswanath SA, Misgar RA, Wani AI, Bashir MI, Shah ZA, Mudassar S. Thyroid Autoimmunity and Subclinical Hypothyroidism in Prolactinoma: A Case Control Study. Indian J Endocrinol Metab 2023; 27:45-49. [PMID: 37215267 PMCID: PMC10198196 DOI: 10.4103/ijem.ijem_425_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/01/2021] [Accepted: 12/31/2021] [Indexed: 03/05/2023] Open
Abstract
Background This study was aimed at determining the frequency of thyroid autoimmunity and subclinical hypothyroidism in patients with hyperprolactinemia due to prolactinoma compared to well-matched healthy controls. Methods This was a cross-sectional study wherein 78 treatment naïve prolactinoma patients and ninety-two healthy control subjects were recruited. Serum prolactin (PRL), thyroid-stimulating hormone (TSH), total thyroxine (T4), circulating anti-thyroid peroxidase (anti-TPO), and anti-thyroglobulin (anti-Tg) antibody levels were measured in all study subjects. Progression of the antibody-positive population to subclinical hypothyroidism was determined. Results The median PRL level among patients was 166 ng/ml (IQR 85-467) compared to 11.4 ng/ml (IQR 8.5-15.9) in controls (P < 0.001). There was no significant difference in levels of T4 (P = 0.83) and TSH (P = 0.82) between the cases and controls. Overall, 25% of patients had the presence of anti-thyroid antibodies as compared to 20% of controls (P = 0.56). SCH was more common in antibody-positive hyperprolactinemia subjects compared with antibody-positive controls. Conclusion We did not find an increased prevalence of thyroid autoimmunity among untreated prolactinoma patients compared to healthy controls. At the same time, subclinical hypothyroidism was more common in thyroid antibody-positive patients with hyperprolactinemia than positive controls.
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Affiliation(s)
- Bashir A. Laway
- Department of Endocrinology, Molecular Medicine, Srinagar, Jammu and Kashmir, India
| | - Danendra Sahu
- Department of Endocrinology, Molecular Medicine, Srinagar, Jammu and Kashmir, India
| | - Moomin H. Bhat
- Department of Endocrinology, Molecular Medicine, Srinagar, Jammu and Kashmir, India
| | - Mohammad S. Baba
- Department of Endocrinology, Molecular Medicine, Srinagar, Jammu and Kashmir, India
| | - S Arun Viswanath
- Department of Endocrinology, Molecular Medicine, Srinagar, Jammu and Kashmir, India
| | - Raiz A. Misgar
- Department of Endocrinology, Molecular Medicine, Srinagar, Jammu and Kashmir, India
| | - Arshad Iqbal Wani
- Department of Endocrinology, Molecular Medicine, Srinagar, Jammu and Kashmir, India
| | - Mir Iftikhar Bashir
- Department of Endocrinology, Molecular Medicine, Srinagar, Jammu and Kashmir, India
| | - Zaffar Amin Shah
- Department of Immunology and Molecular Medicine, Srinagar, Jammu and Kashmir, India
| | - Syed Mudassar
- Department of Biochemistry, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Elenkova A, Racheva P, Kirilov G, Zacharieva S. Clinical course of autoimmune thyroid diseases in women with prolactinomas: Results from a prospective study in a single tertiary centre. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Han Y, Zhang H, Huang T, Wang F, Zhu Y. A retrospective study of pituitary-thyroid interaction in patients with first-episode of bipolar disorder type I in Mania State. Medicine (Baltimore) 2021; 100:e24645. [PMID: 33578589 PMCID: PMC10545404 DOI: 10.1097/md.0000000000024645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/24/2020] [Accepted: 01/14/2021] [Indexed: 10/22/2022] Open
Abstract
