Table 1.
Clinical characteristic of patients with NMO, TM and MS.
Table 2.
Distribution of serum abnormal thyroid parameters in 243 samples.
Figure 1.
Changes in levels of TSH, TG-Ab, and TPO-Ab after ivMP administration in nine paired patients (a, b, c): changes of TSH; (d, e, f): changes of TG-Ab; (g, h, i): changes of TPO-Ab.
Table 3.
Thyroid parameters of nine paired patients before and after IVMP.
Figure 2.
Frequency of abnormal thyroid parameters among NMO, TM, and MS patients at their first attack.
(a) In 96 patients, higher numbers of NMO and TM samples had abnormal levels of TSH, TG-Ab and TPO-Ab than MS samples (p<0.0001). (b) The 96 patients were divided into those with (n = 58) and without myelitis (n = 38). TSH, TG-Ab and TPO-Ab levels in patients with myelitis were significantly different to patients without myelitis. (c) Of 52 MS patients, greater numbers with myelitis showed abnormal TSH (p<0.0001) levels compared with those without myelitis.
Figure 3.
Level of thyroid parameters among different groups at the first attack.
(a) In total patients (n = 96) and NMO (n = 19) and TM (n = 48) subgroups, TSH levels were not significantly different between AQP4 antibody positive or negative patients (p>0.05). In total patients (n = 96) and MS subgroup (n = 52), TSH levels were significantly different between patients with and without myelitis (p<0.05). (b) In total patients and of NMO and TM subgroups, TG-Ab levels were not significantly different between AQP4 antibody positive or negative patients (p>0.05). In total patients, TG-Ab levels were significantly different between patients with and without myelitis (p = 0.034). (c) In total patients, AQP4 antibody positive patients had higher TPO-Ab levels than AQP4 antibody negative patients (p = 0.007). Patients with myelitis had higher TPO-Ab levels than patients without myelitis (p = 0.021). Ab: AQP4 antibody; MY: myelitis; +: positive; -: negative; red dashed line: normal range.
Table 4.
Comparison of thyroid parameters in patients with and without myelitis.
Table 5.
Comparison of thyroid parameters in 96 patients with and without AQP4 antibodies.
Figure 4.
MRI of spinal cord and thyroid parameters of representative cases.
A: MRI shows longitudinal extensive lesion in the cervical and thoracic cord (C3-T1) at the first attack; B: At the second attack, T2-weighed spinal MRI shows a lesion extending from C1 to T1; C: Immunofluorescence staining shows serum antibodies bind to the cytoplasmic membranes of follicular cells (short arrow) and thyroid microsoma (dot arrow); (a): Changes of TSH in myelitis attack and remission; (b): Changes of TG-Ab in myelitis attack and remission; (c): (a): Changes of TPO-Ab in myelitis attack and remission.