C chronic hepatitis and thyroid gland function
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StatusThe thesis was presented on the 15 September, 2004Approved by NCAA on the 14 October, 2004 Abstract – 0.32 Mb / in romanian |
Keywords
chronic hepatitis, C viral chronic hepatitis, hyperthyroidism, hypothyroidism, euthyroidism, autoimmune thyroidism, cytolisis syndrome, cholestasis syndrome, immunoinflamatory syndrome, antiperoxidasis, antithyroglobaline antibodies, extrahepatic manifestationSummary
107 patients with viral chronic hepatitis C (VCHC) from the Republic of Moldova and 50
patients suffering from VCHC from the Yemen Republic were examined. All the patients to
comparative analysis of clinical symptoms, basic laboratory syndromes, which characterized the
liver functional state, including the immune status under different functional conditions of thyroid
gland (euthyroidism, hyperthyroidism, hypothyroidism, as well as in dependency on presence or
absence of antibodies to peroxidase and thyroglobulin) were subjected . The presence of thyroidian
dysfunction in 41-44 % of patients with VCHC was attested : hyperthyroidism – in 23-24 % and
hypothyroidism – in 18-20% of cases. Hepatomegalism, splenomegalism, sleep disturbances,
arthralgia, hemorrhagic vasculism were more frequent at patients suffering from VCHC
accompanied with thyroidian dysfunction. The dependence of cytolysis and cholestasis syndromes
expressivity upon the function of thyroid gland was more evident at patients from the Yemen
Republic, in comparison with those from the Republic of Moldova. In such a way, in the group
from Yemen, the ALAT and ASAT activity was higher in case of hyperthyroidism than in those of
euthyroidism and hypothyroidism, while alkaline phosphatase, general and indirect bilirubin were at
maximal levels during hypothyroidism. At VCHC patients from Moldova, the GGTP activity was
higher in hyperthyroidism. The increase of IgA, IgM, IgG and CIC levels was attested in both
Yemen and Moldavian patients groups, comparative with healthy people. The dependence of IgA
and IgG levels upon the functional state of thyroid gland was identified. The disturbances of cell
immunity in different groups were different. The increase of the total T lymphocytes number was
characteristic for Moldavian patients, while in the case of persons suffering from VCHC from
Yemen, especially at hyperthyroidism, this parameter was lower than in control group. The thyroid
gland function influenced the level of t-sensible T lymphocytes (maximal in hypothyroidism) at
patients from Moldova and the level of active T lymphocytes (decreased in hyperthyroidism), as
well as that of t-resistant T lymphocytes (decreased in hypothyroidism and hyperthyroidism) at
Yemen patients. The thyroglobulin antibodies (ATTG) were identified in 18% of Moldavian
patients and 16% of patients from Yemen, and the thyroperoxidase antibodies (APO) – in 40% and
16% respectively. The dependence of the expressivity of basic syndromes of liver affectation upon
the thyroperoxidasis antibodies was established. At APO+ patients from Moldova an evident
increase of ALAT, LDH, direct bilirubin, AP and IgG levels was ascertained. In the Yemen group,
in the case of APO+, the levels of total bilirubin and its fractions, IgA, IgM, IgG, and t-resistant T
lymphocytes were higher than in the group of APO- patients. In clinical practice the investigation of
thyroidian status of patients suffering from VCHC is necessary for the early diagnosis of
autoimmune disturbances of thyroid gland aiming the differential tactics while administrating the
antiviral treatment.
Oficial Reviewers
- Ion Ţîbîrnă
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova - Tatiana Raba
doctor habilitat, associate professor (docent)
Theses
