The association of neuropsychiatric disorders and endocrine parameters in hashimoto thyroiditis

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Abstract


Hashimoto thyroiditis is the most common thyroid disease. This form of pathology has a diverse clinical picture, including neuropsychiatric disorders. There are frequent cases of comorbidity of autoimmune thyroiditis and psychiatric forms of pathology, along with such a nosological entity as Hashimoto’s encephalopathy (aka: Steroid-responsive encephalopathy of autoimmune thyroiditis), characterized by an increased level of antithyroid autoantibodies and various mental disorders, with still unclear pathogenesis. The question arises, how to regard patients with psychiatric disorders and Hashimoto thyroiditis — either as patients having autoimmune thyroiditis, comorbid with psychiatric forms of pathology, or as patients with Hashimoto’s encephalopathy? We studied groups of patients with autoimmune thyroiditis free from any psychiatric disorders, autoimmune thyroiditis comorbid with psychiatric forms of pathology, and a group of healthy donors similar as regards to their age and sex. We also studied medical history, clinical manifestations of the disease, instrumental data and the serum levels of thyrotropin, thyroid hormones, various antithyroid autoantibodies, and prolactin. We analyzed the correlation of laboratory and instrumental parameters and clinical data in all groups of patients. There was a significant relationship (p < 0,05) between various psychiatric symptoms and a decreased level of free thyroxine, an increased level of thyroid stimulating hormone (TSH), an increased level of prolactin and an increased volume of a thyroid gland. A significant relationship (p < 0,05) was also found between various symptoms of hypothyroidism and a decreased level of free triiodothyronine (FT3), an increased level of antibodies to thyroglobulin (anti-TG Ab), and an increased level of antibodies to thyroid peroxidase (anti-TPO Ab).


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About the authors

Polina A. Sobolevskaia

Saint Petersburg State University

Author for correspondence.
Email: dr.polinasobolevskaia@bk.ru

Russian Federation, Saint Petersburg

Researcher, Laboratory of the Mosaic of Autoimmunity

Boris V. Andreev

St. Petersburg State Budgetary Healthcare Institution “Psychiatric Hospital No. 1 named after P.P. Kashchenko”

Email: bandreev1947@list.ru

Russian Federation, Nikolskoe, Leningrad Region

MD, PhD, Dr Med Sci, Professor

Anton N. Gvozdetckii

Saint Petersburg State University

Email: comisora@yandex.ru

Russian Federation, Saint Petersburg

Graduate Student

Anastasia A. Dolina

Saint Petersburg State University

Email: dolinanast.357@mail.ru

Russian Federation, Saint Petersburg

Student, Research Assistant

Anna M. Stepochkina

Saint Petersburg State University; Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences

Email: annastepochkina23.11@mail.ru

Russian Federation, Saint Petersburg

Student, Research Assistant, Senior research assistant

Yurii I. Stroev

Saint Petersburg State University

Email: svetlanastroeva@mail.ru

Russian Federation, Saint Petersburg

MD, PhD, Professor

Vladimir J. Utekhin

Saint Petersburg State University; St. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation

Email: utekhin44@mail.ru

Russian Federation, Saint Petersburg

MD, PhD, Associate Professor

Tamara V. Fedotkina

Saint Petersburg State University; St. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation

Email: t.v.fedotkina@gmail.com

Russian Federation, Saint Petersburg

PhD, Leading Researcher, Associate Professor

Leonid P. Churilov

Saint Petersburg State University; St. Petersburg Scientific Research Institute of Phthisiopulmonology of the Ministry of Healthcare of the Russian Federation

Email: elpach@mail.ru

Russian Federation, Saint Petersburg

MD, PhD, Associate Professor, Head of the Department of Pathology, Leading Researcher

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Supplementary files

Supplementary Files Action
1.
Fig. 1. Scheme of pathogenesis of Hashimoto’s encephalopathy. Abbreviations: aTG –autoantibodies against thyroglobulin; aTPO – autoantibodies against thyroid peroxidase; aNAE – autoantibodies against N-terminal peptide of alfa-enolase; a1DMA – autoantibodies against 1-dimethylarginase; a1AR – autoantibodies against 1-aldoreductase; aGS – anti-ganglioside autoantibodies; aMOG – autoantibodies against myelin-oligodendrocyte glycoprotein; TSH –thyroid stimulating hormone

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2.
Fig. 2. The structure of psychiatric diagnoses in the autoimmune thyroiditis group in comorbidity with a psychiatric disorder

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3.
Fig. 3. Structure of psychiatric symptoms in groups of patients with autoimmune thyroiditis (AIT)

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4.
Fig. 4. Structure of psychiatric symptoms in groups of patients with autoimmune thyroiditis

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5.
Fig. 5. Structure of psychiatric symptoms in groups of patients with autoimmune thyroiditis and psychiatric disorder

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6.
Fig. 6. Laboratory results (FT3 and FT4) using the logistic regression model. AIT – autoimmune thyroiditis

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7.
Fig. 7. Results of laboratory tests (prolactin and thyroid stimulating hormone (TSH)) using a logistic regression model

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8.
Fig. 8. Results of laboratory tests using the logistic regression model. AIT – autoimmune thyroiditis; antiTG – autoantibodies to thyroglobulin; antiTPO – autoantibodies to thyroid peroxidase

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9.
Fig. 9. Comparative analysis of thyroid volume according to the results of ultrasound using a model of logistic regression

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10.
Fig. 10. Statistically significant associations between psychiatric symptoms and laboratory instrumental data. TSH – thyroid stimulating hormone

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11.
Fig. 11. Statistically significant relationships between symptoms of hypothyroidism and laboratory instrumental findings. antiTG – autoantibodies to thyroglobulin; antiTPO – autoantibodies to thyroid peroxidase

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12.
Fig. 12. The correlation between antiTPO level and thyroid gland volume

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Copyright (c) 2020 Sobolevskaia P.A., Andreev B.V., Gvozdetckii A.N., Dolina A.A., Stepochkina A.M., Stroev Y.I., Utekhin V.J., Fedotkina T.V., Churilov L.P.

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