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Endocrine Abstracts (2015) 37 EP1045 | DOI: 10.1530/endoabs.37.EP1045

1Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece; 2Department of Gastroenterology, Athens, Greece.


Introduction: Inflammatory bowel disease (IBD) has been associated with various disorders of thyroid function. Many of these patients are now treated with biological agents targeting on TNF-a.

Aim: To investigate thyroid function in patients with IBD and the potential effect of anti-TNF therapy.

Patients and methods: We studied 41 patients with IBD (25M/16F, 36.4±11 years), without any known thyroid disorder. Eighteen patients (9M/9F, 33.6±8.8 years) were on anti-TNF therapy for more than 1 year, while 23 patients (16M/7F, 38.7±12.5 years) were treated with azathioprine and mesalazine (Aza/Mes). Nine patients from the second group were then treated with anti-TNF and studied again 6 months later. We assessed thyroid function by measuring T3, FT4, TSH, anti-TG, and anti-TPO levels.

Results: One patient presented with clinical and one with subclinical hyperthyroidism. Thyroid auto-antibodies were positive in 12.2% (one anti-TG and four anti-TPO). Patients from the anti-TNF group had reduced levels of FT4 (1.09±0.15 ng/dl vs 1.38±0.9 ng/dl, P=0.042), with no differences in T3 levels (1.8±0.28 nmol/l vs 2.02±1.7 nmol/l) and TSH (1.76±0.8 mIU/ml vs 1.58±0.9 mIU/ml, P>0.05). The percentage of patients with positive thyroid auto-antibodies were lower in the anti-TNF group, 5.6% (1/18) vs 17.4% (4/23), but without statistical significance (P>0.05). In patients who were treated for 6 months with anti-TNF, we found statistically significant reduction in FT4 (1.24±0.26 ng/dl vs 1.11±0.16 ng/dl, P=0.048), without changes in T3 (1.5±0.43 nmol/l vs 1.8±0.2 nmol/l) and TSH (1.82±1.28 mIU/ml vs 1.68±0.96 mIU/ml), in all comparisons P>0.05. There was no change regarding thyroid auto-antibodies.

Conclusions: Patients with IBD showed high percentage of thyroid autoimmunity, while the functional thyroid disorders presented were clinical and subclinical hyperthyroidism. Treatment with anti-TNF resulted in reduced levels of FT4, without changes in T3, TSH, and thyroid auto-antibodies.

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