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Thyroid function and autoimmunity in pernicious anemia before and during cyanocobalamin treatment

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Abstract

Out of 35 consecutive patients with decreased plasma-cobalamin 22 had newly diagnosed overt pernicious anemia (PA) six of which had a known history of thyroid disease. At referral, 5 of these 6 were thyroid peroxidase antibody (TPOAb)-positive and 2 were thyroglobulin antibody (TgAb)-positive, while none were thyroid stimulating antibody (TSAb)-positive (an overall autoantibody appearance of 83.3%). Fifty percent of the 22 patients had TPOAb and 13.6% had TgAb compared to 18.2% and 4.5%, respectively in sex and age matched healthy controls. Six PA-patients without a history of thyroid disease had thyroid autoantibodies and another patient seroconverted within the first year during treatment with cyanocobalamin. Measurements of serum concentrations of thyroid hormones and thyroid stimulating hormone were performed during the first year of treatment with cyanocobalamin. Two cases of subclinical myxoedema were found among PA-patients and another case was found among patients with latent PA. The female:male ratio of thyroid disease among PA-patients and among thyroid autoantibody-positive PA-patients was interestingly found to be 1:1. Treatment with cyanocobalamin did not have any systematic effect on thyroid function. Routine screening for thyroid function and thyroid autoantibodies in patients with latent or overt PA is recommended.

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References

  1. Irvine W.J. The association of atrophic gastritis with autoimmune thyroid disease. Clinics in Endocrinol. Metabol. 4: 351, 1975.

    Article  Google Scholar 

  2. Ardeman S., Chanarin I., Krafchik B., Singer W. Addisonian pernicious anaemia and intrinsic factor antibodies in thyroid disorders. Quart J. Med. 35: 421, 1966.

    PubMed  CAS  Google Scholar 

  3. Furszyfer J., McConahey W.M., Kurland L.T., Maldonado J.E. On the increased association of Graves’ disease with pernicious anemia. Mayo Clin. Proc. 46: 37, 1971.

    PubMed  CAS  Google Scholar 

  4. Tudhope G.R., Wilson G.M. Deficiency of vitamin B12 in hypothyroidism. Lancet 1: 703, 1972.

    Google Scholar 

  5. Davis R.E., McCann V.J., Stanton K.G. Type 1 diabetes and latent pernicious anaemia. Med. J. Australia 156: 160, 1992.

    PubMed  CAS  Google Scholar 

  6. Leshin M. Southwestern Internal Medicine Conference. Polyglandular autoimmune syndromes. Am. J. Med. Sciences 290: 77, 1985.

    Article  CAS  Google Scholar 

  7. Humbert P., Dupond J.L. Les syndromes auto-immunes multiples (S.A.M.). Ann. Med. Interne 139: 159, 1988.

    CAS  Google Scholar 

  8. Singer W., Sahey B.M. Myastenia Gravis, Hashimoto’s thyroiditis and pernicious anaemia. BMJ 1: 904, 1966.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  9. Feld S., Landau Z., Gefel D., Green L., Resnitzky P. Pernicious anemia, Hashimoto’s thyroiditis and Sjogren’s in a woman with SLE and autoimmune hemolytic anemia. J. Rheumatol 16: 258, 1986.

    Google Scholar 

  10. Rilay W., Toskes P.P., Maclaren N.K., Silverstein J.H. Predictive value of gastric parietal cell autoantibodies as a marker for gastric and hematologic abnormalities associated with insulin-dependent diabetes. Diabetes 31: 1051, 1982.

    Article  Google Scholar 

  11. Krassas W., McHardy-Young S., Ramsay I., Florin-Christensen A. Thyroid function and antibody studies in pernicious anaemia. Clinical Endocrinol. 6: 145, 1977.

