Adolesan Çağındaki Çocuklarda Otoimmün Tiroiditte Parvovirus B19’un Rolü

Yıl 2022, Cilt: 7 Sayı: 3, 493 - 498, 01.09.2022

Cansu Durak , Zehra Yavas Abalı , Muammer Osman Köksal , Hayati Beka , Ali Ağaçfidan , Prof. Dr. Fatma Oğuz , Firdevs Baş

https://doi.org/10.26453/otjhs.1127928

Öz

Amaç: Bu çalışmanın amacı adolesan çağındaki otoimmün tiroidit patogenezinde Parvovirus B19'un (PV-B19) tetikleyici rolünü belirlemektir.

Materyal ve Metot: Çalışmaya son 6 ayda Hashimoto tiroiditi tanısı konulan 10-18 yaş arası 35 hasta dahil edildi. Kontrol grubu olarak PV-B19 ile ilişkili akut hastalığı olmayan, fizik muayenesinde guatr olmayan, ailede tiroid hastalığı öyküsü olmayan ve tiroid fonksiyon testleri normal olan 35 sağlıklı gönüllü alındı. Katılımcılardan alınan serum örnekleri PV-B19 IgM ve IgG antikorları ve PV-B19 DNA için test edildi. İstatistiksel analiz SPSS programı kullanılarak yapıldı.

Bulgular: Dört (%11,4) hasta ve 5 (%14,3) kontrolde PV-B19 IgM antikorları pozitif iken, 13 (%37,1) hasta ve 6 (%17,1) kontrolde PV-B19 IgG antikorları mevcuttu. PV-B19 DNA'sı hastaların %11,4'ünde (n:4) ve kontrollerin %14,3'ünde (n:5) saptandı. Antikor ve polimeraz zincir reksiyonu pozitifliği açısından hasta ve kontrol grupları arasında anlamlı fark yoktu. Lojistik regresyon analizinde PV-B19 IgG pozitifliği üzerine serbest tiroksin düzeyi (p:0,021), antitiroid peroksidaz antikor düzeyi (p:0,005) ve istmus kalınlığı (p:0,021) etkili bulundu.

Sonuç: Geçirilmiş PV-B19 enfeksiyonları, Hashimoto tiroiditi patogenezinde tetikleyicilerden biri olabilir.

Anahtar Kelimeler

adolesan, Hashimoto hastalığı, otoimmün hastalık, parvovirus B19

The Role of Parvovirus-B19 in Autoimmune Thyroiditis in Adolescent Children

Öz

Objective: This study aims to determine the triggering role of parvovirus B19 (PV-B19) in the pathogenesis of autoimmune thyroiditis in adolescence.

Materials and Methods: Thirty-five patients aged 10-18 years who were diagnosed with Hashimoto's thyroiditis in the last 6 months were included in the study. As the control group, 35 healthy volunteers without PV-B19 associated acute disease, no goiter in physical examination, no family history of thyroid disease, and normal thyroid function tests were recruited. Serum samples were tested for PV-B19 IgM and IgG antibodies and PV-B19 DNA. Statistical analysis was performed using the SPSS.

Results: PV-B19 IgM antibodies were positive in 4 (11.4%) patients and 5 (14.3%) controls whereas PV-B19 IgG antibodies were present in 13 (37.1%) patients and 6 (17.1%) controls. PV-B19 DNA was detectable in 11.4% of patients (n:4) and 14.3% of controls (n:5). There was no significant difference between the patient and control groups in terms of antibody and polymerase chain reaction positivity. In logistic regression analysis, free thyroxine level (p:0.021), anti-thyroid peroxidase antibody level (p:0.005), and isthmus thickness (p:0.021) were found to be effective on PV-B19 IgG positivity.

Conclusion: Previous PV-B19 infections may be one of the triggers in the pathogenesis of Hashimoto’s thyroiditis. 

