Is there a link between Parvovirus B19 infection and autoimmune thyroid diseases?
Autoimmune thyroid diseases are among the most common autoimmune disorders, with a worldwide prevalence of around 10%. The study presented below, recently published in the International Journal of Endocrinology and Metabolism, examined the connection between Parvovirus B19 infection (the cause of erythema infectiosum in children) and these diseases.
Studied Population and Parameters
The observational study included a total of 1132 adult patients (80% women; average age 35 years) with Hashimoto's thyroiditis (n = 404) or Graves' disease (n = 248) newly diagnosed between April 2019 and September 2020, or with euthyroid (n = 480). Parameters assessed included (among others) concentrations of free thyroxine (fT4), free triiodothyronine (fT3), thyrotropin (TSH), antibodies against thyroperoxidase (TPOAb), antibodies against thyroglobulin (TgAb), antibodies against the TSH receptor, and IgG antibodies against Parvovirus B19.
Exclusion criteria were as follows:
- infectious or malignant cancer diseases
- previous thyroid disease therapy
- smoking
- pregnancy or breastfeeding
Findings
The seroprevalence of IgG antibodies against Parvovirus B19 in patients with Hashimoto's thyroiditis, Graves' disease, and euthyroid conditions was 61.1%, 58.9%, and 47.1%, respectively.
In the group of patients with Hashimoto's thyroiditis, a significant correlation was observed between IgG antibodies against Parvovirus B19 and TPOAb (r = 0.764; p < 0.001) as well as TgAb (r = 0.533; p < 0.001). This trend was also noted in patients with Graves' disease: TPOAb (r = 0.799; p < 0.001), TgAb (r = 0.467; p < 0.001).
In the group of individuals with Hashimoto's thyroiditis, the prevalence of Parvovirus B19 infection was 68.4% in TPOAb-positive individuals, while no TPOAb-negative patients had a confirmed infection. In patients with Graves' disease, the prevalence of infection in TPOAb-positive and negative individuals was 71.8% and 2.2%, respectively. Similarly, in the Hashimoto's thyroiditis group, the prevalence of Parvovirus B19 infection among TgAb-positive patients was 71.7%, while among TgAb-negative patients it was only 20.5%. In patients with Graves' disease, this prevalence reached 70.8% and 6.5%, respectively.
In patients with Hashimoto's thyroiditis, the level of IgG antibodies against Parvovirus B19 negatively correlated with BMI and TSH levels, and positively correlated with fT4, fT3, TPOAb, and TgAb levels. In patients with Graves' disease, a positive correlation was observed with TPOAb and TgAb levels.
Conclusion
The prevalence of Parvovirus B19 infection was significantly higher in the group of patients with autoimmune thyroid diseases compared to those with euthyroid conditions. However, further prospective studies are needed to confirm the causal role of Parvovirus B19 in the pathogenesis of Hashimoto's thyroiditis and Graves' disease.
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Source: Heidari Z., Jami M. Parvovirus B19 infection is associated with autoimmune thyroid disease in adults. Int J Endocrinol Metab 2021; 19 (4): e115592, doi: 10.5812/ijem.115592.
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