Clinical Utility of Thyroid Autoantibodies in Early Detection of Autoimmune Thyroid Disease in a Tertiary Care Hospital of Bangladesh

Abstract

Background: Autoimmune thyroid disease (AITD) is the most common organ-specific autoimmune disorder worldwide. Early detection is essential to prevent complications such as hypothyroidism, hyperthyroidism, and associated metabolic consequences. Thyroid autoantibodies such as anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-Tg), and TSH receptor antibodies (TRAb) are key markers for detecting subclinical and early-stage AITD. Objective: To evaluate the clinical utility of thyroid autoantibodies in early detection of autoimmune thyroid disease presenting with suspected thyroid dysfunction. Methods: A cross-sectional observational study was conducted over 12 months on 45 patients with clinical suspicion of thyroid disease. Serum levels of TSH, FT4, FT3, anti-TPO, anti-Tg, and TRAb were measured and correlated with clinical and ultrasonographic findings. Results: Anti-TPO antibodies were positive in 71.1% (n=32) of cases, anti-TG in 55.5% (n=25), and TRAb in 17.7% (n=8) in autoimmune thyroid patients. Among patients with normal thyroid function tests (TFTs), 33.3% had positive anti-TPO antibodies, indicating early autoimmune thyroiditis. Female patients showed significantly higher antibody positivity (p<0.05). Conclusion: Thyroid autoantibody testing, particularly anti-TPO, is a sensitive tool for detecting early AITD, even in euthyroid individuals. Routine screening in high-risk groups (females, family history of thyroid disease) is recommended for early diagnosis and management.