Increased prevalence of antibodies to central nervous system tissue and gangliosides in Hashimoto's thyroiditis compared to other thyroid illnesses
Received 26 January 2009; received in revised form 12 March 2009; accepted 14 March 2009.
Summary
Background
Previous studies point to central nervous system (CNS) alterations in euthyroid patients with Hashimoto's thyroiditis (HT). The aim of the present study was to investigate the prevalence and clinical significance of antibodies (Abs) against CNS tissue and gangliosides in female patients with HT compared to patients with other non-autoimmune thyroid disorders, comprising diffuse or nodular goitre and thyroid surgery for goitre.
Methods
58 HT patients (mean age: 46±17 years) and 89 patients with other thyroid disorders (mean age: 51±15 years) were recruited consecutively from our endocrine outpatient clinic. Serum Abs against CNS tissue and gangliosides were determined using an enzyme-linked immunosorbent assay (ELISA). In a subgroup of 23 HT patients, neurocognitive function was studied using established neuropsychological tests.
Results
In HT patients, the prevalence of serum anti-ganglioside-Abs and anti-CNS-Abs were significantly higher compared to patients with other thyroid disorders (p<0.05 and p<0.005, respectively). In both cases, the number of Ab-positive HT patients was twice that of Ab-positive controls. Reactivity of IgM-Abs to gangliosides and IgG-Abs to CNS tissue was significantly higher in HT patients than in controls (p<0.05 and p<0.01, respectively). However, prevalence and reactivity of Abs to gangliosides and CNS tissue were associated neither with the prevalence of depression nor with impairment of neurocognitive function in HT patients.
Conclusion
Ab reactivity towards CNS tissue and gangliosides is markedly enhanced in patients with HT as compared to patients with other thyroid disorders. Whether these Abs could be of prognostic value to evaluate the risk of future neurocognitive impairment has to be investigated in longitudinal studies.
aDivision of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
bDepartment of Psychiatry and Psychotherapy, University of Tübingen, Osianderstraße 24, 72076 Tübingen, Germany
cGeriatric Center at the University Hospital of Tübingen, University of Tübingen, Osianderstraße 24, 72076 Tübingen, Germany
dDivision of Haematology, Oncology, Immunology, Rheumatology and Pulmonology, Department of Internal Medicine, University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
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