ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2016, Vol. 25 ›› Issue (6): 526-532.DOI: 10.3969/cndt.j.issn.1006-298X.2016.06.005

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Analysis of autoimmune thyroid diseases in lupus nephritis patients

  

  • Online:2016-12-28 Published:2017-01-03

Abstract:

Objective:To analyze the clinical manifestation of antithyroid antibodies (ATA), thyroid function and autoimmune thyroid diseases (AITD) in lupus nephritis (LN),  the clinical and histological feature between AITD and LN.
Methodology:Two hundred and twenty eight patients diagnosed LN by renal biopsy from 2012 to 2016, including 41 male and 187 female with the average age of 29 (11-73), were enrolled in this study. ATA included thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and thyrotrophin receptor antibody (TRAb), in which any of the ATA positive was defined as ATA positive. Thyroid dysfunction was classified as hyperthyroidism, hypothyroidism and low T3 syndrome.
Results:97 of 228 (425%) patients showed ATA positive, the positive rates of TgAb, TPOAb and TRAb were 342%, 224% and 285% respectively, among which 149% were triple positive ATA. TPOAb was more common in females than that in males (257% vs 73%,P<005). 167 cases showed thyroid dysfunction, including 18 (79%) hypothyroidism, 29 (127%) subclinical hypothyroidism, 5 (22%) hyperthyroidism and 115 (504%) low T3 syndrome. 26 patients had AITD, among them, 22 were Hashimotos thyroiditis, and 4 were Gravesdisease. The incidence of malar rash, oral ulcer, leukopenia anemia, positive of antiC1q antibody and antiphospholipid antibody were much higher in ATA positive group than that in ATA negative group. SLE disease activity index was much higher in patients with hypothyroidism, subclinical hypothyroidism and low T3 syndrome than in patients with normal thyroid function. Urine protein was higher in subclinical hypothyroidism group than low T3 syndrome and normal thyroid function groups. No significant differences were found in ATA positive rates, the incidence of thyroid dysfunction and AITD among different LN histological classes.
Conclusion:Patients with LN showed higher prevalence of ATA and thyroid dysfunction, ATA was associated with SLE activity and clinical manifestations, but had no significant correlation with renal histology.