THYROID-FUNCTION AND AUTOIMMUNITY IN PERNICIOUS-ANEMIA BEFORE AND DURING CYANOCOBALAMIN TREATMENT

Out of 35 consecutive patients with decreased plasma-cobalamin 22 had newly diagnosed overt pernicious anemia (PA) six of which had a known history of thyroid disease. At referral, 5 of these 6 were thyroid per oxidase antibody (TPOAb)-positive and 2 were thyroglobulin antibody (T gAb)-positive, while none were thyroid stimulating antibody (TSAb)-pos itive (an overall autoantibody appearance of 83.3%). Fifty percent of the 22 patients had TPOAb and 13.6% had TgAb compared to 18.2% and 4.5 %, respectively in sex and age matched healthy controls. Six PA-patien ts without a history of thyroid disease had thyroid autoantibodies and another patient seroconverted within the first year during treatment with cyanocobalamin. Measurements of serum concentrations of thyroid h ormones and thyroid stimulating hormone were performed during the firs t year of treatment with cyanocobalamin. Two cases of subclinical myxo edema were found among PA-patients and another case was found among pa tients with latent PA. The female:male ratio of thyroid disease among PA-patients and among thyroid autoantibody-positive PA-patients was in terestingly found to be 1:1, Treatment with cyanocobalamin did not hav e any systematic effect on thyroid function. Routine screening for thy roid function and thyroid autoantibodies in patients with latent or ov ert PA is recommended.