Serum thyroid-stimulating hormone and anti-thyroglobulin antibody are independently associated with lesions in spinal cord in central nervous system demyelinating diseases

• Published in: PloS one Vol. 9; no. 8; p. e100672
• Main Authors: Long, Youming, Zheng, Yangbo, Chen, Mengyu, Zhang, Bin, Gao, Cong, Shan, Fulan, Yang, Ning, Fan, Yongxiang
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 05.08.2014; Public Library of Science (PLoS)
• Subjects: Abnormalities; Adolescent; Adult; Age; Aged; Antibodies; Aquaporin 4; Aquaporins; Autoantibodies - blood; Biology and Life Sciences; Central nervous system; Child; Cohort Studies; Demyelinating diseases; Demyelinating Diseases - blood; Demyelinating Diseases - epidemiology; Demyelinating Diseases - pathology; Demyelination; Education; Female; Hospitals; Humans; Immunoglobulins; Inflammatory diseases; Intravenous administration; Laboratories; Lesions; Male; Males; Medicine and Health Sciences; Methylprednisolone; Middle Aged; Multiple sclerosis; Multiple Sclerosis - blood; Multiple Sclerosis - epidemiology; Myelitis; Myelitis, Transverse - blood; Myelitis, Transverse - epidemiology; Nervous system; Neurology; Neuromyelitis; Neuromyelitis Optica - blood; Neuromyelitis Optica - epidemiology; Neurosciences; Parameters; Patients; Peroxidase; Regression analysis; Remission; Research and Analysis Methods; Serum levels; Spinal cord; Spinal Cord - pathology; Spinal Cord Diseases - blood; Spinal Cord Diseases - epidemiology; Thyroglobulin; Thyroid; Thyroid diseases; Thyroid-stimulating hormone; Thyrotropin - blood; Young Adult; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0100672

Transverse myelitis (TM) is associated with neuromyelitis optica (NMO) and multiple sclerosis (MS). Early recognition of useful parameters may be helpful to distinguish their difference. This retrospective study analyzed thyroid parameters from 243 serum samples (relapse = 128; remission = 115) of 178 patients with demyelinating diseases (NMO, n = 25; TM, n = 48; MS, n = 105). The relationship between thyroid and clinical parameters was analyzed. Patients with NMO and TM had a higher frequency of abnormal thyroid-stimulating hormone (TSH), anti-thyroglobulin antibodies (TG-Ab), and antithyroid peroxidase antibody (TPO-Ab) than MS patients (p<0.05). The level of TSH and TG-Ab returned to normal levels after administration of high-dose intravenous methylprednisolone (p<0.05). In 96 patients (NMO, n = 19; TM, n = 25; MS, n = 52) without treatment, serum levels of TSH, TG-Ab and TPO-Ab were significantly different between patients with and without myelitis (p<0.01). Patients positive for aquaporin-4 (AQP4) antibodies showed higher abnormalities of TSH (p = 0.001), TG-Ab (p = 0.004) and TPO-Ab (p<0.0001) levels than AQP4 antibodies negative patients. Logistic regression analyses revealed independent relationships between TSH (odds ratio [OR]  = 33.994; p<0.0001), TG-Ab (OR = 7.703; p = 0.017) and myelitis occurrence in 96 patients at the active stage. In 52 MS patients experiencing their first attack, MS patients with myelitis were associated with TSH abnormalities (OR = 42.778; p<0.0001). This study showed increased abnormalities of thyroid parameters in patients with NMO and TM than in MS patients. MS patients with myelitis also had greater TSH abnormality than in MS patients without myelitis. Abnormal TSH and TG-Ab were independently associated with myelitis occurrence in central nervous system demyelinating disorders.