Endocrine Abstracts

Background: thyroid function (TSH levels) and thyroid autoimmunity are involved in the immunomodulation of early pregnancy stages and can affect assisted reproductive technology (ART).Aims: 1) to evaluate if pre-conceptional TSH is associated with an increased risk of miscarriage, 2) to identify a TSH cut-off significantly associated with risk of miscarriage, 3) to assess the impact of TSH levels on primary and surrogate outcomes.M...

TSH is involved in the immunomodulation of early pregnancy stages. Thyroid guidelines have indicated 2.5 mU/l as the best TSH level below which women undergoing assisted reproductive technology (ART) need to be maintained, though this treshold is still controversial. Aims of the present study were to evaluate if pre-conceptional TSH is associated with an increased risk of miscarriage, to identify a TSH cut-off significantly associated with risk of miscarriage and to assess the...

The anti-CD 20 antibody rituximab (RTX) has been employed in the treatment of several autoimmune diseases and its effect may not involve autoantibody secretion. Preliminary studies have shown that RTX induced improvement of active Graves’ orbitopathy (GO) but caused no change of serum anti-thyroid antibodies in relation to peripheral CD 20+ cells depletion, usually observed at the second week after therapy. A 50-year-old woman with GO predominantly active in the left eye ...

A seasonal occurrence of Graves’ disease (GD) has been reported in previous studies, with a peak of frequency in the warmer half of the year (Ford 1988, 1991, Westphal 1994) or the period of the year with a higher iodine intake (Phillips 1985); other studies (Facciani 2000) have failed to find a different seasonal occurrence of Graves’ orbitopathy (GO). Aim of the present study was to evaluate a possible seasonal difference in the onset of GD and GO in a series of ou...

Aim: The aim of this retrospective study was to assess the efficacy of different doses of rituximab (RTX) in patients with active moderate-severe Graves’ Orbitopathy (GO).Methods: Overall 40 patients, 5 M/35 F; mean age (± S.D.) 58±11 years were treated with RTX; 21 were smokers. The patients received the following treatment: 14 patients (group 1) a single 100 mg dose; 15 patients (group 2) a single 500 mg dose and 11 Patien...

Previous studies have shown that Rituximab (RTX) is effective as a disease modifying drug at doses of 500 mg or 1000×2 mg in active Graves’ orbitopathy (GO). We have conducted a pilot study (EUDRACT 2012-001980-53) in which patients with active moderate-severe GO were treated with a single infusion of low dose RTX (100 mg). Ten patients were enrolled of whom seven completed the study at 52 weeks. Five patients did not respond to a previous treatment with i.v. methylp...

We described a significant clinical response to RTX treatment in patients with active TAO. In order to understand the possible mechanisms of action of RTX, we measured serum concentrations of IL-6 and its soluble receptor (sIL-6R). We treated 10 patients with RTX: 8 women, 2 men aged 31–51 yr with Graves’ disease. We also treated 14 patients with i.v. steroids (IVGC). All had active TAO. In all patients we studied thyroid function, serum autoantibodies and peripheral...

Background: Changes of the gut microbiota may impact on the mechanisms of immune tolerance in Graves’ disease (GD) and Graves’ orbitopathy (GO). Probiotics, which contain live micro-organisms, can modify the composition of the gut microbiota.Aims: We tested in a double-blind randomized placebo controlled trial whether the administration of a well-characterized, commercially available, probiotic would 1) modify the microbiota composition in GD/G...

As known, an imbalance of the gut microbiota is associated with a higher risk for autoimmune diseases. Moreover the increased rates of autoimmunity reported in urban residential areas worldwide suggest a possible influence of diet. We report on the antibody response to food antigens in GD patients. Since 10% of celiac patients develop an autoimmune thyreopathy we focused on gliadin (DGP), transglutaminases (tTG) and 40 other food antigens (FA). Commercially available ELISA ass...

It is known that high levels of TSH are associated with higher miscarriage risk, though the precise TSH cut-offs are debated. Aim of the present study was to evaluate if pre-conceptional TSH levels associate with increased risk of early miscarriage in a large series of infertile women submitted to IVF and to determine the threshold of TSH associated with the highest prevalence of pregnancy loss. We retrospectively studied 1484 infertile women (mean±age 36.7±4.1 years...