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Thyro-gastric autoimmunity in patients with differentiated thyroid cancer: a prospective study

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Abstract

Thyro-gastric autoimmunity has not been previously evaluated in patients with differentiated thyroid cancer (DTC), although its long-term complications may be relevant for the management of DTC patients. We assessed the prevalence of gastric autoimmunity and autoimmune gastritis (AG) in patients with Hashimoto’s thyroiditis (HT) and concomitant DTC. Prevalence of parietal cell antibody (PCA) positivity, iron deficiency anemia (IDA), and pernicious anemia (PA) were prospectively assessed in 150 DTC patients referred for radioiodine ablation after total thyroidectomy. Patients were classified as HT (n = 31) and non-HT (n = 119) based on a combination of serological, ultrasonographic, and histological findings. Patients with PCA positivity were subsequently addressed to endoscopy for confirmation of atrophy body gastritis, required for the diagnosis of AG. For all the variables under study, a comparison between groups was made using Fisher’s exact test and appropriate parametric and non-parametric tests. PCA positivity was significantly more prevalent in HT than in non-HT patients (12.9 vs 1.6 %, p = 0.017). After Hp eradication, a reversal of PCA positivity was observed in 3/4 patients in the HT group. IDA and PA did not differ significantly between groups. In the HT group, only one patient had endoscopical confirmation of mild gastric corporal atrophy. Gastric autoimmunity shows higher prevalence in patients with DTC and concomitant HT than in patients with DTC alone; however, in most cases, PCA positivity was associated with Hp infection. Furthermore, although previous reports found up to one-third of patients with HT to have associated AG, in our cohort AG was extremely rare.

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Acknowledgments

This project was supported by a grant from the “Sapienza” University of Rome (Progetto di Avvio alla Ricerca 2013, Prot. Number: C26N13R29B). We are sincerely thankful to all the medical and non-medical staff of the Unit of Nuclear Medicine, Sant’Andrea Hospital of Rome, for taking care of the patients. Thanks also to Dr. Silvia Rigucci for statistical assistance.

Conflict of interest

The authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, “Sapienza” University of Rome, Rome, Italy

    Francesco Cicone, Annalisa Papa, Chiara Lauri, Francesco Scopinaro & Bruno Annibale

  2. Unit of Nuclear Medicine, Sant’Andrea Hospital, Rome, Italy

    Francesco Cicone, Annalisa Papa, Chiara Lauri, Anna Tofani & Francesco Scopinaro

  3. Unit of Endocrinology, AUSL Latina, Latina, Italy

    Camilla Virili & Marco Centanni

  4. Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, Rome, Italy

    Camilla Virili & Marco Centanni

  5. Unit of Gastroenterology, Sant’Andrea Hospital, Rome, Italy

    Bruno Annibale

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  1. Francesco Cicone
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Correspondence to Francesco Cicone.

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Cicone, F., Papa, A., Lauri, C. et al. Thyro-gastric autoimmunity in patients with differentiated thyroid cancer: a prospective study. Endocrine 49, 163–169 (2015). https://doi.org/10.1007/s12020-014-0424-6

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