Diseases of the thyroid gland during pregnancy. What's new.

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Indications for the analysis of antibodies to thyroid peroxidase

A test for antibodies to the thyroid gland is prescribed as part of a comprehensive examination of patients with:

• signs of hyperthyroidism: increased nervousness, weight loss with good appetite, rapid heart rate, arrhythmia, protruding eyeballs, trembling hands, heat intolerance, shortness of breath with light exertion;
• symptoms of hypothyroidism: swelling of the face, eyelids, lethargy, drowsiness, apathy, hair loss, chilliness, weight gain with decreased appetite;
• spontaneous abortion, preeclampsia, unsuccessful IVF attempts;
• an established diagnosis of autoimmune thyroid disease to monitor the effectiveness and duration of treatment;
• an established diagnosis of other autoimmune diseases (for example, systemic lupus erythematosus, pernicious anemia, systemic autoimmune vasculitis, type 1 diabetes mellitus or rheumatoid arthritis) when signs of thyroid dysfunction appear;
• symptoms of disruption of the normal functioning of the thyroid gland and/or detected changes in test results for T3, T4, thyroid-stimulating hormone of the pituitary gland;
• the need to prescribe drugs that affect the functioning of the thyroid gland (for example, lithium, amiodarone, interferon alpha);
• family predisposition to autoimmune thyroid diseases;
• as a preventive measure in the first trimester of pregnancy to identify the risk of thyroid dysfunction during pregnancy and the development of postpartum thyroiditis.

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Antibodies to thyroid peroxidase are specific immunoglobulins directed against the enzyme contained in the cells of the thyroid gland and responsible for the formation of the active form of iodine for the synthesis of thyroid hormones. They are a specific marker of autoimmune thyroid diseases.

Synonyms Russian

Antibodies to thyroid peroxidase, microsomal antibodies, antibodies to microsomal antigen, ATTPO, ATPO.

English synonyms

Anti-thyroid Peroxidase Autoantibodies, Antimicrosomal Antibodies, Antithyroid Microsomal Antibodies, Thyroid Peroxidase Autoantibodies, TPO Antibodies, Thyroid Peroxidase Test, Thyroid microsomal antibody, Thyroperoxidase antibody, TPOAb, Anti-TPO.

Research method

Chemiluminescent immunoassay.

Determination range: 5.00 - 600.00 IU/ml.

Units

IU/ml (international unit of milliliter).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for research?

Do not smoke for 30 minutes before the test.

General information about the study

This test is designed to determine specific antibodies to thyroid tissue in the blood serum - anti-TPO. They are formed when the human immune system mistakenly recognizes thyroid tissue as a foreign biological substance, which can lead to thyroiditis, damage to the thyroid tissue and various disorders of its function.

The thyroid gland synthesizes a number of vital hormones: thyroxine (T4) and triiodothyronine (T3), which are of great importance in the regulation of metabolism. In turn, the functioning of the thyroid gland is regulated by the pituitary thyroid-stimulating hormone (TSH), which ensures adequate production of thyroid hormones depending on the needs of the body. The damaging effect of antibodies on various biochemical structures can lead to disruption of the normal production of thyroid hormones and negatively affect the regulation of its function, which ultimately causes chronic pathologies associated with hypo- or hyperthyroidism. Hypothyroidism manifests itself in the form of symptoms such as weight gain, goiter, dry skin, hair loss, constipation, and increased sensitivity to cold. Hyperthyroidism is accompanied by sweating, rapid heartbeat, anxiety, tremors in the limbs, weakness, sleep disturbances, weight loss, and exophthalmos.

The thyroid enzyme thyroid peroxidase plays a key role in the formation of thyroid hormones. Thyroid peroxidase is involved in the formation of the active form of iodine, without which the biochemical synthesis of thyroid hormones T4 and T3 is impossible. The appearance of antibodies to this enzyme in the blood disrupts its normal function, resulting in a decrease in the production of the corresponding hormones.

Quantitative serum analysis for antibodies to thyroid peroxidase is the most sensitive method for diagnosing autoimmune thyroid diseases. Deviation from the norm of its results is an early sign of Hashimoto’s thyroiditis and diffuse toxic goiter (Graves’ disease). Modern highly sensitive methods for detecting antibodies to thyroid peroxidase make it possible to correctly diagnose 95% of patients with Hashimoto's thyroiditis and 85% of patients with diffuse toxic goiter. During pregnancy, anti-TPO can significantly affect the development of the thyroid gland and the health of the unborn child, since they are able to penetrate the placental barrier from the mother's blood into the fetus. Anti-TPO levels are often elevated in other thyroid diseases, such as idiopathic hypothyroidism, adenoma and cancer, and in all types of autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, insulin-dependent diabetes mellitus, autoimmune adrenal insufficiency and pernicious anemia, which In a number of cases, this indicates the involvement of the thyroid gland in this pathological process. Therapy with certain medications (amiodarone, lithium, interferon) can also cause the appearance of antibodies to thyroid peroxidase and, as a result, hypothyroidism.

What is the research used for?