ABSTRACT Bipolar disorder (BD)-mania is related to the dysfunction of anterior pituitary gland, but the pituitary-thyroid interaction on the acute stage of BD has been controversial. In order to rule out the effects of drugs, we aimed to determine the upstream interaction of first-episode of BD type I in mania state, and tried to find the relationship between thyroid-stimulating-hormone (TSH) and Prolactin (PRL)This study included 70 real-world patients diagnosed with first-episode BD-mania recuited and 70 healthy controls (HC) matched for age and sex from 2016 to 2017 in the same district of Shanghai. We compared the levels of thyroid hormones and prolactin between the two groups, and linear regression and curve estimation were used for the correlation analysis of TSH and PRLThere were differences in triiodothyronine (TT3), total thyroxin (TT4), and free thyroxine (FT4) concentrations between the groups (P's < .05). After being grouped by sex, higher PRL in the male and female BD-mania subgroup were observed compared to each isosexual HC [(P's < .01, Cohen's d = 0.82/1.08, 95%CI (0.33, 1.31)/(0.58, 1.58)]. Higher FT4 in the male BD-mania group was observed compared to the HC males [(P's < .01, Cohen's d = 0.90, 95%CI (0.41, 1.39)] while the female BD-mania group showed lower TT3 and TT4 compared to the HC females [(P's < .01, Cohen's d = 0.93/0.88, 95%CI (0.43, 1.42)/(0.39, 1.37)]. In the female BD-mania group, correlation analysis established an inverse relationship between PRL and TSH (r2 = 0.25, F = 11.11, P < .01).The findings demonstrate that sex impacts the concentration of hormones secreted by the anterior pituitary of patients with first-episode BD-mania. The increased PRL may be a putative mechanism that underlies the onset in female patients with a moderate inverse relationship between TSH and PRL. Thyroid hormones and prolactin levels may be developed as potential markers for identifying BD-manic.
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Affiliation(s)
- Yi Han
- Navy Characteristic Medical Center of PLA
| | | | - Tao Huang
- Navy Characteristic Medical Center of PLA
| | - Fang Wang
- Shanghai Yangpu Mental Health Center
| | - Yuncheng Zhu
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Pilli T, Cardinale S, Dalmiglio C, Secchi C, Fralassi N, Cevenini G, Di Cairano G, Maino F, Forleo R, Pacini F, Castagna MG. Autoimmune thyroid diseases are more common in patients with prolactinomas: a retrospective case-control study in an Italian cohort. J Endocrinol Invest 2019; 42:693-698. [PMID: 30406929 DOI: 10.1007/s40618-018-0972-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/26/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Prolactin may exert immunological effects. Over the years, a higher prevalence of autoimmune thyroid diseases (ATD) has been reported in patients with prolactinomas (PRLs) in areas with sufficient iodine intake. PURPOSE The aim of our study was to evaluate the prevalence of ATD [Graves' disease (GD) and chronic autoimmune thyroiditis (AIT)] in a retrospective cohort of Italian patients with PRLs compared to a sex-matched control group, represented by subjects with non-functioning pituitary adenoma (NFPA) or empty sella (ES). MATERIALS AND METHODS We enrolled 149 patients (108 F/41 M) with PRLs (110 micro/39 macro) and 143 subjects (100 F/43 M) with NFPA (n = 96, 56 micro/40 macro) or ES (n = 47), with normal serum prolactin. Neck ultrasound and thyroid function tests (anti-thyroid antibodies, TSH, FT3 and FT4) were performed in all patients. RESULTS In PRLs, median serum prolactin was significantly higher (98.3 vs. 8.9 ng/ml, p ≤ 0.0001), while age was lower (34 vs. 46 years, p ≤ 0.001) compared to controls. The prevalence of ATD was 13.4% (20/149) in PRLs (1 GD and 19 AIT) compared to 6.3% (9/143) in the controls (p = 0.042). At the multivariate analysis, serum prolactin was the only independent factor predicting ATD. Thyroid volume (12.5 ± 5.9 ml vs. 12.8 ± 10 ml, p = 0.47) and the presence of uni- or multinodular goiter (29.5% vs. 35%, p = 0.35) did not differ between PRLs and control groups. CONCLUSIONS Our data in an area with mild iodine deficiency confirm a higher prevalence of ATD in patients with prolactinomas.
