Disfunção tireoidiana e sua associação com anticorpos não órgão específico (NOSAs) em portadores de hepatite C
Authors: De Oliveira Andrade Luis Jesuino , Ferreira Lins Augusto Cesar , Paraná Raymundo 
Published: November 2017

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</style> <![endif]--> <p class="MsoNormal" style="margin-bottom: .0001pt; text-align: justify; line-height: normal; mso-layout-grid-align: none; text-autospace: none;"><strong><span style="font-size: 8.0pt; font-family: Calibri-Bold; mso-bidi-font-family: Calibri-Bold;">Introdução</span></strong><span style="font-size: 8.0pt; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri; mso-bidi-font-family: Calibri;">: As manifestações extra-hepáticas são bem conhecidas no curso das hepatites virais agudas ou crônicas. Na hepatite C crônica (HCV) destacam-se, dentre muitas delas, as disfunções tireoidianas (DT), que podem ser decorrentes de fenômenos imunológicos como a ocorrência de autoanticorpos não órgão específicos (NOSAs). </span><strong><span style="font-size: 8.0pt; font-family: Calibri-Bold; mso-bidi-font-family: Calibri-Bold;">Objetivo</span></strong><span style="font-size: 8.0pt; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri; mso-bidi-font-family: Calibri;">: Avaliar a associação entre DT e NOSAs em pacientes com HCV antes e durante o tratamento com interferon (PEG-IFN) e ribavirina (RBV). </span><strong><span style="font-size: 8.0pt; font-family: Calibri-Bold; mso-bidi-font-family: Calibri-Bold;">Metodologia</span></strong><span style="font-size: 8.0pt; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri; mso-bidi-font-family: Calibri;">: Estudo de coorte prospectivo. No período de dois anos, no Ambulatório de Hepatologia da Faculdade de Medicina da Universidade Federal da Bahia, foram estudados prospectivamente 65 pacientes com HCV candidatos à terapia com PEG-IFN e RBV, avaliando-se a função tireoidiana, através da dosagem da tiroxina livre (T4L) e do hormônio estimulante da tireóide (TSH) e seu perfil de autoimunidade por meio da titulação do anticorpo antiperoxidase (TPO-Ab) antes (S0) e nas semanas 12 (S12) e 24 (S24) de tratamento, correlacionando sua associação com o painel de NOSAs. O painel de NOSAs constou da avaliação do anticorpo antinuclear (ANA), anticorpo anti-músculo liso (SMA), anticorpo antimitocondrial (AMA), anticorpo anti-neutrófilo-citoplasmático (ANCA) e anticorpo microssomal anti-fígado/rim (LKM1). </span><strong><span style="font-size: 8.0pt; font-family: Calibri-Bold; mso-bidi-font-family: Calibri-Bold;">Resultados</span></strong><span style="font-size: 8.0pt; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri; mso-bidi-font-family: Calibri;">: A idade média dos pacientes (38 mulheres e 27 homens) foi 49,61 ± 11,83 anos (22-66 anos). Dos 65 pacientes, 7 (10,76%) apresentavam alterações tireoidianas em S0, 11 pacientes (16,92%) em S12 e 18 pacientes (27,69%) em S24. A avaliação do painel de NOSAs apresentou os seguintes resultados: SMA positivo em 22 indivíduos (33,8%), ANA positivo em 8 (12,3%), ANCA positivo em 6 (9,6%), ACA positivo em 5 pacientes (7,7%) e LKM1 positivo em 1 paciente (1,5%). A positividade de SMA apresentou o maior risco relativo (3,91) de desenvolvimento de DT ao final de M6. </span><strong><span style="font-size: 8.0pt; font-family: Calibri-Bold; mso-bidi-font-family: Calibri-Bold;">Conclusão</span></strong><span style="font-size: 8.0pt; mso-ascii-font-family: Calibri; mso-hansi-font-family: Calibri; mso-bidi-font-family: Calibri;">: Os NOSAs apresentam frequência importante em HCV, estando associada à DT, demonstrando assim que a função tireoidiana e seu perfil de autoimunidade devem ser avaliados em pacientes com HCV.</span></p></p> <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves /> <w:TrackFormatting /> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF /> 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