Thyroid Function and Low Free Triiodothyronine in Chinese Patients With Autoimmune Encephalitis.


Journal

Frontiers in immunology
ISSN: 1664-3224
Titre abrégé: Front Immunol
Pays: Switzerland
ID NLM: 101560960

Informations de publication

Date de publication:
2022
Historique:
received: 24 11 2021
accepted: 24 01 2022
entrez: 28 2 2022
pubmed: 1 3 2022
medline: 9 4 2022
Statut: epublish

Résumé

Low free triiodothyronine (FT3) is usually associated with worse functional outcome in critical illness; however, the information on thyroid dysfunction and autoimmune encephalitis (AE) is limited. This study aims to evaluate the clinical prognostic value of thyroid function and low-T3 syndrome in patients with multiple subtypes of AE. In this retrospective study, we identified the hospital records of 319 candidate patients with AE admitted between January 2016 and December 2020. We then extracted the clinical features and outcomes. Modified Rankin scale (mRS) scores were used to evaluate the patients' neurological function. The serum levels of FT3, free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were measured upon admission. Normal thyroid stimulating hormone level with FT3 below the lower limit of the reference interval (2.63 nmol/L) was defined as low-T3 syndrome. A total of 237 AE cases remained after screening. Among these, 57.81% (137/237) were men and the average age at onset was 41 y (interquartile range, 12-61 y). We found that 83.54% (198/237) of the patients had a good prognosis, and 16.46% (39/237) had a poor prognosis. Abnormal thyroid function was observed in 30.80% of these patients, with a relatively greater prevalence in the group with a poor prognosis ( Abnormal thyroid function in AE is frequent, and serum FT3 levels in patients with poor prognosis are significantly lower than in those with good prognosis. Low-T3 syndrome could be a potential candidate for predicting the prognosis of AE following future research.

Sections du résumé

Background and Objectives
Low free triiodothyronine (FT3) is usually associated with worse functional outcome in critical illness; however, the information on thyroid dysfunction and autoimmune encephalitis (AE) is limited. This study aims to evaluate the clinical prognostic value of thyroid function and low-T3 syndrome in patients with multiple subtypes of AE.
Methods
In this retrospective study, we identified the hospital records of 319 candidate patients with AE admitted between January 2016 and December 2020. We then extracted the clinical features and outcomes. Modified Rankin scale (mRS) scores were used to evaluate the patients' neurological function. The serum levels of FT3, free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were measured upon admission. Normal thyroid stimulating hormone level with FT3 below the lower limit of the reference interval (2.63 nmol/L) was defined as low-T3 syndrome.
Results
A total of 237 AE cases remained after screening. Among these, 57.81% (137/237) were men and the average age at onset was 41 y (interquartile range, 12-61 y). We found that 83.54% (198/237) of the patients had a good prognosis, and 16.46% (39/237) had a poor prognosis. Abnormal thyroid function was observed in 30.80% of these patients, with a relatively greater prevalence in the group with a poor prognosis (
Conclusions
Abnormal thyroid function in AE is frequent, and serum FT3 levels in patients with poor prognosis are significantly lower than in those with good prognosis. Low-T3 syndrome could be a potential candidate for predicting the prognosis of AE following future research.

Identifiants

pubmed: 35222399
doi: 10.3389/fimmu.2022.821746
pmc: PMC8866758
doi:

Substances chimiques

Triiodothyronine 06LU7C9H1V
Thyroxine Q51BO43MG4

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

821746

Informations de copyright

Copyright © 2022 Qiao, Zhang, Zhang, Wang, Wang, Jiang, Wang and Liu.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Shan Qiao (S)

Department of Neurology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China.
Department of Medical Genetics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China.

Shan-Chao Zhang (SC)

Department of Neurology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China.
Medical Research and Laboratory Diagnostic Center, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.

Ran-Ran Zhang (RR)

Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Lei Wang (L)

Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Zhi-Hao Wang (ZH)

Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Jing Jiang (J)

Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Ai-Hua Wang (AH)

Department of Neurology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China.

Xue-Wu Liu (XW)

Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Institute of Epilepsy, Shandong University, Jinan, China.

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