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Chronic Autoimmune Thyroiditis in Industrial Areas in Brazil: A 15-Year Survey



To investigate whether there is an increased incidence of chronic autoimmune thyroiditis (CAT) in individuals living in the vicinity of industrial plants that manufacture petroleum byproducts in the state of São Paulo, Brazil.


Between 1989 and 2004, 6,306 patients of both sexes, from 5 to 78 years old were divided in two groups according to their home location: Group 1: 3,356 residents living near industrial plants that manufacture petroleum byproducts (Region A), and Group 2: 2,950 residents living far from Region A in an area with predominantly steel industries (Region B). For all patients, we measured the serum levels of antithyroglobulin antibody, antithyroperoxidase antibody, triiodothyronine, thyroxine, free thyroxine and thyrostimulating hormone. Sonographic scans of the thyroid gland were also conducted.


The proportion of patients with CAT coming from Region A increased from 2.5 % (5 patients with CAT/200 total patients) in 1992 to 57.6 % (106 patients with CAT/184 total patients) in 2001. This striking increase was highly significant (p < 0.001). Similar findings were not observed in Region B. The difference in the number of patients with CAT between 1989 and 2004 coming from Region A and Region B was highly significant (p < 0.001), with 905 CAT patients (83.95 %) in Region A and 173 CAT patients (16.05 %) in Region B.


Our results showed a striking increase in the incidence of CAT in residents in the vicinity of large industrial plants that manufacture petroleum byproducts compared with residents living near steel industries, which opens the field to new areas of research.

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To our patients for all of their information and understanding.

To Professor Walter Bloise, PhD, at the University of São Paulo Medical School, Internal Medicine Department, Endocrinology Service (FMUSP), São Paulo, SP, Brazil, we grant a special recognition for his important support in the elaboration of this paper.

To Antonio Achur, MD, for laboratory examinations (Fleming Laboratory) and to Edson R. Iglezias, MD, for Image examinations (DISA), Santo André, SP, Brazil, for their collaboration and confidence.

To Professors Rui M. B. Maciel and Roberto Z. Esteves, PhD, at the Federal University of São Paulo Medical School, Internal Medicine Department, Endocrinology Service (UNIFESP), São Paulo, SP, Brazil, for their collaboration and confidence.

To Professor Éder Quintão, PhD, at the University of São Paulo Medical School, Internal Medicine Department, Endocrinology Service (FMUSP), São Paulo, SP, Brazil, for his trust and support.

To Professor Paulo H. N. Saldiva, PhD, at the University of São Paulo Medical School, Pathology Department, Laboratory of Atmospheric Pollution (FMUSP), São Paulo, SP, Brazil, for his collaboration, trust and support.

Conflicts of Interest

The author declares that she has no conflicts of interest that could be perceived as affecting the impartiality of the research reported. In particular, this study did not receive any support from industry or the makers of the studied compounds.

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Correspondence to Maria Angela Zaccarelli-Marino.

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Zaccarelli-Marino, M.A. Chronic Autoimmune Thyroiditis in Industrial Areas in Brazil: A 15-Year Survey. J Clin Immunol 32, 1012–1018 (2012).

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  • Autoimmune
  • thyroiditis
  • petroleum byproducts
  • industrial
  • Brazil