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Affiliation(s)
- T Pilli
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - S Cardinale
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - C Dalmiglio
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - C Secchi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - N Fralassi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - G Cevenini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - G Di Cairano
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - F Maino
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - R Forleo
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - F Pacini
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - M G Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
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Kalsi AK, Halder A, Jain M, Chaturvedi PK, Mathew M, Sharma JB. Association of raised levels of IL-4 and anti-TPO with hyperprolactinemia. Am J Reprod Immunol 2019; 81:e13085. [PMID: 30614113 DOI: 10.1111/aji.13085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/07/2018] [Accepted: 12/22/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The modulatory role of prolactin in autoimmune regulation is well established. Hyperprolactinemia is often associated with autoimmune disease like systemic lupus erythematosus and autoimmune thyroid diseases. The objective was to compare levels of direct and indirect autoimmune factors in different categories of hyperprolactinemia cases and predict the direction of association between hyperprolactinemia and autoimmune factors, if any. METHODS A total of 102 hyperprolactinemia cases (>100 ng/mL serum prolactin level) were included along with 24 controls. Among 102 hyperprolactinemia cases, there were 36 idiopathic cases, 19 pituitary adenoma cases, 36 drug-induced cases, and 11 cases associated with other secondary/systemic diseases (chronic renal failure, chronic hepatic failure, etc). MEASUREMENTS Direct autoimmune markers, IL-2, IFN-γ, IL-4, and IL-5, were measured in serum by ELISA. Indirect autoimmune markers, anti-TPO, anti-tg, anti-CCP, VDRL, platelet count, and aPTT, were measured as per laboratory-defined protocol. RESULTS Serum levels of IL-4 and anti-TPO were significantly high in idiopathic hyperprolactinemia cases. Serum IL-4 levels were also significantly high in pituitary adenoma cases, drug-induced cases, and in cases with other secondary causes of hyperprolactinemia. Serum anti-TPO levels were also significantly high in drug-induced hyperprolactinemia cases. CONCLUSION No significant difference in autoimmune factors is observed between macroprolactinemia and true hyperprolactinemia. Serum IL-4 and anti-TPO were high in all categories of hyperprolactinemia. This suggests a possible association of hyperprolactinemia with autoimmune conditions (high IL-4 and anti-TPO), mostly subclinical. Thus, hyperprolactinemia case with serum prolactin level >100 ng/mL may require long-term follow-up for the development of autoimmune disease in future.
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Affiliation(s)
- Amanpreet Kaur Kalsi
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashutosh Halder
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Jain
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep K Chaturvedi
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Mary Mathew
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Jai Bhagwan Sharma
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
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Chen D, Yan Y, Huang H, Dong Q, Tian H. The association between subclinical hypothyroidism and erectile dysfunction. Pak J Med Sci 2018; 34:621-625. [PMID: 30034427 PMCID: PMC6041544 DOI: 10.12669/pjms.343.14330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objectives Erectile dysfunction (ED) is highly prevalent among males, and hypothyroidism is previously reported to be related with ED. However there have been rare studies to investigate the association between subclinical hypothyroidism (SCH) and ED, hence our objective was to fill this gap. Methods ED patients who visited the Urology Outpatients Clinic owere recruited consecutively, and males from the Health Manage Center were included as the controls. Serum thyroid and sexual hormones were estimated, and the International Index of Erectile Function (IIEF-5) questionnaires were evaluated as well. Subjects with normal sexual hormones were included for statistical analysis. Results One hundred nine ED patients and 32 healthy controls were included in this study. The ratio of SCH and euthyroidism in ED males was 29.36% and 66.06% respectively. The IIEF-5 scores in ED patients with SCH were significantly lower than the controls with euthyroidism (P<0.05). The serum concentrations of TSH and prolactin were significantly higher and free thyroxine lower in ED patients with SCH when compared with the controls with euthyroidism (all p<0.05), and no significant differences of estradiol and total testosterone were found between those two groups. However the IIEF-5 scores were not significantly different between males with SCH and euthyroidism among ED patients (P>0.05). Conclusions SCH is common in ED patients and may be associated with ED, whereas the severity of ED is not related to SCH. Screening for thyroid dysfunction in men presenting with ED is recommended.
