Hereditary
transthyretin (TTR)
amyloidosis is a fatal disease causing systemic organ dysfunctions. Histopathological studies revealed that thyroid glands are major target tissues. However, details about thyroid functions remain to be fully elucidated in this disease. For patient treatment,
liver transplantation (LT) reportedly prolongs patient survival, but thyroid gland function after LT still remains poorly understood. In this study, we investigated the thyroid functions in 101 patients with hereditary TTR
amyloidosis and the effects of LT on thyroid functions in those patients. In addition, we investigated histopathological and biochemical findings of thyroid specimens obtained at autopsy. Disease duration and age at examination inversely correlated with serum levels of free
triiodothyronine (fT3) in hereditary TTR
amyloidosis. On the contrary, in patients who underwent
transplantation, time from disease onset to
transplantation and age at
transplantation clearly correlated with serum fT3and
thyroid stimulating hormone (TSH) levels. In autopsy studies, amounts of thyroid
amyloid deposits in patients with
transplantation were significantly lower than those in patients without
transplantation. Mass spectrometric analyzes also revealed that proportions of wild-type (WT) TTR in thyroid
amyloid deposits in patients with hereditary TTR
amyloidosis who underwent
transplantations were higher than those in patients without
transplantation.
Thyroid hormone functions may diminish according to the
disease progression. LT could prevent thyroid dysfunction in hereditary TTR
amyloidosis.