The first aim of this study was to compare the serum thyroglobulin (Tg) positive rate between differentiated thyroid carcinoma (DTC) patients with positive thyroglobulin antibody (TgAb) and patients with negative TgAb. The second aim of this study was to investigate the correlation between serum Tg value and antithyroglobulin (TgAb) concentration of patients with DTC. We collected the serum Tg value and TgAb concentration of patients with DTC after thyroid ablation by operation and radioiodine therapy retrospectively. Then we investigated the Tg positive rate of DTC patients with positive TgAb and patients with negative TgAb separately. The scatter diagram between serum Tg value and TgAb concentration of DTC patients was performed to analyze their potential relationship. As a result, among 252 patients with DTC after thyroid ablation, 7 of 47 patients (14.89%) with positive TgAb (>115 IU/mL) had positive serum Tg (>10 microg/L), and 61 of 205 (29.76%) patients with negative TgAb (<115 IU/mL) had positive serum Tg. Eighty three of the 252 patients with DTC had accurate serum Tg and TgAb concentration. No correlation between serum Tg value and TgAb concentration was found among these Eighty three patients. Thus, it may be concluded that positive TgAb could cause much more TgAb interference in serum Tg value than negative TgAb could because of a different quality of TgAb. Serum Tg value is not correlated with serum TgAb concentration in patients with DTC after thyroid ablation.
Adolescent ; Adult ; Aged ; Autoantibodies ; blood ; Carcinoma ; blood ; immunology ; pathology ; Female ; Humans ; Male ; Middle Aged ; Thyroglobulin ; blood ; Thyroid Neoplasms ; blood ; immunology ; pathology ; Young Adult

OBJECTIVETo evaluate the clinical validity of anti-thyroperoxidase antibody (anti-TPOAb) and anti-thyroglobulin antibody (anti-TgAb).

METHODSerum levels of anti-TPOAb and anti-TgAb were assayed using chemiluminescence immunoassay in 434 subjects, including 51 patients with Hashimoto's thyroiditis, 58 with Graves' disease, 68 with nodular goiter, 56 with thyroid adenoma and carcinoma, 56 with subacute thyroiditis, 65 with euthyroid non-thyroid endocrine disease, 35 with euthyroid non-thyroid autoimmune diseases, and 45 euthyroid controls.

RESULTSThe highest level and most positive results of serum anti-TgAb and anti-TPOAb were observed in patients with Hashimoto's thyroiditis (median 373 and 6 974 U/ml, positive rate 84.3% and 86.3%), followed by patients with Graves' disease (median 84 and 1 369 U/ml, positive rate 44.8% and 72.4%). Serum anti-TgAb and anti-TPOAb were also more common in patients with subacute thyroiditis and other autoimmune diseases than in the controls.

CONCLUSIONThe assay of serum anti-TPOAb and anti-TgAb by chemiluminescence immunoassy are useful in the differential diagnosis of autoimmune thyroid disease.

Adenoma ; blood ; Adolescent ; Adult ; Aged ; Autoantibodies ; blood ; Female ; Graves Disease ; blood ; Hashimoto Disease ; blood ; Humans ; Iodide Peroxidase ; immunology ; Male ; Middle Aged ; Thyroglobulin ; immunology ; Thyroid Gland ; immunology ; Thyroid Neoplasms ; blood ; Thyroiditis, Subacute ; blood

To explore immune intervention effects of the combined use of cycloporin A (CsA) and 1, 25-dihydroxyvitamin D3[1,25(OH)2D3] at low doses on experimental autoimmune thyroiditis (EAT), porcine thyroglobulin (pTG) was injected into a CBA mouse at the dose of 100 micrograms on day 0 and day 14 to establish the model of EAT. The immune prevention group from day 0 to day 28, and treatment group from day 10 to day 38 were daily administered CsA (10 mg/kg) intragastrically and/or 1,25(OH)2D3 (0.2 microgram/kg) i.p. After immunized by pTG, the mice were sacrificed on day 28 and day 38 to examine their thyroid gland pathologically, and to check the levels of serum porcine thyroglobulin antibodies (pTGAb), porcine thyromicrosomal antibodies (pTMAb). The incidences of EAT in the immune prevention group and treatment group, with administration of low dose of CsA and 1,25(OH)2D3, were decreased respectively by 44.44% and 37.50%. Those of severe disease in the two groups were decreased respectively by 71.43% and 60.32%. The levels of serum pTGAb and pTMAb in the immune prevention group were lower than those of the positive control group. It was concluded that combined use of CsA and 1,25(OH)2D3 at low doses could effectively prevent EAT with a synergic effect.
Animals ; Antibodies ; blood ; Calcitriol ; therapeutic use ; Cyclosporine ; therapeutic use ; Drug Synergism ; Female ; Mice ; Mice, Inbred CBA ; Thyroglobulin ; immunology ; Thyroiditis, Autoimmune ; drug therapy ; immunology ; prevention & control

BACKGROUNDReports are increasingly appearing on the side effects caused by excessive iodine intake. Our objective was to find out whether iodine excess would impair the thyroid function and intelligence of schoolchildren in rural areas of China.

