Steroid responsive encephalopathy associated with autoimmune thyroiditis as a cause of acuteencephalopathy.

Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), known as Hashimoto's encephalopathy (HE), represents a heterogeneous group of neurological and neuropsychiatric symptoms associated with a presence of antithyroid antibodies in case of other causes of encephalopathy were excluded. Clinical symptoms most commonly includes acute onset of encephalopathy, behaviour changes and cognitive dysfunction, epileptic seizures as well as cerebellar and extrapyramidal symptoms. Corticoids provides rapid and sustained therapeutic benefit in most patients and only a few patients require other immunosuppressive therapy such as plasmapheresis, intravenous immunoglobulins, or others. We present the cases of two patients with acute onset of encephalopathy, status epilepticus based on SREAT, with rapid improvement after steroid treatment.

[The prevalence of type 2 diabetes mellitus in patients with autoimmune thyroiditis in hypothyroid stadium]. / Výskyt diabetes mellitus 2. typu u pacientov s autoimunitnou tyroiditídou v stádiu hypotyreózy.

INTRODUCTION: Autoimmune thyroiditis (AIT) and type 2 diabetes mellitus (DM2T) are the two most common endocrinological diseases worldwide. The relationship between T1DM and autoimmune thyreopathies is known and described, but the relationship between thyreopathies and diabetes type 2 is not clarified sufficiently through that studies manifest increasingly the connection between them. OBJECTIVE: Investigate the prevalence of DM2T in patients with AIT in hypothyroid stadium and compare with common population and investigate a possible association between thyroid and glucose metabolism parameters. MATERIAL AND METHODS: The group consisted of 100 patients (33 men and 67 women) with AIT without until now documented glucose metabolism disorder, average age 65.63 ± 19.05 years. The control group (CG) consisted of 100 subjects without until now documented thyreopathy and glucose metabolism disorder (37 men and 63 women), average age 63.85 ± 18.98 years. We realised venous blood sampling and determined thyroidal and glycid metabolism parameters. RESULTS: The study did not confirm higher prevalence of diabetes in patients with AIT [3 (3 %) vs 4 (4 %), p = 1]. There were no statistical significant differences between glycid metabolism parameters in patients with AIT and CG. Also no glycid metabolism parameters correlated to thyroidal parameters. CONCLUSION: We did not confirm higher prevalence of DM in patients with AIT.Key words: autoimmune thyroiditis - diabetes mellitus type 2.

CTLA4 exon1 A49G polymorphism in Slovak patients with rheumatoid arthritis and Hashimoto thyroiditis-results and the review of the literature.

Autoimmune thyroid diseases frequently overlaps with rheumatoid arthritis (RA). Among genetic factors, the role of the HLA antigens and CTLA4 gene polymorphisms in the overlapping has been suggested. The aim of this study was to investigate the alleles and genotypes frequency of the CTLA4 exon1 A49G polymorphism in Slovak patients with RA, Hashimoto thyroiditis (HT), both (RA + HT) and in healthy controls. Fifty-seven unrelated adults with RA, 57 patients with HT, 34 patients with both (RA + HT), and 51 normal subjects were studied. All were ethnic Slovaks living in the same geographical area. The CTLA4 exon1 A49G polymorphism was genotyped by using small amplicon melting analysis after real-time PCR. The CTLA4 49GG genotype and G allele frequency in the group with RA was not significantly higher in comparison with controls (10.53% vs. 9.8%, p = 0.62, OR 1.39, 95% CI 0.35-5.74 and 39.47% vs. 34.31%, p = 0.43, OR 1.25, 95% CI 0.72-2.18). The frequency of GG genotype was slightly but not significantly higher in patients with HT as compared with control group (19.3% vs. 9.8%, p = 0.17, OR 2.27, 95% CI 0.67-8.45). However, the frequency of GG genotype and G allele in patients with both RA and HT was significantly higher than that in controls (29.41% vs. 9.8%, p = 0.02, OR 4.49, 95% CI 1.20-18.54 and 51.47% vs. 34.31%, p = 0.03, OR 2.02, 95% CI 1.08-3.81). The frequency of GG genotype of CTLA4 A49G gene polymorphism in Slovak patients with RA is not significantly higher in comparison to control group. However, carriers of GG genotype with RA may be susceptible to develop HT.

Clinically silent adrenal adenomas - their relation to the metabolic syndrome and to GNB3 C825T gene polymorphism.

OBJECTIVES: Aim of the study was to assess the prevalence of C825T GNB3 gene polymorphism in patients with adrenal incidentaloma (AI) as well as its relation to the metabolic syndrome (MS) and cortisol status. SUBJECT AND METHODS: Alltogether 82 subjects (50 patients with AI, mean age 57.9 + 15 years and 32 subjects without AI, mean age 53.8 + 6.9 years) were included in this study. Parameters of glucose and lipid metabolism, serum adiponectin and the single nucleotide polymorphism C825T in GNB3 gene using PCR-RFLP method were examined. To detect subclinical Cushing syndrome an overnight dexamethason test was performed in all patients with AI. RESULTS: Patients with AI had signifcantly higher BMI, HOMA, triacylglycerols (p < 0.05) and significantly lower serum adiponectine (p < 0.05) than controls. There were no significant differences in metabolic parameters between group with and without subclinical Cushing syndrome (SCS). The prevalence of T allele of GNB3 gene in patients with AI was not significantly higher as compared with control group (32% vs. 47%). No significant differences in serum glucose and lipids between carriers of T and C alleles were detected. However carriers of T allele had significantly lower serum adiponectin than those with allele C (p < 0.01). CONCLUSION: We conclude that patients with AI had significantly higher cardiovascular risk factors that is not related to the presence of SCS. Moreover patients with AI and TC or TT genotype have significantly lower serum adiponectin which may be an early symptom of metabolic syndrome in patients with AI.

Autoimmune thyroid disease and autoimmune rheumatic disorders: a two-sided analysis.

UNLABELLED: Chronic autoimmune thyroiditis (ATD) frequently overlaps with autoimmune rheumatic diseases. The aim of this study was to evaluate the prevalence of various non-organ-specific autoantibodies in patients with ATD, as well as the presence of ATD in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). SUBJECTS AND METHODS: Group 1 comprised 80 patients with ATD, and group 2 contained 80 patients with SLE or RA. A control group consisted of 34 healthy subjects. Group 1 was examined for the presence of non-organ-specific autoantibodies. Serum fT3, fT4, TSH, and antibodies against thyroglobulin, thyroperoxidase, as well as ultrasound of thyroid gland, were determined in group 2. RESULTS: Patients with ATD had a significantly higher prevalence of antinuclear antibodies (ANA) than control subjects (45% vs. 14.7%, P < 0.001). There were no significant differences in the prevalence of other antibodies between the groups. ANA-positive patients were younger than ANA-negative ones and had significantly higher anti-TG values (P < 0.05). The prevalence of ATD in group 2 was significantly higher than in the control subjects (24% vs. 8%, P < 0.05). No significant differences in the prevalence of ATD were detected between SLE and RA. CONCLUSION: The authors conclude that ANA is the most frequent non-organ-specific antibody associated with ATD, while the other antibodies occur rarely. The prevalence of ATD in SLE and RA patients was 24%. These results indicate that it is clinically important to screen patients with SLE and RA for the coexistence of thyroid autoimmune disease.