Abstract
The occurrence of antinuclear antibody (ANA), rheumatoid factor (RF), antibodies to
double-stranded DNA (anti-dsDNA) and to single-stranded DNA (anti-ssDNA) was investigated
in 51 patients with autoimmune thyroid diseases (AITD), and in 25 matched control
subjects. In comparison with controls, the prevalence of anti-dsDNA was 74.5 % in
AITD patients (p = 0.0001), 82.0 % in 39 hyperthyroid Graves' disease (GD) (p = 0.0001),
and 50.0 % in 12 euthyroid Hashimoto's thyroiditis (HT) patients (p = 0.0001). The
prevalence of anti-ssDNA was 90.1 % in AITD (94.8 % in GD and 75 % in HT; p = 0.001).
The concentration of both anti-dsDNA and anti-ssDNA were higher (p = 0.002) in AITD,
in GD (p = 0.001), and in HT (p = 0.01) patients than in controls. Two patients with
AITD were identified as positive for ANA. RF was detected in 4 AITD patients. Positive
correlation was noted between anti-dsDNA with T4 (p = 0.001), T3 (p = 0.002), thyroid
peroxidase antibody (anti-TPO) (p = 0.0001), and TSH (p = 0.001) values but not with
thyroglobulin antibody (anti-Tg). Serum anti-ssDNA values were also correlated with
T3 (p = 0.0001), TSH (p = 0.003), and anti-TPO (p = 0.0001). However, by using a multiple
regression analysis only anti-TPO remained associated with anti-dsDNA and both anti-Tg
and anti-TPO with anti-ssDNA values. The predisposition to develop systemic autoimmune
disorders is not influenced by thyroid hormones. The elevated prevalence of serum
anti-dsDNA and anti-ssDNA in AITD patients points out that we must be aware of the
risk for predisposition for the development of other systemic autoimmune diseases.
Key words
Antinuclear antibodies - Graves' disease - Hashimoto's thyroiditis - thyroid autoantibodies
References
1
Armengol M P, Juan M, Lucas-Martin A, Fernández-Figueras M T, Jaraquemada D, Gallart T,
Pujol-Borrell R.
Demonstration of thyroid antigen-specific B cells and recombination-activating gene
expression in chemokine-containing active intrathyroidal germinal centers.
Am J Pathol.
2001;
159
861-873
2
Baethge B A, Levine S N, Wolf R E.
Antibodies to nuclear antigens in Graves' disease.
J Clin Endocrinol Metab.
1988;
66
485-488
19
Dittmar M, Kahaly G J.
Polyglandular autoimmune syndromes: immunogenics and long-term follow-up.
J Clin Endocrinol Metab.
2003;
88
2983-2992
3
Gumà M, Salinas I, Roverter J L, Roca J, Valls-Roc M, Juan M, Olivé A.
Frequency of antineutrophil citoplasmic antibody in Graves' disease patients treated
with methimazole.
J Clin Endocrinol Metab.
2003;
88
2141-2146
20
Inamo Y, Harada K.
Antinuclear antibody positivity in pediatric patients with autoimmune thyroid disease.
J Rheumatol.
1997;
24
576-578
4
Katakura M, Yamada T, Aizawa T, Kunihide H, Yukimura Y, Ishihara M, Takasu N, Maruyama K,
Kameko M, Kanai M, Kobayashi I.
Presence of antideoxyribonucleic acid antibody in patients with hyperthyroidism of
Graves' disease.
J Clin Endocrinol Metab.
1987;
64
405-408
5
Kawasaki E, Abiru N, Yano M, Uotani S, Matsumoto K, Matsuo H, Yamasaki H, Yamamoto H,
Yamaguchi Y, Akazawa S, Nagataki S.
Autoantibodies to glutamic acid decarboxylase in patients with autoimmune thyroid
disease: relation to competitive insulin autoantibodies.
J Autoimmun.
1995;
8
633-643
6
Kern P, Kron M, Hiesche K.
Measurement of antinuclear antibodies: assessment of different test systems.
Clin Diagn Lab Immunol.
2000;
7
72-78
7
Loviselli A, Velluzzi F, Pala R, Marcello A, Nurchis P, Mathieu A, Bartalena L, Martina E,
Grasso L.
Circulating antibodies to DNA-related antigens in patients with autoimmune thyroid
disease.
J Reumatol.
1992;
24
576-578
8
McDermott M T, West S G, Emlen J W, Kidd G S.
Antideoxyribonucleic acid antibodies in Graves' disease.
J Clin Endocrinol Metab.
1990;
71
509-511
9
Morita S, Arima T, Matsuda M.
Prevalence of nonthyroid specific autoantibodies in autoimmune thyroid diseases.
J Clin Endocrinol Metab.
1995;
80
1203-1206
10
Ottesen M, Feldt-Rasmussen U, Andersen J, Hippe E, Schouboe A.
Thyroid function and autoimmunity in pernicious anemia before and during cyanocobalamin
treatment.
J Endocrinol Invest.
1995;
18
91-97
11
Parkim J, Cohen B.
An overview of the immune system.
Lancet.
2001;
357
1777-1789
12
Perilloux B C, Shetty A K, Leiva L E, Gedalia A.
Antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders:
a retrospective study.
Clin Rheumatol.
2000;
19
200-203
13
Petri M, Karlson E W, Cooper D S, Ladenson P W.
Autoantibody tests in autoimmune thyroid disease: a case-control study.
J Rheumatol.
1991;
18
1529-1531
14
Ruggeri R M, Galetti M, Mandolfino M G, Aragona P, Bartolone S, Giorgianni G, Alesci D,
Trimarchi F, Benvenga S.
Thyroid hormone autoantibodies in primary Sjogren syndrome and rheumatoid arthritis
are more prevalent than autoimmune thyroid disease, becoming progressively more frequent
in these diseases.
J Endocrinol Invest.
2002;
25
447-454
22
Smeenk R.
Detection of antibodies to dsDNA: Current insights into its relevance.
Clin Exp Rheumatol.
2002;
20
294-300
21
Sofield R H.
Autoimmune thyroid disease in systemic lupus erythematosus and Sjorgren's syndrome.
Clin Exp Rheumatol.
1996;
14
321-330
15
Tachi J, Amino M, Iwatani Y, Tamaki H, Mori M, Aozaka M, Tanizawa O, Miyai K.
Increase in antideoxyribonucleic acid antibody titer in postpartum aggravation of
autoimmune thyroid disease.
J Clin Endocrinol Metab.
1988;
67
1049-1053
16
Tektonidou M G, Anapliotou M, Vlachoyiannopoulos P, Moutsopoulos M.
Presence of systemic autoimmune disorders in patients with autoimmune thyroid disease.
Ann Rheum Dis.
2004;
63
1159-1161
17
Vaidya B, Kendall-Taylor P, Pearce S.
Genetics of endocrine disease.
J Clin Endocrinol Metab.
2002;
87
5385-5387
18
Weetman A P.
Graves' disease.
N Engl J Med.
2000;
343
1236-1248
1 Presented in part at the 74th Annual Meeting of the American Thyroid Association,
Los Angeles, CA, USA, October 10 - 13, 2002
João H. Romaldini
Av. Indianópolis, 530
04062 - 000 São Paulo
SP Brazil
Fax: + 55 11 32 53 44 94
Email: jhroma@netpoint.com.br