Serum concentrations of anti-thyroid peroxidase and anti-thyroglobulin antibodies in children and adolescents without apparent thyroid disorders

https://doi.org/10.1016/j.clinbiochem.2013.09.017Get rights and content

Highlights

  • TPOAb and TGAb levels of thyroid-healthy children are age- and gender-dependent.

  • Infants showed increased TPOAb- and TGAb-values during the first year of life.

  • A significant increase in TPOAb and TGAb was shown in healthy girls during puberty.

Abstract

Objective

The age-dependent prevalence and clinical relevance of anti-thyroid peroxidase (TPOAb) and anti-thyroglobulin (TGAb) antibodies in children and adolescents without thyroid diseases are unknown. The aim of this study was to measure the concentration of these thyroid autoantibodies in a large cohort of hospitalized and out-patient subjects. Additionally, we investigated the correlation of TPOAb and TGAb with thyroid parameters as well as with putative confounding parameters such as standard deviation scores (SDS) of height, BMI–SDS and CRP.

Methods

Serum samples from 841 patients with non-thyroid related diseases between 1 day post partum and 20 years of age were used in a cross-sectional study. TPOAb, TGAb, thyroid parameters (TSH, fT3, fT4 and thyroglobulin) and CRP were measured by the Modular System (Roche, Mannheim).

Results

The values of TPOAb and TGAb showed an age-dependent maximum of antibody frequency for both genders during the first year of life with concentrations of 163 IU/mL and 161 IU/mL in the 95th percentile. In girls, a second maximum was observed during puberty with concentrations of 82 IU/mL TPOAb and 582 IU/mL TGAb in the 95th percentile. Both antibodies correlated significantly (p < 0.05) with each other, with fT3, fT4, BMI–SDS (only TPOAb) and CRP and TSH (only TGAb).

Conclusion

The prevalence of TPOAb and TGAb was shown to be age-dependent with increased values in the first year of life and during puberty. The increased “physiological” concentrations of TPOAb and TGAb have to be considered when used as diagnostic indicators of autoimmune thyroid disease in a paediatric population.

Introduction

Antibodies to antigenic components of the thyroid gland, such as thyroid peroxidase (TPO) and thyroglobulin (TG) are known to be the hallmark of autoimmune thyroid disease [1]. Moreover, both autoantibodies were found to be diagnostic indicators for thyroid diseases, e.g. Hashimoto's thyroiditis, postpartum thyroiditis and Graves' Disease [2], [3]. For the laboratory diagnostic of thyroid diseases and its interpretation, the knowledge of the overall prevalence of TPOAb and TGAb in peripheral blood of healthy subjects and its prognostic value is mandatory. While the diagnostic relevance of thyroid autoantibodies in adults is rather frequently discussed [4], their role in children and adolescents remains widely unclear [5]. However, there is no generally acknowledged way of obtaining and interpreting data of thyroid autoantibodies from young patients. Guidelines for establishing reference intervals for TPOAb and TGAb were established for adults only [5]. Data for the prevalence of thyroid antibodies in children and adolescents are scarce and studies mainly include small numbers of subjects [6]. Therefore, specific reference intervals for children have not been published so far. This study aims to investigate the prevalence of TPOAb and TGAb in children and adolescents without known thyroid disease in dependence on age and gender. In a following step it was investigated whether anthropometric and thyroid function associated serum parameters were correlated with the concentrations of both antibodies.

Section snippets

Study participants

Blood samples of 841 newborns, infants, children and adolescents (396 girls, 445 boys) of Caucasian origin were measured. Age ranged from birth (cord blood) up to 20 years. Detailed information about the study group has been published recently [7]. The samples were obtained from three groups of subjects:

  • 1)

    521 children and adolescents from the Department of Otorhinolaryngology of the Leipzig University Hospital, admitted for minor surgical interventions.

  • 2)

    193 patients from the Paediatric Clinic of

Results

Serum samples of 841 children and adolescents were investigated. An overview about age, gender and thyroid hormones is given in Table 1.

Discussion

This cross-sectional study reveals age- and gender-dependent variation of TPOAb and TGAb values in infants, children and adolescents with apparently normal thyroid function. In detail: we observed that infants demonstrated increased antibody values up to 1 year of age. Whether the postpartal increase in antibody values is due to remaining maternal antibodies after transplacental transmission or by de novo immunoinduction remains unclear. Considering the half life of IgG with 21 days [9], the

Acknowledgements

The authors thank Gerold Schubert and Renate Förster for their excellent work on obtaining and evaluating the thyroid function of this study group. We also thank Silke Zachariae for her help considering statistical analyses of our data. Thanks are also due to all researchers, who so generously shared their findings, namely Klaus Zöphel.

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