In several studies, the state of the endothelial function is analyzed in clinical thyrotoxicosis. Increased level of von Willebrand factor is detected. Many events of association of trombosis at these patients with high level of VWF are described. An association between autoimmune thyroid disease and pulmonary arterial hypertension (PAH) has been reported too. We have studied factors which influence on level of VWF at patients with a clinical thyrotoxicosis of a various genesis. The present study includes 74 normotensive patients with a thyrotoxicosis of Graves disease (GD) and 15 patients with a thyrotoxicosis of not immune genesis (TNIG) (toxic nodular goitre) without any CVD. The level of von Willebrand factor was mesured by the immunoturbidimetric method (the normal range 50160%). The patients were examined echocardiography by standard method. The mean level of VWF had been increased (181.6±13.57%) before the therapy. The mean level of VWF has been increased (192.95±13.74%) in group of patients with GD in comparison with group TNIG (120.5±11.29%) (P<0.01). Correlation analysis detects the relationship between VWF and a level of thyroid hormones: fT3 (r=0.38, P<0.01), fT4 (r=0.27, P<0.05) and an antibody to TSH (r=0.26, P<0.05) and an antibody to TPO (r=0.32, P<0.01). From EchoCG parameters the moderate correlation with pressure in pulmonal artery (PPA) (r=0.27, P<0.05) is noted and very strong relationship is detected between level of VWF and PPA at the dynamic control over year (r=0.86, P<0.001). After treatment level of VWF has been decreased (97.8±6.85%) in comparison with first examination (P<0.01). These results demonstrated, firstly, that rising of a level of a VWF is associated with an autoimmune genesis of a thyrotoxicosis, secondly, that these changes can be a predictor/marker of a PAH. Immune system dysfunction may underlie this association.
03 - 07 May 2008
European Society of Endocrinology