Prevalence and factors associated with immunological thyroid disease among thyroid disorder patients at Moi teaching and referral hospital (MTRH), western Kenya

Abstract

Autoimmune thyroiditis is an inflammatory or antireceptor autoimmune condition characterized by reactivity to expressed self-thyroid antigens, and is one of the principal \ thyroid gland diseases. In Kenya, where the mode of treatment to thyroid' disorders is mainly thyroidectomy, documentation of case patterns, prevalence and etiology is still very poor. Therefore this study was done to determine the prevalence, histological patterns, and the levels of thyroid hormones and autoantibodies in immunological thyroid disease patients at Moi Teaching and Referral Hospital (MTRH) in western Kenya. This was a retrospective study in which, samples and data from 388 patients who presented with thyroid pathologies between 2008 and 2011, had thyroidectomy done, and samples taken for histological analysis and diagnosis. Clinical data on thyroid hormones and histopathological diagnosis were extracted from the patient's medical records. Data was analyzed using STAT A version SEII0 (College Station, Texas, USA). The results showed that the prevalence levels were; thyroiditis 24 (6.2%), thyroid carcinoma 18 (4.6%), thyroid adenoma 51 (13.1%), colloid goitre 286 (73.7%), thyroid cysts 8 (2.1%) and thyroid abscess 1 (0.3%). Immunological thyroid disease was present in 175 (45%,95% CL: 40-50) subjects. The median thyroid stimulating hormone levels was TSH 1.8 (IQR: 0.9-2.9), T3 1.8 (IQR: 1.3-2.7) and T4 1.2 (IQR: 0.7-1.9). Thyroid stimulating hormone (TSH) and triiodothyronine hormone (T3) levels for immunological thyroid disease patients were higher (p=0.0232; 0.040, respectively), for those aged 30-39 years. Similarly, creatinine level for immunological thyroid disease patients, median: 58 (lQR: 50-67), were higher (p=0.039) for immunological thyroid disease patients. The presence of the thyroid auto antibodies was significantly associated with the autoimmune thyroid disease (p=O.OOI). The results showed that the prevalence of immunological thyroid disease was higher (7.5%) than the earlier reported prevalence (2%) by other studies in Kenya and that thyroid hormone levels (TSH) and triiodothyronine hormones (T3) significantly contribute to the occurrence of immunological thyroid disease. This study has shown that the hormonal, auto antibodies, biochemical and hematological profiles are altered in immunological thyroid disease patients and hence these parameters can serve as a tool for diagnosing thyroid autoimmunity.