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Affiliation(s)
- Dawei Chen
- Dawei Chen, MD. West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
| | - Yuerong Yan
- Yuerong Yan, MD. West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
| | - Hui Huang
- Prof. Hui Huang. West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
| | - Qiang Dong
- Prof. Qiang Dong. Department of Urology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
| | - Haoming Tian
- Prof. Haoming Tian. West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
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Oh YJ, Lee WS, Yoo WH, Hahm JR, Kim HO, Suh YS, Lee SI, Cheon YH. Sjögren's Syndrome Accompanied by Prolactinoma: a case report and literature review. Int J Rheum Dis 2017; 20:1823-1826. [DOI: 10.1111/1756-185x.12731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yu-Jeong Oh
- Division of Rheumatology; Department of Internal Medicine; Chonbuk National University Medical School of Chonbuk National Unversity; Jeonju Korea
| | - Won-Seok Lee
- Division of Rheumatology; Department of Internal Medicine; Chonbuk National University Medical School of Chonbuk National Unversity; Jeonju Korea
| | - Wan-Hee Yoo
- Division of Rheumatology; Department of Internal Medicine; Chonbuk National University Medical School of Chonbuk National Unversity; Jeonju Korea
| | - Jong-Ryeal Hahm
- Divison of Endocrinology; Department of Internal Medicine and Institute of Health Science; Gyeongsang National University School of Medicine; Jinju Korea
| | - Hyun-Ok Kim
- Divison of Rheumatology; Department of Internal Medicine and Institute of Health Science; Gyeongsang National University School of Medicine; Jinju Korea
| | - Young Sun Suh
- Divison of Rheumatology; Department of Internal Medicine and Institute of Health Science; Gyeongsang National University School of Medicine; Jinju Korea
| | - Sang- Il Lee
- Divison of Rheumatology; Department of Internal Medicine and Institute of Health Science; Gyeongsang National University School of Medicine; Jinju Korea
| | - Yun-Hong Cheon
- Divison of Rheumatology; Department of Internal Medicine and Institute of Health Science; Gyeongsang National University School of Medicine; Jinju Korea
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Nishihara E, Amino N, Kudo T, Ito M, Fukata S, Nishikawa M, Nakamura H, Miyauchi A. Comparison of thyroglobulin and thyroid peroxidase antibodies measured by five different kits in autoimmune thyroid diseases. Endocr J 2017; 64:955-961. [PMID: 28768936 DOI: 10.1507/endocrj.ej17-0164] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
It is generally believed that the detection of thyroid peroxidase antibodies (TPOAb) is superior to that of thyroglobulin antibodies (TgAb) for the diagnosis of Hashimoto's thyroiditis. However, limited data are available on the comparison of TgAb and TPOAb prevalence as a diagnostic measurement for Hashimoto's thyroiditis using sensitive immunoassays. We herein used five different current immunoassay kits (A-E) to compare the prevalence of TgAb and TPOAb in Hashimoto's thyroiditis (n = 70), Graves' disease (n = 70), painless thyroiditis (n = 50), and healthy control subjects (n = 100). In patients with Hashimoto's thyroiditis, positive TgAb was significantly more frequent than positive TPOAb in kits A-D (mean ± SD of the four kits: 98.6 ± 1.7 vs 81.4 ± 2.0%). In patients with Graves' disease, TgAb prevalence was almost equivalent to that of TPOAb in five kits. Patients with painless thyroiditis exhibited positive TgAb significantly more frequently than positive TPOAb in kits A-D (73.5 ± 4.1 vs 33.0 ± 3.4%). The prevalence of TgAb alone was significantly higher than that of TPOAb alone in both Hashimoto's thyroiditis and painless thyroiditis in kits A-D. In kit E, TgAb and TPOAb prevalence did not differ significantly for any disease, and TgAb distribution was different from other kits. In conclusion, the prevalence of TgAb was higher than that of TPOAb in patients with Hashimoto's thyroiditis and painless thyroiditis using commercially available kits. We suggest that TgAb immunoassay is the first choice of screening test for thyroid autoimmune abnormalities in Japan.
