Anti-thyroid antibodies and thyroid function in neuromyelitis optica spectrum disorders

[helvella]

This morning I received an alert from PubMed where I have a permanent search set up. The paper that caught my eye was the one just below (abstract only, I’m afraid).

Neuromyelitis optica (NMO), also known as Devic's disease or Devic's syndrome, seems to have an association with thyroid disease, especially Thyroid Peroxidase antibodies and Thyroglobulin antibodies.

Whilst NMO is clearly a very severe disease, there were too many references to symptoms I have seen reported here. Wiki mentions:

The main symptoms of Devic's disease are loss of vision and spinal cord function. Optic neuritis may manifest as visual impairment with decreased visual acuity, although visual field defects, or loss of color vision may occur in isolation or prior to formal loss of acuity. Spinal cord dysfunction can lead to muscle weakness, reduced sensation, or loss of bladder and bowel control. The typical patient has an acute and severe spastic weakness of the legs (paraparesis) or all four limbs (quadriparesis) with sensory signs, often accompanied by loss of bladder control.

en.wikipedia.org/wiki/Neuro...

Not for one minute am I suggesting that everyone here has NMO. It would be a surprise if anyone has it. But the simple existence of the apparent link seems, to me, to be of interest.

Both thyroid disorders and B12 deficiency/pernicious anaemia have also been referred to quite a few times in the research on NMO.

And a few more random links:

nmouk.nhs.uk/

ninds.nih.gov/disorders/neu...

guthyjacksonfoundation.org/...

orpha.net/consor/cgi-bin/OC...

J Neurol Sci. 2016 Jul 15;366:3-7. doi: 10.1016/j.jns.2016.04.039. Epub 2016 Apr 21.

Anti-thyroid antibodies and thyroid function in neuromyelitis optica spectrum disorders.

Wang X1, Yi H2, Liu J3, Li M4, Mao ZF5, Xu L6, Peng FH7.

Author information

• 1Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province 510630, China. Electronic address: [e-mail].

• 2Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province 510630, China. Electronic address: [e-mail].

• 3Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province 510630, China. Electronic address: [e-mail].

• 4Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province 510630, China. Electronic address: [e-mail].

• 5Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province 510630, China. Electronic address: [e-mail].

• 6Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province 510630, China. Electronic address: [e-mail].

• 7Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province 510630, China. Electronic address: [e-mail].

Abstract

BACKGROUND:

Neuromyelitis optica spectrum disorders (NMOSD) are complicated neuroautoimmune disorders which can coexist with other organ-specific autoimmune disorders. The most frequently specific organ is the thyroid. The aim of this study is to evaluate the thyroid function of NMOSD patients and detect the difference between anti-thyroid antibodies (ATAbs) seropositive and seronegative NMOSD patients.

METHODS:

88 patients diagnosed with NMOSD were enrolled and their thyroid functions were evaluated. They were divided into two groups by ATAbs abnormalities. In addition, demographic characteristics, clinical symptoms and MRI scan results of brain and spinal cord were assessed.

RESULTS:

Anti-thyroid peroxidase antibodies (TPOAbs) and anti-thyroglobulin antibodies (TGAbs) seropositivities were detected more frequently in patients with NMOSDs when compared with healthy controls (37.5% vs 14.9%, P=0.01, Diff22.6%, 95CI[9.0%, 34.9%]; 31.8% vs 16.2%, P=0.022, Diff15.6%, 95CI[2.27%, 27.9%]). In NMOSD patients, the Expanded disability status scale score (EDSS) score was significantly higher in ATAbs seropositive group than that in ATAbs seronegative group (median 6.5 vs 3.75, P=0.012). However, there is no significant difference for demographic characteristics and other clinical symptoms. Moreover, NMOSD patients with ATAbs abnormalities had more brain and cervical cord lesions when compared with ATAbs negative NMOSD patients (83.8% vs 61.4%, P=0.029, Diff22.4%, 95CI[0.9%, 40.9%]; 93.9% vs 59.6%, P=0.001, Diff34.3%, 95CI[13.6%, 50.4%]).

CONCLUSIONS:

NMOSD patients have a higher frequency of ATAbs abnormalities. ATAbs may be associated with disability status, brain abnormalities and cervical cord lesions.

Copyright © 2016 Elsevier B.V. All rights reserved.

KEYWORDS:

Anti-thyroid antibodies; Expanded disability status scale (EDSS) score; Magnetic resonance imaging (MRI); Neuromyelitis optica spectrum disorder (NMOSD)

PMID: 27288767 [PubMed - in process]

A bit more information compiled from searches by me - there is lots more out there.

dl.dropboxusercontent.com/u...

[helvella Administrator Thyroid UK]

By the way, I could not find a single mention of neuromyelitis optica on this Thyroid UK forum in all the years it has been going. Either search is broken, or it really is not a link that is recognised by those here who have even heard of it.

[Marz]

Thank you for this interesting paper. Dr Datis Kharrazian covers this topic quite well and is speaking at the present Hashimotos Healing On-line summit. He was the reason I went gluten free in an attempt to reduce the TPO anti-bodies - and it has taken me 3 years Still a way to go. He wrote the book - Why Isn't My Brain Working ? - a big fat book but a good read.

I have just this minute posted that I do not know what is causing my ataxia/spinal issues - could it be the B12 - the Hashimotos - the Gluten - or more than likely a combination of all three !

healinghashimotossummit.com...

[helvella Administrator Thyroid UK in reply to Marz]

Whichever, or whatever, best of luck in identifying the cause.

[Gemmasully]

Good morning I am awaiting my diagnosis for NMO devic's disease. Is this the group/ community for it?

[helvella Administrator Thyroid UK in reply to Gemmasully]

Gemmasully,

Not really!

Obviously, all are welcome, but I don't think we have any special understanding.

I posted because people here have often been interested in what else is associated with thyroid antibodies.

I had a quick look round and found few communities with even a single mention. For example, I did this search:

healthunlocked.com/search/n...

And only a handful of forums came up.