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Antinuclear antibody positivity in pediatric patients with autoimmune thyroid disease
1Department of General Pediatrics, Nerima Hikarigaoka Hospital, Nihon University School of Medicine, Tokyo, Japan.
Objective:
The incidence of antinuclear antibody (ANA) positivity was investigated in pediatric patients with autoimmune thyroid diseases.
Methods:
Subjects were 21 untreated patients with Graves' disease, 12 untreated patients with Hashimoto's disease, and 16 untreated patients with non-autoimmune thyroid disease, including one patient with Plummer's disease, 11 patients with simple goiter (probable), and 4 patients with cretinism. Patients with Graves' disease were treated with either propylthiouracil or methimazole. ANA was measured using HEp-2 cells. Anti-dsDNA antibody was measured using double stranded DNA derived from an Escherichia coli plasmid.
Results:
The incidence of ANA positivity was significantly higher in patients with untreated Graves' disease (n = 21; age range 9-15 yrs) than in Hashimoto's thyroiditis (n = 12; age range 7-15 yrs) (p < 0.03, Fisher's exact probability test). However, the 2 diseases were not significantly different with respect to anti-dsDNA antibody positivity. Most of the ANA positive patients with Graves' disease required treatment for more than 2 years, unlike the 6 ANA negative patients (p < 0.002, Fisher's exact probability test).
Conclusion:
We conclude that ANA positivity may predict a poor response to antithyroid drugs in Graves' disease.