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Affiliation(s)
- Eijun Nishihara
- Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan
| | - Nobuyuki Amino
- Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan
| | - Takumi Kudo
- Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan
| | - Mitsuru Ito
- Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan
| | - Shuji Fukata
- Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan
| | | | - Hirotoshi Nakamura
- Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan
| | - Akira Miyauchi
- Kuma Hospital, Center for Excellence in Thyroid Care, Kobe 650-0011, Japan
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Elenkova A, Аtanasova I, Кirilov G, Natchev Е, Ivanova R, Кovatcheva R, Vandeva S, Tcharaktchiev D, Zacharieva S. Autoimmune hypothyroidism is three times more frequent in female prolactinoma patients compared to healthy women: data from a cross-sectional case-control study. Endocrine 2017; 57:486-493. [PMID: 28726182 DOI: 10.1007/s12020-017-1372-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 07/04/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The potent immunomodulatory action of prolactin has been demonstrated in many experimental in vitro studies. In accordance with these data, our retrospective analyses revealed higher prevalence of autoimmune thyroid diseases in prolactinoma patients compared to general population. PURPOSE A cross-sectional case-control study was carried out in a single tertiary referral centre. The main aim was to assess the frequency of newly diagnosed autoimmune thyroid diseases in female patients with prolactinomas. METHODS The study population consisted of 260 females (154 patients and 106 sex-matched, ethnicity-matched, and age-matched healthy controls) enroled in a prospective manner. Physical exam, thyroid ultrasound, and laboratory testing (measurement of antibodies to thyroglobulin, thyroid peroxidase, TSH-receptor, serum TSH and FT4 levels) were performed in all study participants. RESULTS Autoimmune thyroid diseases were diagnosed in 29.9% of the patients and 10.4% of the healthy subjects (p = 0.0002). Subclinical hypothyroidism was found in 9.7% of the patients versus 2.8% of the controls (p = 0.044). Autoimmune hyperthyroidism was observed in 1.3% of all patients. CONCLUSIONS The prevalence of newly diagnosed autoimmune thyroid diseases, and especially the subclinical hypothyroidism, was significantly higher in our female prolactinoma patients in comparison to age-matched healthy women. Based on our results, we suggest routine screening for autoimmune thyroid diseases (thyroid function, immunology and ultrasound examination) in all female patients with prolactinoma at the time of diagnosis. We also recommend a close follow-up of thyroid function in these women in case of pregnancy and after delivery.
