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• W2890456764 abstract "INTRODUCTION :There are a number of auto antibodies associated with the autoImmune thyroid diseases, which are characterized as either primary or secondary antibodies.Primary antibodies are directly pathogenic and often directed against cell membraneReceptors, whilst secondary antibodies do not appear to be involved in pathogenesis but canServe as a useful diagnostic marker for the presence of autoimmune thyroid disease. ThyroidPeroxidase (TPO) antibodies are one of the major secondary antibodies associated withAutoimmune thyroid disease.TPO was previously known as thyroid microsomal antigen. It is a107 KD enzyme which is involved in thyroid hormone synthesis. TPO is located both on theCell surface and within the cytoplasm of thyroid acinar cells, bound to the vesicle whichTransports newly synthesized thyroglobulin, where it is involved in the iodination ofThyroglobulin. High affinity antibodies (predominantly IgG) directed against TPO is found atElevated levels in the serum of patients with autoimmune thyroid disease such as graves’sDisease, hashimoto’s thyroiditis, diabetes mellitus and myxoedema.autoimmune thyroidDisease (AITD) causes cellular damage and alters thyroid gland function by humoral and cellmediatedMechanisms.OBJECTIVES :1. To detect and measure TPO – Ab in young IDDM individuals.2. To find out the Thyroid abnormalities in TPO – Ab positive individuals in IDDM –Using Thyroid function tests.CONCLUSION :Type-I DM being a chronic auto immune disease which is associates withdifferent auto-anitbodies to thyroid, viz, anit TPO-Ab, anti TGAb and anti thyroid antibodies.Thyro peroxidase being responsible for iodination of thyrosine moieties,responsible for active thyroid hormone T4 and T3 synthesis, when inhibited by anti TPO Absdecreases the active T4 ,T3 synthesis resulting in low T4, T3 level and there is acompensatory increase in TSH level, which with increased anti TPO tier and duration leads todeterioration of thyroid function from sub clinical dysfunction to fully manifest clinical hypothyroidism.Anti TPO- Abs being the autoimmune parameter measured in Type-1 DMpatients. In our study it is characterised by low T4 and T3 levels and increased TSH level.While in a study it was found anti TPO-Ab with anti TG Abs may present with thyrotoxicosis. Similarly anti thyroid Abs in Type-1 DM patients leads to thyro toxicosis.In this study TPO – Ab were measured. All the cases of TPO – Ab positiveindividuals show sub clinical hypo thyroidism with elevated level of TSH. So annual screeningof TSH is essential to detect and prevent further deterioration into clinical hypo thyroidismand follow up.Type-1 DM is an auto immune disorder which affects pancreatic beta cell andother endogenous involvement is in not only to pancreas but also to the other organs(Thyroid, Adrenals and non endocrine organs like GI mucosa with Hypo, Hyper thyroidism,Addison’s diseases, celiac disease).There is mean latent period of 10 years between the onset of Type-1 DM andthyroid disease. During which sub-clinical thyroid dysfunction turns into clinical hypo function.So annual screening of TSH level is recommended in anti TPO positive individuals withType-1 DM.AITD also has influence on DM control because hypo or hyper thyroidism willaffect the diabetic control while sub-clinical hypo thyroidism has no effect on diabetic control.In anti TPO positive Type-1 DM patients estimation of TSH level raise should be doneannually, in order to detect hypo function of thyroid , even in sub clinical itself so as tomaintain Euglycemic status.In reference 20, based on study of 237 diabetic children the authors proposedthe following screening protocol.1) Thyroid dysfunction coexisted with Type-1 DM in 5.5% of theircohort but not with Type-2 DM.2) Screening for fT4 and TSH levels identifies asymptomaticchildren.3) Thyroid dysfunction was strongly associated with thyroidauto-antibodies.4) Thyroid function should be assessed annually in diabeticchildren.Based on their study the author recommend that1) fT4 and TSH level should be measured at diagnosis andannually thereafter.2) Thyroid auto – antibodies should be measured at diagnosis ofType-1 DM and should be repeated if TSH level exceededthe reference range.While the other studies suggest , Type-1 DM young patients with anti TPO Absdevelop clinical thyroid disease with a mean latent interval of 10 years from the onset ofType-1 DM, during which sub clinical thyroid dysfunction occurs and it should be suffice tomeasure TSH level annually in anti TPO positive Type-1 DM patients with which we concur." @default.
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• W2890456764 date "2006-09-01" @default.
• W2890456764 modified "2023-09-27" @default.
• W2890456764 title "Prevelance of Anti TPO Antibody in Insulin DependentDiabetes in a Tertiary Care Centre." @default.
• W2890456764 hasPublicationYear "2006" @default.
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