Primer biliyer kolanjit hastalarında tiroid otoimmünitesinin değerlendirilmesi

Yıl 2018, Cilt: 8 Sayı: 3, 511 - 517, 30.09.2018

Sezgin Vatansever Zehra Betül Paköz , Süleyman Günay , Altay Kandemir , Belkıs Ünsal

https://doi.org/10.31832/smj.416304

Öz

Amaç: Primer biliyer kolanjit (PBK) sıklıkla diğer
otoimmün hastalıklarla, özellikle de otoimmün tiroit hastalığı ile
ilişkilendirilmektedir. Çalışmalar, otoimmün tiroid hastalığı ve anti-tiroid
antikorlarının prevalansının PBK’de %14-24 olduğunu göstermiştir. Bu çalışmanın
amacı, PBK’li hastalarda eşlik eden tiroid otoimmünitesini
ve diğer tiroid hastalıklarını araştırmaktır.  
                          

Yöntemler:
Bu retrospektif kohort, Haziran 1999 ile Aralık 2017 tarihleri arasında
üçüncü basamak merkezimizin gastroenteroloji bölümünde tedavi edilen 263 PBK
hastasının tıbbi dosyalarından alınan verilere dayanmaktadır. Tiroid otoimmünitesi,
normal aralığın üzerinde anti TPO ve/veya anti TG şeklinde tanımlanmaktadır. Otoimmün
tiroid hastalığı olan ve olmayan PBK hastalarının klinik özellikleri ve
laboratuvar bulgularındaki farklılıklar kaydedilmiştir.

Bulgular:
Tiroid
otoimmünitesi, serimizdeki 80 hastada (%30,4) saptanmıştır. Hashimato tiroiditi 47 hastada tespit edilmiştir. Otoimmun tiroid hastalığı olan grupta hipertiroidi
olan iki hastanın birinde Graves hastalığı, diğerinde ise Hashimato hastalığı
olduğu belirlenmiştir.

Otoimmün dışı tiroid hastalıkları grubunda
19 hasta olup, bunlar arasında 15 hastada multinodüler guatr, 3 hastada toksik
tiroid nodül ve bir hastada tiroid kanseri olduğu belirlenmiştir. Otoimmün dışı
tiroid hastalığı grubunda 9 hipertiroidi hastası  saptanmıştır. Bu hastalar, toksik tiroid nodülü
olan 3 hasta, akut tiroiditi olan 1 hasta ve diğer tiroid hastalıkları olan 5 hasta
şeklindedir. Toksik tiroid nodülü olan bir hastada tiroid papiller mikrokarsinom olduğu belirlenmiştir.

Sonuç:
Tiroid
otoimmünitesi, PBK hastalarında sıklıkla görülmektedir. PBK’li hastaların tiroid
otoimmünitesi açısından taranması gerekir.

Anahtar Kelimeler

Primer biliyer kolanjit, tiroid otoimmünitesi

Assessement of thyroid autoimmunity in primary biliary cholangitis patients

Öz

Purpose: PBC is frequently associated with other autoimmune diseases, especially with auto-immune  thyroid disease. Studies showed 14-24% prevalence of autoimmune thyroid disease and anti-thyroid antibodies vary considerably in primary biliary cholangitis (PBC). The aim of the present study was to investigate thyroid autoimmunity in patients with PBC.                                            

Methods: This study was based on data derived from the medical files of 263 consecutive PBC patients treated in the gastroenterology department of our tertiary care center between June 1999 and Aug 2017. Thyroid autoimmunity was defined as Anti TPO and/or Anti TG above the normal range. The differences in clinical features and laboratory findings of PBC patients with and without autoimmune thyroid disease were documented.                                      

Results: The average age was 55.0±12.4 (28-84) and 244 (92,7%) patients were female. Thyroid autoimmunity was evident in 80 patients (30,2 %) of our series. There were 19 patients in non- autoimmune thyroid diseases group, 15 patients with multinoduler goiter, 3 patients with toxic thyroid nodul and one patient with thyroid cancer. We found 9 hyperthyroid patients in non-thyroid autoimmunity group, 3 patients with toxic thyroid nodul, one patient with acute thyroiditis and 5 patients with other thyroid diseases. One patient who had toxic thyroid nodul was determined as thyroid papillary microcarcinoma.

Conclusion: Thyroid autoimmunity is frequently seen in PBC patients. There were no significant clinical parameters differences in our study. However, patients with PBC should be screened for thyroid disease.

 

Anahtar Kelimeler

primary biliary cholangitis;, thyroid auto-immunity

Kaynakça

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