Sezgin VATANSEVER, Zehra Betül PAKÖZ, Süleyman GÜNAY, Altay KANDEMİR, Belkıs ÜNSAL

Primer biliyer kolanjit hastalarında tiroid otoimmünitesinin değerlendirilmesi

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

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.

Keywords:

primary biliary cholangitis;, thyroid auto-immunity,

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