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Affiliation(s)
| | | | | | - Еmil Natchev
- University Hospital of Endocrinology, Sofia, Bulgaria
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Tirgar-Tabari S, Sharbatdaran M, Manafi-Afkham S, Montazeri M. Hyperprolactinemia and Hirsutism in Patients Without Polycystic Ovary Syndrome. Int J Trichology 2016; 8:130-4. [PMID: 27625565 PMCID: PMC5007919 DOI: 10.4103/0974-7753.188998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Hirsutism is one of the most important diseases that lead women to refer to dermatology clinic. Hyperprolactinemia is one of the causes of hirsutism. The aim of this study was to determine prolactin (PRL) levels in hirsute women. Materials and Methods: In this cross-sectional study, hirsute patients were evaluated. For all of the patients, 2 or 3 days after mense starting, hormone level tests were performed, and 200 patients that had not polycystic ovary syndrome enrolled to the study. A questionnaire of history and physical examination were performed. Data have been analyzed with SPSS version 21. Results: Hyperprolactinemia were seen in 25 patients (12.5%). There was no significant relation between marital statuses, galactorrhoea, positive family history, and infertility with hyperprolactinemia. But significant relation was seen between irregular mense and hyperprolactinemia. Conclusion: Although hyperprolactinemia is the rare cause of hirsutism, the prevalence of hyperprolactinemia was high in our study. Thus, PRL level in hirsute patients should be evaluate.
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Affiliation(s)
- Soudabeh Tirgar-Tabari
- Department of Dermatology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Majid Sharbatdaran
- Department of Pathology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Sara Manafi-Afkham
- Department of Internal Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Montazeri
- Young Researchers Club, Islamic Azad University, Babol Branch, Babol, Iran
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13
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Dogansen SC, Selcukbiricik OS, Bilir BE, Yarman S. The higher incidence of autoimmune thyroid disease in prolactinomas than in somatotrophinomas. Growth Horm IGF Res 2016; 29:45-49. [PMID: 27105040 DOI: 10.1016/j.ghir.2016.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 02/03/2016] [Accepted: 04/08/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Many studies have shown that prolactin (PRL) plays an important role in autoimmune diseases. The aim of this study was to compare the current frequency of autoimmune thyroid disease (ATD) in prolactinomas with another type of functional pituitary adenoma (FPA), somatotrophinoma. Another aim of the study was to evaluate possible factors related to thyroid autoimmunity and the process of ATD in FPAs. METHODS We retrospectively evaluated the presence of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) and thyroid morphologic findings in our patients with FPA (78 with acromegaly and 83 with prolactinoma). The relationship of autoantibody positivity with baseline PRL levels, activity of acromegaly, and treatment of dopamine agonists (DA) and hypogonadism was also assessed. Patients with ATD and hypothyroidism due to autoimmune thyroiditis were also evaluated. RESULTS ATD (Hashimoto's thyroiditis) was detected more frequently in patients with prolactinoma than in patients with acromegaly (33% and 17%, respectively; p=0.01). Thyroid autoantibody positivity was found more frequently in females in the whole group (p=0.02) and in the acromegaly group (p=0.008). There was no difference according to sex among the patients with prolactinoma (p=0.800). ATD was found not to be related with baseline PRL levels, treatment of DA, and presence of hypogonadism (p=0.232, p=0.435, p=0.464, respectively) in the prolactinoma group, and activity of acromegaly, presence of hypogonadism in the acromegaly group (p=0.753, p=0.654, respectively). Autoimmune hypothyroidism was more frequent in the prolactinoma group than in the acromegaly group among patients with thyroid autoantibody positivity (p=0.004). CONCLUSION Thyroid autoantibodies should be evaluated both at the time of diagnosis and during the course of treatment in patients with prolactinoma, and thyroid function tests should be closely monitored in patients with autoantibody positivity.
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Affiliation(s)
- Sema Ciftci Dogansen
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey.
