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The prevalence of positive thyroid autoantibodies in patients with subacute thyroiditis: a systematic review and meta-analysis

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Abstract

Purpose:

Subacute thyroiditis (SAT) is a transient inflammatory disorder of the thyroid gland with a possible viral etiology. We conducted this study to estimate the pooled prevalence of thyroid autoantibodies in SAT patients. This question arose due to the varying reports on the positivity rates of thyroid autoantibodies among SAT patients.

Methods:

We searched PubMed, Embase, Scopus, and Web of Science from their inception until March 25th, 2023. Observational studies reporting the positivity rate of thyroid autoantibodies for more than ten patients were included. We used the Joanna Briggs Institute’s (JBI) critical appraisal checklist to assess the quality of the included studies. Pooled prevalence estimates with 95% confidence intervals were calculated using the random effects model. Subgroup analyses were performed to find sources of heterogeneity.

Results:

Out of 1373 identified records, 32 studies involving 2348 SAT patients were included in our study. Thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) were positive in 22.8% and 12.2% of patients, respectively. The Study design, mean erythrocyte sedimentation rate and mean thyroid-stimulating hormone of patients were identified as sources of heterogeneity. As our secondary objectives, we found a recurrence rate of 14.7% and permanent hypothyroidism in 11.6% of patients.

Conclusion:

The results of our study revealed a low TPOAb positivity rate in SAT patients, consistent with its non-autoimmune etiology. The TgAb positivity rate in SAT patients was higher than that of the general population, possibly explained by the transient release of thyroglobulin into the bloodstream during the thyrotoxic phase, leading to subsequent TgAb production. Furthermore, our findings demonstrate a notable recurrence rate and permanent hypothyroidism among SAT patients, highlighting the importance of ongoing follow-up care.

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Author contributions

A.S.: search strategy development, study selection, data extraction, quality assessment, drafting the manuscript, M.F.: search strategy development, quality assessment, statistical analysis, manuscript revision, S.M.-T.: data extraction, manuscript revision, A.Y.: study selection, manuscript revision, M.H.: study conceptualization, resolving the disagreements during the study selection, data extraction, and quality assessment processes, manuscript revision, All authors read and approved the final version of the manuscript.

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Authors and Affiliations

  1. Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Arman Shekarian & Maryam Heidarpour

  2. Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohammad Fakhrolmobasheri

  3. Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

    Sadegh Mazaheri-Tehrani

  4. Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Amirhossein Yousefian

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  1. Arman Shekarian
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Shekarian, A., Fakhrolmobasheri, M., Mazaheri-Tehrani, S. et al. The prevalence of positive thyroid autoantibodies in patients with subacute thyroiditis: a systematic review and meta-analysis. Endocrine 84, 29–41 (2024). https://doi.org/10.1007/s12020-023-03655-6

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