Thyroid hormone profiles in patients with chronic renal failure on conservative management and regular haemodialysis.

Patients with chronic non-thyroid illness (NTI) generally show biochemical features of hypothyroidism despite their being clinically euthyroid. Using assays that employ the antibody coated tubes technique, we measured thyroid hormone levels in 52 patients with chronic renal failure. 30 of the patients were on conservative management while 22 were on regular haemodialysis (HD) for a mean period of 14.2 +/- 9.9 months. The findings were compared to those of 14 healthy controls. All patients were clinically euthyroid. Only 3 patients on HD had goitres. The mean value of total thyroxine (TT4) total triiodo thyronine (TT3), free thyroxine (FT4) and the free triiodothyronine (FT3) were low in patients compared with controls (P less than 0.01). The mean basal thyroid stimulating hormone (TSH) levels were significantly higher in patients than in controls (P less than 0.001). There were no significant differences in all parameters between the patients on conservative management and those on haemodialysis (P greater than 0.05). Although all patients were clinically euthyroid, the biochemical features suggest hypothyroidism.

Autoantibody profile in thyroid diseases in black Kenyans.

A controlled prospective study of autoantibody profile on black Kenyan patients with non-toxic goitre (116), thyrotoxicosis (131) and age, sex matched hospital controls is reported. The prevalence of thyroid microsomal and thyroglobulin antibodies is 3.5% in smooth non-toxic goitre and is 5.2% in the nodular non-toxic goitre compared to 1% of the control. The results reflect that autoimmune thyroiditis is less common in Kenyan hospital controls and smooth simple goitre which is even more pronounced in case of multinodular simple goitre as compared to the Caucasians. The prevalence of microsomal antibody of 54% and the occurrence of high titres in 19% of the toxic group is relatively similar in Caucasians and black Kenyans. However, thyroglobulin antibody and parietal cell antibody are far less frequent in the Kenyan toxic group as compared to Caucasians. In conclusion, the black Kenyan toxic cases are reluctant to produce thyroglobulin and parietal cell antibodies while microsomal antibody production is unaffected. The latter is thought to be more significant in the development and progression of autoimmune thyroiditis. The dissociated behaviour of the two thyroid specific antibodies and thyrogastric axis in black Kenyans strongly suggest that the immunogenetic control of these and the related diseases is different in them as compared to the Caucasians.