| | - Ozlem Soyluk Selcukbiricik
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey
| | - Betul Ekiz Bilir
- Trakya University, Trakya Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Edirne, Turkey
| | - Sema Yarman
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey
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14
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Elenkova A, Petrossians P, Zacharieva S, Beckers A. High prevalence of autoimmune thyroid diseases in patients with prolactinomas: A cross-sectional retrospective study in a single tertiary referral centre. ANNALES D'ENDOCRINOLOGIE 2016; 77:37-42. [PMID: 26874995 DOI: 10.1016/j.ando.2015.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 10/14/2015] [Accepted: 10/14/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Prolactin has been shown to exert potent immunomodulatory activities. DESIGN Retrospective cross-sectional study examining the prevalence of autoimmune thyroid diseases (AITD) in patients with prolactinomas. The medical files of 462 patients (367 women and 95 men) followed up at a single tertiary referral centre were analyzed. RESULTS The prevalence of AITD among prolactinoma patients was estimated at 21.0% (23.2% in females and 12.6% in males). In 51.5% of the patients, diagnosis of prolactinoma preceded the development of AITD; in 37.2%, both diseases were simultaneously diagnosed and 11.3% of patients were diagnosed first with AITD. Hyperthyroidism was observed in 1.24% of the investigated subjects. Primary hypothyroidism was detected in 15.6% of all patients (16.4% in women; 10.7% in men) with a mean incidence of 24 cases/1000/year. CONCLUSIONS Our results demonstrate the high frequency of AITD in patients with prolactinomas. The prevalence rate of hyperthyroidism is comparable with the literature data from community-based studies. In contrast, the prevalence of the spontaneous hypothyroidism due to autoimmune thyroiditis is significantly higher in female and male subgroups of patients with prolactinomas in comparison with the general population. A possible role of supraphysiologically increased prolactin levels in the pathogenesis and the clinical course of AITD in patients with prolactinomas can be suggested. Based on these findings we recommend routine screening for AITD with simple thyroid tests (TSH, TPO-Abs and ultrasound examination) in all patients diagnosed with prolactinoma.
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Affiliation(s)
- Atanaska Elenkova
- University Hospital of Endocrinology, Medical University, Sofia, Bulgaria.
| | - Patrick Petrossians
- University of Liege, CHU of Liege, Department of Endocrinology, Liege, Belgium
| | - Sabina Zacharieva
- University Hospital of Endocrinology, Medical University, Sofia, Bulgaria
| | - Albert Beckers
- University of Liege, CHU of Liege, Department of Endocrinology, Liege, Belgium
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15
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Guclu M, Cander S, Kiyici S, Vatansever E, Hacihasanoğlu AB, Kisakol G. Serum macroprolactin levels in pregnancy and association with thyroid autoimmunity. BMC Endocr Disord 2015; 15:31. [PMID: 26091810 PMCID: PMC4475296 DOI: 10.1186/s12902-015-0025-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 06/01/2015] [Indexed: 12/16/2022] Open
Abstract
BACGROUND To assess the contribution of macroprolactin to high serum prolactin levels and their association with thyroid status and thyroid autoimmunity during pregnancy. METHODS 138 pregnant women who suspected of having thyroid dysfunction were studied and divided into three groups according to the thyroid status; group 1; euthyroidism (n 40), group 2; hypothyroidism (n 54), and group 3; hyperthyroid (n 44). Polyethylene glycol (PEG) precipitation method was used for detection of macroprolactin. A percentage recovery of 40 % or less is considered as macroprolactinemia. If macroprolactin was negative, the percentage of monomeric prolactin recovery (monoPRL %) after PEG precipitation was used for comparison between the groups. RESULTS Macroprolactinemia was found in two patients (1.4 %) one from hypothyroid and other from euthyroid group. Basal prolactin levels in these patients were 400 and 403 ng/mL respectively. Referring to all patients, there was no correlation between PRL, macroPRL or monoPRL % with thyroid hormone status and also with the serum levels of thyroid antibodies (p > 0.05). A positive correlation was observed between the serum levels of PRL with TSH (p = 0.014 and r = 0.219), while a negative correlation was found with FT4 (p = 0.011 and r = -0.227). CONCLUSIONS Despite the fact that serum prolactin levels were found to be high during pregnancy, the contribution of macroprolactin was found to be insignificant in our study. Unlike other auto immune diseases, we could not find any relationship between thyroid autoimmunity and PRL, macroPRL or monoPRL %. These results confirmed that measured prolactin was quite homogeneous during pregnancy.