METHODSA comparative epidemiological study was made on thyroid function and intelligence of the schoolchildren in the areas of low, moderate or excessive intake of iodine. In the area of low intake of iodine (Panshan, Liaoning province, median urinary iodine (MUI) was 99 microg/L), of moderate intake of iodine (Zhangwu, Liaoning Province, MUI was 338 microg/L) and of excessive intake of iodine (Huanghua, Hebei Province, MUI was 631 microg/L). The numbers of schoolchildren from each area selected to take part in a Chinese version of Raven's Test were 190, 236 and 313, respectively, and then 116, 110 and 112 of them were tested for thyroid function, thyroid autoantibody (TAA) and urinary iodine (UI).

RESULTSThere were no significant differences in the incidences of overt hyperthyroidism, subclinical hyperthyroidism and overt hypothyroidism in Panshan, Zhangwu and Huanghua. But significant differences were found in the incidences of subclinical hypothyroidism (P = 0.001) in these three areas. The incidences of subclinical hypothyroidism in Huanghua and Zhangwu were 4.76 and 3.37 times higher than that in Panshan. TAA were negative in all the schoolchildren with subclinical hypothyroidism except for one. No significant difference was found among the rates of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in these three areas. Mean serum thyroglobulin (TG) value of Huanghua was markedly higher than those of the other two (P = 0.02). Mean serum TG value of Zhangwu was higher than that of Panshan but the difference was not significant. Mean IQ value of the schoolchildren in Huanghua was markedly higher than that for Zhangwu (P = 0.001). Mean IQ value of the schoolchildren in Panshan was lower than that of Huanghua and higher than that of Zhangwu but, again, the differences were not significant.

CONCLUSIONSThe increase of iodine intake may increase the risk for schoolchildren of subclinical hypothyroidism. In the area of iodine excess, most of the subclinical hypothyroidism cases are not of autoimmune origin. No obvious effect of excess iodine was found on mental development of schoolchildren.

Child ; Female ; Humans ; Intelligence ; Iodide Peroxidase ; immunology ; Iodine ; administration & dosage ; Male ; Prevalence ; Rural Health ; Thyroglobulin ; immunology ; Thyroid Diseases ; epidemiology ; Thyrotropin ; blood

Serum thyroglobulin (Tg) is primarily used as a tumor marker to detect the recurrent or persistent disease in patients with differentiated thyroid carcinomas. Unfortunately, the serum Tg measurement is technically challenging and the thyroglobulin autoantibody (TgAb) interference remain the most serious problem limiting the clinical value of serum Tg. The direction and magnitude of the interference are related to the method and the concentration and affinity of the TgAb in the specimen. The objective of this study was to evaluate TgAb's interference with assay of Tg by electrochemiluminescent assay (ECLIA). The Tg and TgAb of 84 sera were measured by the ECLIA. Recovery tests were carried out in 3 groups. 3 different Tg calibrators, 50, 100, 200 ng/ml, respectively, were added into the sera of the first group. The sera of second group were doubly diluted 5 times, and meawhile the Tg and TgAb were measured after each dilution, and then 100 ng/ml Tg calibrator was added into the sera. The sera of third group were divided into different subgroups according to TgAb concentration and then 100 ng/ml Tg calibrators were added. Recovery rate (%) was calculated. Tg value decreased when TgAb concentration increased by ECLIA, TgAb value became lower when sera were diluted, Tg value increased. The added Tg calibrator had not significant influence on Tg value and Recovery rate. Recovery rate was lower when TgAb concentration increased. When sera were diluted, the recovery rate was increased. Tg value were underestimated by TgAb interference. After sera were diluted, Tg value became increasing by ECLIA. The added Tg calibrator had not significantly influence on Tg value and Recovery rate. When sera were diluted, the recovery rate was increased. TgAb concentration had significant influence on Recovery rate. Recovery test can not efficiently rectify Tg value when TgAb was positive.
Adolescent ; Adult ; Aged ; Autoantibodies ; blood ; immunology ; Child ; Electrochemical Techniques ; False Positive Reactions ; Female ; Graves Disease ; blood ; Hashimoto Disease ; blood ; Humans ; Luminescent Measurements ; methods ; Male ; Middle Aged ; Thyroglobulin ; blood ; immunology ; Young Adult

