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Antithyroid Antibodies Are Implicated in Epileptogenesis of Adult Patients With Epilepsy.

Tsai MH, Fu TY, Chen NC, Shih FY, Lu YT, Cheng MY, Chuang HY, Chuang YC - Medicine (Baltimore) (2015)

Bottom Line: Antimicrosomal Abs were significantly more frequent in patients who were female, older at disease onset, older at the time of study, and had unknown seizure etiology.The presence of aCL was significantly associated with more frequent seizures.The role of antithyroid Abs in adult focal epilepsy with unknown cause, especially in females, warrants further evaluation because of the potential implications on treatment.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Neurology (M-HT, N-CC, Y-TL, Y-CC), Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Pathology and Laboratory Medicine (T-YF), Kaohsiung Veteran General Hospital, Kaohsiung, Taiwan; Shu-Zen Junior College of Medicine and Management (T-YF), Kaohsiung, Taiwan; Department of Neurosurgery (F-YS), Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Neurology (M-YC), Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Public Health (H-YC), Kaohsiung Medical University; Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital Kaohsiung, Taiwan; Center for Translational Research in Biomedical Sciences (Y-CC), Kaohsiung, Taiwan; Department of Biological Science (Y-CC), National Sun Yet-Sen University, Kaohsiung, Taiwan; and Faculty of Medicine (Y-CC), Kaohsiung Medical University, Kaohsiung, Taiwan.

ABSTRACT
Antithyroid antibodies (Abs) are associated with epilepsy in steroid-responsive encephalopathy, but have been rarely studied in unselected epilepsy patients. This study aimed to characterize the prevalence and associated factors of antithyroid Abs and other auto-Abs in adult patients with epilepsy.Epilepsy patients without autoimmune disorders were surveyed for antinuclear antibody (ANA), anti-β2 glycoprotein 1 antibody (aβ2GP1), anticardiolipin IgG Ab, antimicrosomal antibody (AMA), antithyroglobulin antibody (ATA), and thyroid function test.Of 319 patients, 75 (23.5%) were positive for at least 1 Ab. The most common Ab was anticardiolipin antibody (aCL) (30/319, 9.4%), followed by AMA (24/319, 7.5%), ANA (18/319, 5.6%), aβ2GP1 (18/319, 6.5%), and ATA (6/319, 3.25%). Antimicrosomal Abs were significantly more frequent in patients who were female, older at disease onset, older at the time of study, and had unknown seizure etiology. The presence of aCL was significantly associated with more frequent seizures. Most patients with antithyroid Ab were female and had focal seizures with unknown etiology.The association of different auto-Abs with different factors suggests that they may have different roles in adult patients with epilepsy. Recurrent seizures and certain antiepileptic medications may cause the production of aCL. The role of antithyroid Abs in adult focal epilepsy with unknown cause, especially in females, warrants further evaluation because of the potential implications on treatment.

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Related in: MedlinePlus

Prevalence of antibody in epilepsy patients. Abs = antibodies, aCL = antinuclear antibody, aβ2GP1 = anti-β2 glycoprotein 1 antibody, AMA = antimicrosomal antibody, ANA = antinuclear antibody, ATA = antithyroglobulin antibody.
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Figure 1: Prevalence of antibody in epilepsy patients. Abs = antibodies, aCL = antinuclear antibody, aβ2GP1 = anti-β2 glycoprotein 1 antibody, AMA = antimicrosomal antibody, ANA = antinuclear antibody, ATA = antithyroglobulin antibody.

Mentions: On the basis of the results of Ab positivity (Figure 1), 75 patients (23.5%) were positive for at least 1 Ab. The most common Ab was aCL in 30 (9.4%), followed by AMA in 24 (7.5%), ANA in 18 (5.6%), aβ2GP1 in 18 (5.6%), and ATA in 6 (1.9%). Fourteen patients were positive for >1 Ab, including 3 with both AMA and ATA, 2 with aCL and AMA, 2 with ANA and ATA, and 1 each with ANA+aβ2GPI and aβ2GPI+aCL. Three patients had 3 Abs: ANA+aβ2GPI+aCL, β2GPI+aCL+AMA, and aβ2BPI+AMA+ATA, whereas 2 patients had 4 Abs: ANA+aβ2GPI+aCL+AMA and ANA+aCL+AMA+ATA.