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Affiliation(s)
- Metin Guclu
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey.
| | - Soner Cander
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
| | - Sinem Kiyici
- Department of Internal Medicine, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
| | - Ebru Vatansever
- Department of Biochemistry, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
| | - Arif Bayram Hacihasanoğlu
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
| | - Gurcan Kisakol
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
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16
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Onal ED, Sacikara M, Saglam F, Ersoy R, Cakir B. Primary thyroid disorders in patients with endogenous hypercortisolism: an observational study. Int J Endocrinol 2014; 2014:732736. [PMID: 24876839 PMCID: PMC4026973 DOI: 10.1155/2014/732736] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 04/27/2014] [Accepted: 04/28/2014] [Indexed: 11/17/2022] Open
Abstract
Cushing's syndrome (CS) may alter the performance of the hypothalamic-hypophyseal-thyroid axis. We searched for a relationship between hypercortisolism and primary thyroid disorders. The medical records of 40 patients with CS were retrospectively examined. Thyroid ultrasonography (USG), basal thyroid function test results (TFT), and antithyroglobulin and antithyroperoxidase antibodies were analyzed. In 80 control subjects, matched by age and gender with CS patients, thyroid USG, TFTs, and autoantibody panel were obtained. Among the CS patients, 17 had nodular goiter, versus 24 controls (42.5% versus 30%, P > 0.05). Among the twenty-five patients with an available TFT and autoantibody panel-before and after surgical curative treatment-autoantibody positivity was detected in 2 (8%) patients before and 3 (12%) after surgery (P = 0.48). Regarding TFT results, 1 (2.5%) patient had subclinical hyperthyroidism and 1 (2.5%) had subclinical hypothyroidism, whereas 1 (2.5%) control had hyperthyroidism. In total, 21 (52.5%) patients and 32 (40%) controls had ≥1 of the features of thyroid disorder, including goiter, positive thyroid autoantibody, and thyroid function abnormality; the difference was not significant (P > 0.05). The prevalence of primary thyroid disorders is not significantly increased in patients with CS.
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Affiliation(s)
- Eda Demir Onal
- Department of Endocrinology and Metabolism, Yildirim Beyazit University Medical School Ataturk Teaching and Research Hospital, Bilkent, Sokak No. 10/6, Ceyhun Atıf Kansu Caddesi 1268, Ehlibeyt Mahallesi, 06520 Balgat, Cankaya, Ankara, Turkey
- *Eda Demir Onal:
| | - Muhammed Sacikara
- Department of Endocrinology and Metabolism, Yildirim Beyazit University Medical School Ataturk Teaching and Research Hospital, Bilkent, Sokak No. 10/6, Ceyhun Atıf Kansu Caddesi 1268, Ehlibeyt Mahallesi, 06520 Balgat, Cankaya, Ankara, Turkey
| | - Fatma Saglam
- Department of Endocrinology and Metabolism, Yildirim Beyazit University Medical School Ataturk Teaching and Research Hospital, Bilkent, Sokak No. 10/6, Ceyhun Atıf Kansu Caddesi 1268, Ehlibeyt Mahallesi, 06520 Balgat, Cankaya, Ankara, Turkey
| | - Reyhan Ersoy
- Department of Endocrinology and Metabolism, Yildirim Beyazit University Medical School Ataturk Teaching and Research Hospital, Bilkent, Sokak No. 10/6, Ceyhun Atıf Kansu Caddesi 1268, Ehlibeyt Mahallesi, 06520 Balgat, Cankaya, Ankara, Turkey
| | - Bekir Cakir
- Department of Endocrinology and Metabolism, Yildirim Beyazit University Medical School Ataturk Teaching and Research Hospital, Bilkent, Sokak No. 10/6, Ceyhun Atıf Kansu Caddesi 1268, Ehlibeyt Mahallesi, 06520 Balgat, Cankaya, Ankara, Turkey
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