Anahtar Kelimeler

adolescent, autoimmune diseases, Hashimoto disease, parvovirus B19

Kaynakça

• Mori K, Yoshida K, Ishii K, et al. Experimental autoimmune thyroiditis in human parvovirus B19 transgenic mice. Autoimmunity. 2011;44(6):483-489. doi:10.3109/08916934.2010.547891
• LaFranchi S. Thyroiditis. In: Kliegman RM, Stanton BF, St.Geme III JW, Behrman RE, Schor NF, ed. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, USA:WB Saunders; 2015:1903-1905.
• Zdraveska N, Kocova M. Hashimoto thyroiditis in childhood – review of the epidemiology, genetic susceptibility and clinical aspects of the disease. Maced J Med Sci. 2012;5(3):336-345. doi:10.3889/MJMS.1857-5773.2012.0247
• Cappa M, Bizzarri C, Crea F. Autoimmune thyroid diseases in children. J Thyroid Res. 2010;2011:675703. doi:10.4061/2011/675703
• Heegaard ED, Brown KE. Human parvovirus B19. Clin Microbiol Rev. 2002;15(3):485-505. doi:10.1128/CMR.15.3.485-505.2002
• Koch WC. Parvovirus B19. In: Kliegman RM, Stanton BF, St.Geme III JW, Behrman RE, Schor NF, ed. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, USA: WB Saunders; 2015:1094-1097.
• Broliden K, Tolfvenstam T, Norbeck O. Clinical aspects of parvovirus B19 infection. J Intern Med. 2006;260(4):285-304. doi:10.1111/j.1365-2796.2006.01697.x
• Lunardi C, Tinazzi E, Bason C, Dolcino M, Corrocher R, Pucetti A. Human parvovirus B19 infection and autoimmunity. Autoimmun Rev. 2008;8(2):116-120. doi:10.1016/j.autrev.2008.07.005
• Vejlgaard TB, Nielsen OB. Subacute thyroiditis in Parvovirus B19 infection. Ugeskr Laeger. 1994;156(41):6039-6040
• Krassas GE, Tziomalos K, Pontikides N, Lewy H, Laron Z. Seasonality of month of birth of patients with Graves' and Hashimoto's diseases differ from that in the general population. Eur J Endocrinol. 2007;156(6):631-636. doi:10.1530/EJE-07-0015
• Desailloud R, Hober D. Viruses and thyroiditis: An update. Virol J. 2009;6:5. doi:10.1186/1743-422X-6-5
• Seishima M, Shibuya Y, Suzuki S. Hyperthyroidism associated with human parvovirus B19 infection. Clin Exp Dermatol. 2009;34(7):e439-e440. doi:10.1111/j.1365-2230.2009.03470.x
• Mori K, Munakata Y, Saito T, et al. Intrathyroidal persistence of human parvovirus B19 DNA in a patient with Hashimoto's thyroiditis. J Infect. 2007;55(2):e29-e31. doi:10.1016/j.jinf.2007.05.173
• Lehmann HW, Lutterbüse N, Plentz A, et al. Association of parvovirus B19 infection and Hashimoto's thyroiditis in children. Viral Immunol. 2008;21(3):379-383. doi:10.1089/vim.2008.0001
• Heidari Z, Jami M. Parvovirus B19 infection is associated with autoimmune thyroid disease in adults. Int J Endocrinol Metab. 2021;19(4):e115592. doi:10.5812/ijem.115592
• Wang J, Zhang W, Liu H, et al. Parvovirus B19 infection associated with Hashimoto's thyroiditis in adults. J Infect. 2010;60(5):360-370. doi:10.1016/j.jinf.2010.02.006
• Gravelsina S, Nora-Krukle Z, Svirskis S, Cunskis E, Murovska M. Presence of B19V in patients with thyroid gland disorders. Medicina (Kaunas). 2019;55(12):774. doi:10.3390/medicina55120774
• Tozzoli R, Barzilai O, Ram M, et al. Infections and autoimmune thyroid diseases: parallel detection of antibodies against pathogens with proteomic technology. Autoimmun Rev. 2008;8(2):112-115. doi:10.1016/j.autrev.2008.07.013