Subclinical hypothyroidism (SCH) is a common clinical condition, whereas it's natural course has not been identified distinctly. We evaluated the natural history of 169 SCH patients over 5-yr and the prognostic factors including thyroid autoantibodies and thyroid ultrasonographic (USG) findings related to develop overt hypothyroidism. After 5 yr, 47.3% of patients showed normalization of TSH, while 36.7% of patients remained persistence of high level of TSH, and overt hypothyroidism developed in 11.2% of patients. There were painless thyroiditis (2.9%) and hyperthyroidism (1.7%) during 5 yr follow-up. The thyroid nodule was seen in 48.6% of patients. Most of patients had 1 to 2 nodules whereas only 3% of patients with thyroid nodule had more than 6 nodules. Overt hypothyroidism patients had more heterogenous echogenecity in USG compared to patients with normalization or persistent SCH (76.5% vs 50.0% vs 35.0%, P = 0.048) and higher prevalence positive anti-thyroid peroxidase (anti-TPO Ab) and anti-thyroglobulin antibody (anti-Tg Ab) and titer of anti-TPO Ab than other two groups. The cut off values for prediction of overt hypothyroidism were TSH > 7.45 microIU/mL, free T4 < 1.09 ng/dL and Anti-TPO Ab > 560 IU/mL. SCH has various courses and initial TSH, free T4, presence of thyroid autoantibody, titer of thyroid autoantibody; and thyroid USG findings can serve as a prognostic factor for progression of overt hypothyroidism. These parameters suggest consideration to initiate thyroid hormone treatment in SCH.
Asymptomatic Diseases/*epidemiology ; Autoantibodies/blood/immunology ; Disease Progression ; Female ; Humans ; Hyperthyroidism/epidemiology ; Hypothyroidism/*epidemiology ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Thyroglobulin/immunology ; Thyroid Function Tests ; Thyroid Gland/immunology ; Thyroid Nodule/epidemiology ; Thyroiditis/epidemiology ; Thyrotropin/*blood

This paper is aimed to evaluatethe thyroglobulin autoantibody (TgAb) interference in measurement of thyroglobulin (Tg) between electrochemiluminescent assay (ECLIA) and radioimmunoassay (RIA). Tg and TgAb of 84 sera, including 22 Graves' hyperthyroidism(GD), 24 Hashimoto thyroiditis (HT) and 38 differentiated thyroid carcinomas (DTC), were measured by RIA and ECLIA, respectively. Recovery tests were carried out in 3 groups. The sera samples of the first group were added 3 different amount of Tg calibrator; the sera samples of the second group were diluted 5 times, then 100 ng/ml Tg calibrator was added; the sera samples of the third group were divided into different subgroups depending on TgAb concentration with adding 100 ng/ml Tg calibrator,Tg and TgAb were measured in each dilution by ECLIA and RIA. Recovery rate was calculated. The Tg and TgAb values measured by ECLIA were correlated with that measured by RIA (r = 0.676, P = 0.000; r = 0.677, P = 0.000, respectively). When TgAb concentration increased, the Tg values decreased by ECLIA and increased by RIA. The TgAb values were decreased when sera were diluted, and the Tg values also reduced by RIA and increased by ECLIA. The added different amount of Tg calibrator had not significant influence on Tg recovery rates. When TgAb concentration increased, recovery rates of Tg were decreased by ECLIA and increased by RIA. When sera were diluted, the recovery rates of Tg were increased by ECLIA while decreased by RIA. RIA and ECLIA have good correlation with Tg measurement in 10-400 ng/ml. ECLIA has wider measuring range and higher sensitivity than RIA. RIA and ECLIA have good correlation with TgAb measurement. When TgAb is positive, Tg values are underestimated by ECLIA and overestimated by RIA. When sera are diluted, Tg value and the recovery rate are increasing by ECLIA and decreased by RIA. Recovery test can not efficiently rectify Tg value when TgAb is positive.
Adolescent ; Adult ; Aged ; Autoantibodies ; blood ; Child ; Electrochemical Techniques ; Female ; Graves Disease ; blood ; Hashimoto Disease ; blood ; Humans ; Luminescent Measurements ; methods ; Male ; Middle Aged ; Radioimmunoassay ; methods ; Thyroglobulin ; blood ; immunology ; Thyroid Neoplasms ; blood ; Young Adult