    Article  CAS  Google Scholar 

  12. Doniach D., Roitt I.M., Taylor K.B. Autoimmune phenomena in pernicious anaemia. Br. Med. J. 1: 1374, 1963.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  13. Markson J.L., Moore J.M. Thyroid autoantibodies in pernicious anaemia. Br. Med. J. 2: 1352, 1962.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  14. Feldt-Rasmussen U., Høier-Madsen M., Bech K., Blichert-Toft M., Bliddal H., Date J., Danneskiold-Samsoe B., Hegedus L., Hippe E., Horness P.J., Kriegbaum N.J., Müller M., Perrild H., Rasmussen N.G., Rasmusson B., Schouboe A. Anti-thyroid peroxidase antibodies in thyroid disorders and non-thyroid autoimmune diseases. Autoimmunity 9: 245, 1991.

    Article  PubMed  CAS  Google Scholar 

  15. Knight A., Knight J., Laing P., Adams D. Coexisting thyroid and gastric autoimmune diseases are not due to cross-reactive autoantibodies J. Clin. Lab. Immunol. 14: 141, 1984.

    CAS  Google Scholar 

  16. McNicol G.P. Thyrotoxicosis associated with pernicious anemia. Am. J. Med. Sci 241: 336, 1961.

    Article  Google Scholar 

  17. Chanarin I. The megaloblastic anaemias, Ed. 1; Oxford, England. Blackwell Scientific Publications 1969. p. 505.

    Google Scholar 

  18. Carmel R., Spencer C.A. Clinical and subclinical thyroid disorders associated with pernicious anemia. Arch. Intern. Med. 142: 1465, 1982.

    Article  PubMed  CAS  Google Scholar 

  19. Ogbuawa O., Johnson R. T4-thyroid storm in pernicious anemia. Arch. Intern. Med. 140: 1245, 1980.

    Article  PubMed  CAS  Google Scholar 

  20. Ottesen M., Feldt-Rasmussen U., Andersen J., Hippe E., Schouboe A. Pernicious anaemia. Investigation of the presenting form of the disease and the diagnostic significance of demonstration of the intrinsic factor antibody and parietal cell antibody. Ugeskr Laeger 154: 3758, 1992.

    CAS  Google Scholar 

  21. Høier-Madsen M., Feldt-Rasmussen U., Hegedus L, Perrild H., Hansen H.S. Enzyme-linked immunosorbent assay for determination of thyroglobulin autoantibodies. Acta Path. Microbiol. Immunol. Scand. 92: 377, 1984.

    Google Scholar 

  22. Weller T.H., Coons A.H. Fluorescent antibody studies with agents of Varicella and Herpes Zoster propagated in vitro. Proc. Soc. Exp. Biol. Med. 86: 789, 1954.

    Article  PubMed  CAS  Google Scholar 

  23. Schwartz M. Antibody to intrinsic factor. Scand. J. Clin. Lab. Invest. 95: 19, 1968.

    Google Scholar 

  24. Ruf J., Czarnocka B., Ferrand M., Doullais F., Carayon P. Novel routine assay of thyroperoxidase autoantibodies. Clin. Chem. 34: 2231, 1988.

    PubMed  CAS  Google Scholar 

  25. Shewring G., Rees Smith B. An improved radioreceptor assay for TSH receptor antibodies. Clin. Endocrinol. (Oxf.) 77: 409, 1982.

    Article  Google Scholar 

  26. Hemmila I., Dakubu S., Mukala V-M., Siitari H., Lovgren T. Europium as a label in time-resolved immunofluorometric assays. Anal. Biochem. 137: 335, 1984.

    Article  PubMed  CAS  Google Scholar 

  27. Conn D. Intrinsic factor antibody seroconversion. Med. Lab. Sciences 44: 326, 1987.

    CAS  Google Scholar 

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Ottesen, M., Feldt-Rasmussen, U., Andersen, J. et al. Thyroid function and autoimmunity in pernicious anemia before and during cyanocobalamin treatment. J Endocrinol Invest 18, 91–97 (1995). https://doi.org/10.1007/BF03349707

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