Antithyroid Antibodies Are Implicated in Epileptogenesis of Adult Patients With Epilepsy.

Tsai MH, Fu TY, Chen NC, Shih FY, Lu YT, Cheng MY, Chuang HY, Chuang YC - Medicine (Baltimore) (2015)

Prevalence of antibody in epilepsy patients. Abs = antibodies, aCL = antinuclear antibody, aβ2GP1 = anti-β2 glycoprotein 1 antibody, AMA = antimicrosomal antibody, ANA = antinuclear antibody, ATA = antithyroglobulin antibody.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4504585&req=5

Figure 1: Prevalence of antibody in epilepsy patients. Abs = antibodies, aCL = antinuclear antibody, aβ2GP1 = anti-β2 glycoprotein 1 antibody, AMA = antimicrosomal antibody, ANA = antinuclear antibody, ATA = antithyroglobulin antibody.
Mentions: On the basis of the results of Ab positivity (Figure 1), 75 patients (23.5%) were positive for at least 1 Ab. The most common Ab was aCL in 30 (9.4%), followed by AMA in 24 (7.5%), ANA in 18 (5.6%), aβ2GP1 in 18 (5.6%), and ATA in 6 (1.9%). Fourteen patients were positive for >1 Ab, including 3 with both AMA and ATA, 2 with aCL and AMA, 2 with ANA and ATA, and 1 each with ANA+aβ2GPI and aβ2GPI+aCL. Three patients had 3 Abs: ANA+aβ2GPI+aCL, β2GPI+aCL+AMA, and aβ2BPI+AMA+ATA, whereas 2 patients had 4 Abs: ANA+aβ2GPI+aCL+AMA and ANA+aCL+AMA+ATA.

Bottom Line: Antimicrosomal Abs were significantly more frequent in patients who were female, older at disease onset, older at the time of study, and had unknown seizure etiology.The presence of aCL was significantly associated with more frequent seizures.The role of antithyroid Abs in adult focal epilepsy with unknown cause, especially in females, warrants further evaluation because of the potential implications on treatment.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Neurology (M-HT, N-CC, Y-TL, Y-CC), Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Pathology and Laboratory Medicine (T-YF), Kaohsiung Veteran General Hospital, Kaohsiung, Taiwan; Shu-Zen Junior College of Medicine and Management (T-YF), Kaohsiung, Taiwan; Department of Neurosurgery (F-YS), Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Neurology (M-YC), Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Public Health (H-YC), Kaohsiung Medical University; Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital Kaohsiung, Taiwan; Center for Translational Research in Biomedical Sciences (Y-CC), Kaohsiung, Taiwan; Department of Biological Science (Y-CC), National Sun Yet-Sen University, Kaohsiung, Taiwan; and Faculty of Medicine (Y-CC), Kaohsiung Medical University, Kaohsiung, Taiwan.

ABSTRACT
Antithyroid antibodies (Abs) are associated with epilepsy in steroid-responsive encephalopathy, but have been rarely studied in unselected epilepsy patients. This study aimed to characterize the prevalence and associated factors of antithyroid Abs and other auto-Abs in adult patients with epilepsy.Epilepsy patients without autoimmune disorders were surveyed for antinuclear antibody (ANA), anti-β2 glycoprotein 1 antibody (aβ2GP1), anticardiolipin IgG Ab, antimicrosomal antibody (AMA), antithyroglobulin antibody (ATA), and thyroid function test.Of 319 patients, 75 (23.5%) were positive for at least 1 Ab. The most common Ab was anticardiolipin antibody (aCL) (30/319, 9.4%), followed by AMA (24/319, 7.5%), ANA (18/319, 5.6%), aβ2GP1 (18/319, 6.5%), and ATA (6/319, 3.25%). Antimicrosomal Abs were significantly more frequent in patients who were female, older at disease onset, older at the time of study, and had unknown seizure etiology. The presence of aCL was significantly associated with more frequent seizures. Most patients with antithyroid Ab were female and had focal seizures with unknown etiology.The association of different auto-Abs with different factors suggests that they may have different roles in adult patients with epilepsy. Recurrent seizures and certain antiepileptic medications may cause the production of aCL. The role of antithyroid Abs in adult focal epilepsy with unknown cause, especially in females, warrants further evaluation because of the potential implications on treatment.

Show MeSH
Related in: MedlinePlus