• First of all, to identify various autoimmune diseases of the thyroid gland: Hashimoto's thyroiditis,
• diffuse toxic goiter,
• postpartum thyroiditis,
• autoimmune thyroiditis,
• hyperthyroidism or hypothyroidism in newborns.

When is the study scheduled?

• For symptoms of disruption of the normal functioning of the thyroid gland.
• When the results of other tests indicate any dysfunction of the thyroid gland.
• When long-term monitoring of the health of a patient with thyroid disease is required, which includes conducting laboratory tests at certain intervals to monitor the effectiveness of treatment.
• If the possibility of prescribing therapy associated with the risk of developing hypothyroidism as a result of the appearance of anti-TPO (lithium drugs, amiodarone, interferon alpha, interleukin-2) is being considered.
• If it is necessary to find out the causes of miscarriage, preeclampsia, premature birth, unsuccessful attempts at artificial insemination - this may be due to the influence of specific antibodies.
• If other test results (T3, T4 and/or TSH) indicate thyroid dysfunction.
• For an autoimmune disease that initially did not affect thyroid function (rheumatoid arthritis, systemic lupus erythematosus, pernicious anemia, systemic autoimmune vasculitis, insulin-dependent diabetes mellitus), if symptoms appear that the thyroid gland is involved in this process.
• If the patient is at high risk for autoimmune thyroiditis (such as pregnant women with a history of this disease in their family).

What do the results mean?

Reference values: 0 - 34 IU/ml.

Reasons for increasing anti-TPO levels

In general, the detection of anti-TPO in blood serum indicates autoimmune aggression against the thyroid gland, and the more the test results deviate from the norm, the higher the likelihood of this type of pathology.

• A slight or moderate increase in thyroid peroxidase levels can be caused by many thyroid diseases and autoimmune disorders: rheumatoid arthritis, systemic lupus erythematosus, insulin-dependent diabetes mellitus, thyroid cancer, systemic autoimmune vasculitis, etc.
• A significant deviation of the results from the norm most often indicates an autoimmune disease of the thyroid gland, for example Hashimoto's thyroiditis, diffuse toxic goiter.
• Positive test results during pregnancy indicate the possibility of hyperthyroidism in the child (during intrauterine development or after birth).
• If the test for antibodies to thyroid peroxidase is used for long-term monitoring of the progress of treatment, and the level of antibodies either remains high throughout the entire observation period, or decreases at the beginning of therapy, and then increases again after a certain period of time, this indicates insufficient effectiveness of the treatment. therapy, as well as that the disease continues or is exacerbating.
• Sometimes the level of anti-TPO is elevated in practically healthy people, more often in women, and this probability increases with age. Most of them are never bothered by thyroid disease, but in any case, the patient’s health condition is monitored for some time.

Reasons for decreased anti-TPO levels

A decrease in the concentration of anti-TPO to low or even more undetectable values ​​indicates that the treatment is successful.

What can influence the result?

• A large amount of fat in the blood serum.

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General information about the thyroid gland, hormones and TPO

The thyroid gland synthesizes vital hormones that regulate metabolic processes throughout the body. Its enzyme thyroid peroxidase plays a dominant role in this process. The negative impact of antigens leads to impaired productivity, negatively affects the condition of the gland and leads to chronic pathologies. Deviations from normal functioning can lead to excess production of hormones - hyperthyroidism, or deficiency - hypothyroidism.

The presence of antibodies in the blood of pregnant women is especially dangerous. Anti-TPO negatively affects not only the mother's health. They are able to pass through the placenta and enter the fetus. Long-term exposure to antibodies can affect the formation of the thyroid gland of the unborn baby.

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Characteristic indicators of the presence of excess hormone levels

If the amount of antibodies to thyroid peroxidase is in excess, the development of a disease such as hypothyroidism is possible. Hypothyroidism is a condition where the concentration of thyroid hormones decreases. This pathology often manifests itself together with the inflammatory process of the thyroid gland and diffuse toxic goiter. Thyroid hormones actively take part in the process of development and growth of the body, therefore, their insufficient or excessive production can provoke the development of various negative consequences.

It is very difficult to diagnose thyroid diseases at an early stage, since they do not have obvious symptoms. At the initial stage, an elevated ATPO level may be characterized by the following symptoms:

• swelling of the legs;
• development of hypotension;
• slight decrease in body temperature;
• dry skin;
• causeless feeling of anxiety;
• hair loss;
• apathy.

There may also be malfunctions in the reproductive, cardiovascular, nervous, digestive and musculoskeletal systems. The size of the thyroid gland increases in order to provide the maximum dosage of hormones required by the body.

An enlarged thyroid gland can cause discomfort in the form of difficulty swallowing, hoarseness when speaking, and pain.

An increase in antibodies may indicate the presence of Graves' disease, thyroid cancer, thyroiditis, hypothyroidism, diffuse toxic goiter. If it is not changed, other indirect factors can also cause a disruption in the process of antibody production: glomerulonephritis, anemia, rheumatoid arthritis, insulin-dependent diabetes, autoimmune gastritis, insufficient amounts of hormones produced by the adrenal glands, scleroderma.

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If a woman has antibodies to thyroid peroxidase during pregnancy, a blood test is required for the child.