Endocrine Abstracts

Introduction: Strong association between pathogenesis of autoimmunity and bacterial infection particularly Helicobacter pylori (H.pylori) had been observed in numerous studies. Nevertheless the possible role of H.pylori in progression of autoimmune thyroid disease is still discussed.

The aim of the study was to reveal the relation between Hashimoto thyroiditis (HT) and presence of H.pylori as well as to analyze the impact of eradication therapy on level of the autoantibodies against thyroid peroxidase (anti-TPO).

Methods: One hundred forty six patients (112 females, 34 males) with HT were prospectively included in this study. Control group consist of 90 volunteers without history of thyroid disease. Urea breath test had been used to detect H.pylori in all subjects. In H.pylori-positive patients the 14 days eradication therapy – clarithromycin 500 mg, pantoprazole 40 mg, amoxicillin 1 g twice a day had been prescribed. The anti-TPO level had been measured using ELISA kits on baseline, 15th and 30th days. The results were analysed using two-sided Fisher’s exact test and the respective odds ratio (OR) was calculated.

Results: The rate of H.pylori evaluation was 70% in HT patients compared with 53% in control group (OR=2.02, 95% CI 1.2–3.3; P=0.01). The successful HP-eradication rate was 86%. We revealed significant reduction of anti-TPO up to 62% (P< 0.001) on 30th day in successfully treated patients. Notable reduction in the severity of tissue inflammation on ultrasound pictures had been observed under H.pylori-eradication therapy.

Conclusion: The sustained relationship between Hashimoto thyroiditis and presence of H.pylori had been revealed. Encouraging data of HP-eradication influence on anti-TPO level suggests the need for further observations and possible optimization of autoimmune thyroiditis diagnostic and treatment protocol.