DAMAGE THYROID IN PATIENTS WITH CHRONIC HEPATITIS C AND ITS RELATIONSHIP WITH CHANGES NONSPECIFIC AUTOANTIBODIES
DOI:
https://doi.org/10.11603/1681-2727.2017.1.7766Keywords:
chronic hepatitis C, thyroid, non-specific autoantibodies.Abstract
Chronic hepatitis C, unlike hepatitis of other etiology, is characterized by a high incidence of extrahepatic manifestations. The role of immune disturbances in the development of HCV-associated disorders is being studied.
The aim of the work – to identify features of thyroid damage in patients with chronic hepatitis C and to investigate their relationship with changes of nonspecific autoantibodies.
Patients and Methods. The study included 225 patients with chronic hepatitis C. For the diagnosis of thyroid damage we examined the contents of serum thyroidstimulating hormone, free triiodothyronine, free thyroxine, antibodies to thyroid peroxidase, antibodies to thyroglobulin. Special methods of investigation included determination of the content in the serum of antinuclear antibodies, rheumatoid factor, cardiolipin IgM and IgG, circulating immune complexes.
Results. In 19.6 % of patients with chronic hepatitis C thyroid damage was developed which is manifested by changes in blood content of thyroid-stimulating hormone, free triiodothyronine and thyroxine, present only nonspecific autoantibodies or combination of these changes. The development of hypothyroidism was dominated (68.2 %). The defeat of thyroid damage develops most often in women than in men (32.1 % 8.4 %, p<0.01). In patients with chronic hepatitis C with thyroid damage, in contrast to patients without this manifestation, we often identify cardiolipin IgM and IgG antibodies, antinuclear antibodies, higher levels of cardiolipin IgM and IgG. The level of antibodies to thyroid peroxidase correlated (p<0.01) with the content of rheumatoid factor IgM (r=+0.66) and cardiolipin IgM (r=+0.39). A direct correlation is revealed between the quantitative content of antibodies to thyroid peroxidase and the content of rheumatoid factor IgM (r=+0.66; p<0.01), the content of cardiolipin IgM (r=+0.39; p<0.05), confirming the role of autoimmunity in the formation of HCV-associated lesions of the thyroid gland.
Conclusions. In every fifth patient with chronic hepatitis C thyroid damage is developed, which is often characterized as hypothyroidism. In the presence of thyroid damage in patients with chronic hepatitis C cardiolipin IgM and IgG antibodies, antinuclear antibodies are often detected. The level of antibodies to thyroid peroxide correlated with the content of rheumatoid factor of IgM and cardiolipin IgM.
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