Introduction: Thyroid peroxidise (TPO) autoantibodies are a secondary response to thyroid injury and do not cause disease themselves. Though the presence of Anti TPO antibody may be a hallmark for autoimmune thyroid disease, there are reports that suggest the presence of Anti TPO antibodies can be a marker of thyroid dysfunction in future.

Objective: To assess the presence of Anti – TPO antibodies in patients with thyroid dysfunction.

Materials and Methods: This is a cross sectional study done on 60 Patients above the age of 18yrs attending General Medicine OPD with history of thyroid dysfunction and were subjected to thyroid function test and measurement of anti – TPO antibodies.         

Results: Of the 60 patients 26 were found to be hypothyroidic, 15 were hyperthyroidic, FNAC of 7 patients suggested the presence of malignancy and 12 patients had Hashimoto’s thyroiditis. A significant association was found between Anti TPO levels and trends of anaemia with a p value of 0.02. On assessing the association between thyroid function test and Anti TPO antibody level, a significant relation with a p value of 0.01 was found with trends of free T3 levels. Of the 7 patients under malignancy group, 5 patients (71.4%) who had papillary carcinoma thyroid had elevated Anti TPO antibody levels.

Conclusion: In presence of Anti TPO antibodies along with a thyroid swelling a direct diagnosis of autoimmune thyroiditis should not be made and an FNAC biopsy should always be performed to rule out the likely possibility of carcinoma thyroid.

1. Zimmerman MB. Iodine deficiency. Endocr Rev 2009; 30: 376-408.
2. Vanderpump MPJ. The epidemiology of thyroid diseases. In: BravermanLE, Utiger RD, editors. Werner and Ingbar's the thyroid: a fundamental and clinical text. 9th edn. Philadelphia: JB Lippincott-Raven 2005.p.398-496.
3. Limm S, (Dec 15, 2012). "Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease. The Lancet 380(9859):2163–96.
4. Delange F et al. Iodine deficiency as a cause of brain damage. Postgrad Med J 2001;77:217-220 doi: 10.1136/pmj.77.906.217.
5. Vanderpump MPJ, Tunbridge WMG, French JM, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickhamsurvey. Clin Endocrinol (Oxf) 1995;43:55-69.
6. A Brander et al (1991) Thyroid gland: US Screening in a random adult population. Radiology. 1991 Dec;181(3):683-7.
7. Tondon N, Garg G. Disorders of thyroid gland. In: Munjal YP, editor in chief. API text book of medicine. 9th edn. New Delhi: Jaypee Brothers 2012:p.419-29.
8. Jameson LJ, Mandel JS, Weetman PA. Disorders of thyroid gland. In: Kasper LD, Fauci SA, Hauser LS, et al. eds. Harrison’s Principles of internal medicine. 19th edn. McGraw-Hill Education 2015:p.2283-308.
9. Hanshuraj R, Suudharsan S, Balasubramaniyan S, et al. A clinical study on patients presenting with thyroid swelling and its correlation with TFT, USG, FNAC and anti TPO antibodies. SSRG International Journal of Medical Science 2016;3(10):1-8. ISSN:2393-9117.
10. Vanderpump MPJ. Epidemiology of thyroid disease and swelling. In: Wass JAH, Stewat PM, eds. Oxford textbook of endocrinology and diabetes. 2nd edn. Oxford University Press 2011:p.358-69.
11. Weetman AP. The thyroid gland and disorder of thyroid gland. In: Warrell DA, Cox TM, Firth JD, eds. Oxford text book of medicine. Vol. 2. 5th edn. Oxford University Press 2010:p.1826-50.
12. Kartha PP, Sadasivan S. Spectrum of thyroid lesion and its clinicopathological correlation – a two year study from a tertiary care centre. Journal of Medical Science and Clinical Research 2017;5(7):25615-22.
13. Maitra A. The endocrine system. In: Kumar V, Abbas KA, Aster CJ, eds. Robbins and Cotran pathologic basis of disease. Vol. 02. South Asia edition. New Delhi: RELX India Pvt Ltd., Publisher 2016:p.1082-100.

Dr M.K. Uthaya Sankar

Professor, Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry-605107, India