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Vestibular disorders in euthyroid patients with Hashimoto's thyroiditis: role of thyroid autoimmunity
Author(s) -
Chiarella Giuseppe,
Tognini Sara,
Nacci Andrea,
Sieli Roberta,
Costante Giuseppe,
Petrolo Claudio,
Mancini Valentina,
Guzzi Pietro Hiram,
Pasqualetti Giuseppe,
Cassandro Ettore,
Fattori Bruno,
Russo Diego,
Monzani Fabio
Publication year - 2014
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12471
Subject(s) - medicine , euthyroid , subclinical infection , vestibular system , thyroid function , thyroid , thyroiditis , endocrinology , thyroid function tests , subacute thyroiditis , caloric theory , autoimmunity , gastroenterology , audiology , disease
Summary Introduction A relationship between vestibular disorders and thyroid autoimmunity independently from thyroid function has been postulated. Aim To shed more light on the actual relationship between vestibular lesions and Hashimoto's thyroiditis ( HT ) regardless of thyroid function. Methods Forty‐seven patients with HT (89·4% F; aged 48·3 ± 12·7 years), 21 with multinodular goitre ( MNG ; 57·1% F; 54·1 ± 9·8 years) and 30 healthy volunteers (56·7% F; 50·7 ± 13·9 years) were enrolled. Inclusion criteria were the presence of normal thyroid function tests and no clinical history of vestibular dysfunction. Each subject was submitted to complete vestibular evaluation [Caloric Test, Vestibular evoked myogenic potentials ( VEMP s), Head Shaking Test ( HST )]. Results 52·2% of HT patients showed an alteration of VEMP s and 44·7% of caloric test ( P < 0·0001 for both). None of the MNG patients showed any vestibular alteration, while one healthy control showed an altered caloric test. A correlation was found between vestibular alterations of HT patients and the degree of serum TPOA b level, not affected by age and serum TSH value. By logistic regression analysis, the absence of thyroid autoimmunity significantly reduced the risk of vestibular alterations: HR 0.19 (95% CI : 0·003–0.25, P = 0·0004) for caloric test; HR 0·07 (95% CI : 0·02–0·425, P < 0·0001) for VEMP s; and HR 0·22 (95% CI : 0·06–0·7, P = 0·01) for HST . Conclusion In euthyroid HT patients, a significant relationship between subclinical vestibular damage and the degree of TPOA b titre was documented. This finding suggests that circulating antithyroid autoantibodies may represent a risk factor for developing vestibular dysfunction. An accurate vestibular evaluation of HT patients with or without symptoms is therefore warranted.