PMID- 3260599
OWN - NLM
STAT- MEDLINE
DCOM- 19880824
LR  - 20061115
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 67
IP  - 2
DP  - 1988 Aug
TI  - Antithyroid microsomal autoantibodies and HLA-DR5 are associated with postpartum 
      thyroid dysfunction: evidence supporting an autoimmune pathogenesis.
PG  - 327-33
AB  - Antithyroid microsomal antibodies (AMA) and human leukocyte antigen (HLA) 
      haplotypes were assessed as markers for the occurrence of postpartum thyroid 
      dysfunction (all forms) and postpartum painless thyroiditis with transient 
      hyperthyroidism, respectively. AMA titers and thyroid function tests were 
      measured sequentially in 261 mothers from delivery to up to 1 yr postpartum. To 
      test for the association of HLA haplotypes in the subgroup of women with 
      postpartum painless thyroiditis with hyperthyroidism, typing for HLA-A, -B, -C, 
      -DR, and -DQ antigens was carried out in a selected group of 38 mothers with this 
      syndrome. Their results were compared to those in 60 women with hypothyroid 
      goitrous autoimmune thyroiditis and 98 regional controls. In the AMA study, 40 
      (15%) of the 261 mothers had positive AMA titers (titer, less than or equal to 
      1:80) at delivery, 54 (21%) 2-4 months postpartum, 69 (26%) 5-7 months 
      postpartum, and 60 (23%) 1 yr postpartum. Among 55 mothers who developed 
      postpartum thyroid dysfunction, 25 (47%) had positive AMA at delivery [relative 
      risk (RR), 10.0; P less than 0.001; sensitivity, 45%; specificity, 95%]. Two to 4 
      months postpartum, 46 mothers had thyroid dysfunction, of whom 35 (76%) had 
      positive AMA, while only 19 of the 215 euthyroid mothers (9%) had positive tests 
      for AMA. Positive AMA tests at these times resulted in a RR for postpartum 
      thyroid dysfunction of 32.8 (P less than 0.0001; sensitivity, 76%; specificity, 
      91%). Five to 7 months postpartum, 55 mothers had thyroid dysfunction, of whom 47 
      (86%) had positive AMA, while only 22 of 206 euthyroid mothers (11%) were 
      positive (RR, 59.0; P less than 0.0001; sensitivity, 86%; specificity, 90%). In 
      the HLA studies, DR5 occurred in 11 of 38 (29%) women with postpartum painless 
      thyroiditis with hyperthyroidism vs. 12 of 98 (12%) controls, resulting in a RR 
      of 2.9 (P less than 0.05). HLA-DR5 was present in 22 of 60 (37%) patients with 
      goitrous autoimmune thyroiditis (RR, 4.2; P less than 0.01). HLA-DR4 and HLA-DQw3 
      were slightly but not significantly increased in women with postpartum painless 
      thyroiditis with hyperthyroidism and goitrous autoimmune thyroiditis compared to 
      those in normal controls. DQw1 was reciprocally decreased (P less than 0.025) in 
      the women with goitrous autoimmune thyroiditis, but not in the women with 
      postpartum painless thyroiditis with hyperthyroidism compared to that in normal 
      controls...
FAU - Vargas, M T
AU  - Vargas MT
AD  - Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
FAU - Briones-Urbina, R
AU  - Briones-Urbina R
FAU - Gladman, D
AU  - Gladman D
FAU - Papsin, F R
AU  - Papsin FR
FAU - Walfish, P G
AU  - Walfish PG
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Autoantibodies)
RN  - 0 (HLA-D Antigens)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (HLA-DR5 Antigen)
SB  - IM
MH  - Adult
MH  - Autoantibodies/*analysis
MH  - Female
MH  - HLA-D Antigens/*analysis
MH  - HLA-DR Antigens/*analysis
MH  - HLA-DR5 Antigen
MH  - Humans
MH  - Microsomes/analysis/*immunology
MH  - Pregnancy
MH  - Puerperal Disorders/*etiology
MH  - Thyroid Diseases/*etiology
MH  - Thyroid Gland/*immunology
MH  - Thyroiditis, Autoimmune/*etiology
EDAT- 1988/08/01 00:00
MHDA- 1988/08/01 00:01
CRDT- 1988/08/01 00:00
PHST- 1988/08/01 00:00 [pubmed]
PHST- 1988/08/01 00:01 [medline]
PHST- 1988/08/01 00:00 [entrez]
AID - 10.1210/jcem-67-2-327 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 1988 Aug;67(2):327-33. doi: 10.1210/jcem-67-2-327.