Low concordance between positive antibodies to thyroperoxidase and thyroid ultrasound autoimmune pattern in pregnant women

Jan Jiskra; Jana Bartáková; Štepán Holinka; Zdenka Límanová; Drahomíra Springer; Tomáš Fait; Marie Antošová; Zdenek Telicka; Eliška Potluková

doi:10.1507/endocrj.EJ11-0026

ORIGINALS

Low concordance between positive antibodies to thyroperoxidase and thyroid ultrasound autoimmune pattern in pregnant women

Jan Jiskra, Jana Bartáková, Štepán Holinka, Zdenka Límanová, Drahomíra Springer, Tomáš Fait, Marie Antošová, Zdenek Telicka, Eliška Potluková

Author information

Jan Jiskra
3^rd Department of Medicine, 1^st Faculty of Medicine, Charles University, General University Hospital, 128 08 Prague, Czech Republic
Jana Bartáková
3^rd Department of Medicine, 1^st Faculty of Medicine, Charles University, General University Hospital, 128 08 Prague, Czech Republic
Štepán Holinka
3^rd Department of Medicine, 1^st Faculty of Medicine, Charles University, General University Hospital, 128 08 Prague, Czech Republic
Zdenka Límanová
3^rd Department of Medicine, 1^st Faculty of Medicine, Charles University, General University Hospital, 128 08 Prague, Czech Republic
Drahomíra Springer
Department of Clinical Biochemistry and Laboratory Medicine, 1^st Faculty of Medicine, Charles University, General University Hospital, 128 08 Prague, Czech Republic
Tomáš Fait
Department of Obstetrics and Gynecology, 1^st Faculty of Medicine, Charles University, General University Hospital, 128 08 Prague, Czech Republic
Marie Antošová
3^rd Department of Medicine, 1^st Faculty of Medicine, Charles University, General University Hospital, 128 08 Prague, Czech Republic
Zdenek Telicka
3^rd Department of Medicine, 1^st Faculty of Medicine, Charles University, General University Hospital, 128 08 Prague, Czech Republic
Eliška Potluková
3^rd Department of Medicine, 1^st Faculty of Medicine, Charles University, General University Hospital, 128 08 Prague, Czech Republic

Keywords: Thyroid texture, Thyroid ultrasound, Antibodies to thyroperoxidase, Pregnancy, Preterm delivery

JOURNAL FREE ACCESS

2011 Volume 58 Issue 10 Pages 849-859

DOI https://doi.org/10.1507/endocrj.EJ11-0026

View "Advance Publication" version (August 27, 2011).

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Abstract

The diagnostic and prognostic role of thyroid ultrasound (TUS) in pregnant women positive for antibodies to thyroperoxidase (TPOAb) is unclear. The aim of our study was to compare the relation of ultrasound thyroid texture to the thyroid laboratory tests in pregnant women and controls. Using a semi-quantitative assessment we compared TUS in two groups of women with positive TPOAb and/or with thyroid dysfunction (TSH out of 0.06-3.67 mIU/L): 186 women in 1^st trimester of pregnancy recruited from universal screening and 67 asymptomatic age-comparable non-pregnant non-postpartum women recruited from screening of general population (controls). Women with previous history of thyroid diseases were excluded. Only 64/131 (48.9 %) of TPOAb-positive pregnant women were TUS-positive (TUS with autoimmune pattern) in comparison with 35/49 (71.4 %) TPOAb-positive controls (p <0.011). Pregnant women had more often TSH >10.0 mIU/L if they were TPOAb-positive/TUS-positive as compared to those TPOAb-positive/TUS-negative (8/64 (12.5 %) vs. 0/67 (0 %), p = 0.009). The prevalence of preterm deliveries among TPOAb-positive women was significantly lower if TPOAb-positivity was not accompanied by TUS-positivity (2/67 (3.0 %) vs. 10/64 (15.6 %) in TPOAb-positive/TUS-positive women, p = 0.028). In conclusion, nearly half of the TPOAb-positive pregnant women did not have an autoimmune pattern in TUS. Normal TUS image in TPOAb-positive pregnant women might be a protective factor for preterm delivery.

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