Radioiodine activity required for remnant thyroid ablation is of great concern, to avoid unnecessary exposure to radiation and minimize adverse effects. We investigated clinical outcomes of remnant thyroid ablation with a low radioiodine activity in Korean patients with low to intermediate-risk thyroid cancer. For remnant thyroid ablation, 176 patients received radioiodine of 1.1 GBq, under a standard thyroid hormone withdrawal and a low iodine diet protocol. Serum levels of thyroid stimulating hormone stimulated thyroglobulin (off-Tg) and thyroglobulin-antibody (Tg-Ab), and a post-therapy whole body scan (RxWBS) were evaluated. Completion of remnant ablation was considered when there was no visible uptake on RxWBS and undetectable off-Tg (<1.0 ng/mL). Various factors including age, off-Tg, and histopathology were analyzed to predict ablation success rates. Of 176 patients, 68.8% (n = 121) who achieved successful remnant ablation were classified into Group A, and the remaining 55 were classified into Group B. Group A presented with significantly lower off-Tg at the first radioiodine administration (pre-ablative Tg) than those of Group B (1.2 +/- 2.3 ng/mL vs. 6.2 +/- 15.2 ng/mL, P = 0.027). Pre-ablative Tg was the only significant factor related with ablation success rates. Diagnostic performances of pre-ablative Tg < 10.0 ng/mL were sensitivity of 99.1%, specificity of 14.0%, positive predictive value of 71.1%, and negative predictive value of 87.5%, respectively. Single administration of low radioiodine activity could be sufficient for remnant thyroid ablation in patients with low to intermediate-risk thyroid cancer. Pre-ablative Tg with cutoff value of 10.0 ng/mL is a promising factor to predict successful remnant ablation.
Adolescent ; Adult ; Aged ; Female ; Humans ; Iodine Radioisotopes/*therapeutic use ; Male ; Middle Aged ; Republic of Korea ; Thyroglobulin/blood/immunology ; Thyroid Gland/*pathology/*radiation effects ; Thyroid Neoplasms/*radiotherapy ; Thyrotropin/blood ; Treatment Outcome ; Young Adult

OBJECTIVETo assess the relationships between iodine biological exposure and subclinical thyroid dysfunctions.

METHODSThe cross-sectional survey was performed to obtain the epidemiologic data of population in three communities with different iodine biological exposure: mild iodine deficiency [median urinary iodine concentration (MUI) of 50-99 microg/L], more than adequate iodine intake (MUI of 200-299 microg/L), and excessive iodine intake (MUI over 300 microg/L). Univariate and multivariate analysis (logistic regression analysis) were used to analyze the risk factors of subclinical hypothyroidism and subclinical hyperthyroidism.

RESULTSLogistic regression analysis with sex and age controlled suggested that more than adequate iodine intake (OR = 3.172, P = 0.0004) and excessive iodine intake (OR = 6.391, P = 0.0001) increased the risk of subclinical hypothyroidism, while excessive iodine intake decreased the risk of subclinical hyperthyroidism (OR = 0.218, P = 0.0001). Logistic regression analysis including interaction of iodine intake and antibodies [thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb)] suggested that excessive iodine intake was an independent risk factor of subclinical hypothyroidism (OR = 6.360, P = 0.0001), but independent protect factor of subclinical hyperthyroidism (OR = 0.193, P = 0.0001). More than adequate iodine intake and it's interaction with TgAb increased the risk of subclinical hypothyroidism independently, in addition, it decreased the risk of subclinical hyperthyroidism at the present of TPOAb.

CONCLUSIONBoth excessive iodine intake and more than adequate iodine intake could increase risk of subclinical hypothyroidism, supplement of iodine should be controlled to ensure MUI within the safe range.

Adult ; Autoantibodies ; blood ; China ; Cross-Sectional Studies ; Dose-Response Relationship, Drug ; Female ; Humans ; Hyperthyroidism ; chemically induced ; epidemiology ; metabolism ; Hypothyroidism ; chemically induced ; epidemiology ; metabolism ; Iodide Peroxidase ; immunology ; Iodine ; administration & dosage ; adverse effects ; urine ; Male ; Multivariate Analysis ; Risk Factors ; Surveys and Questionnaires ; Thyroglobulin ; immunology