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High Thyroglobulin Antibodies- can anyone help?

My 7 year old daughter has been breaking out in hives for about a year and a half with angioedema sporadically as well. The allergist ordered labs for Chronic Urticaria and some of the results are concerning me about a thyroid condition. High results were-
BUN 22 reference range 5-18
BUN/Creatinine Ratio 55 reference range 13-32
EOS 1.4 reference range 0.0-0.3
Immunoglobulin E, total 3199 reference range 0-90
Thyroglobulin Antibody 5.2 reference range 0.0-0.9

Does this seem to be maybe Hashimotos or another thyroid problem? Should we have her kidneys checked?

3 Responses
649848 tn?1534633700
It would appear that your daughter might have more than one problem, not necessarily related.

The elevated Thyroglobulin Antibodies (TgAb) is the only thyroid related test and it does indicate Hashmioto's.  Did your doctor, by any chance, order Thyroid Peroxidase Antibodies, as well?  Those are the other antibodies that are often (though not always) present with Hashimotos'.  

Does your daughter have symptoms of a thyroid condition?  Although some people do have hives with thyroid condition, the most common symptoms are those of hypo or hyperthyroidism.  For hypothyroidism, symptoms include fatigue, weight gain/inability to lose, swelling/puffiness, especially around the eyes, muscle/joint aches/pains, cold intolerance, constipation, etc.  For hyperthyroidism, common symptoms include fatigue, heat intolerance, rapid weight loss, irritability, mood swings. diarrhea, hand tremors, etc.  

Depression, anxiety, rapid heart rate or heart palpitations can apply to either, but are most often considered to be symptoms of hyper.

BUN and BUN/creatinine ratio is related to blood flow to the kidneys/kidney function.  BUN can be elevated if the patient is dehydrated when the blood is drawn, such as when one has been fasting overnight.  Many people don't realize that, unless instructed otherwise, it's, typically, okay to drink plain water prior to a fasting lab draw in order to prevent dehydration.  Although elevated, the BUN is not "very" high, so the doctor may ask for a repeat of this test or do further tests to make sure there is no kidney malfunction.

EOS is a type of white blood cell that fights disease.  Its presence can indicate a parasitic infection, an allergic reaction or a cancer.  High EOS can be present in blood or at the site of infection or inflammation.  High EOS could be present because of an autoimmune condition, such as Hashimoto's or they could be elevated because of inflammation caused by an allergy/infection, etc.

Immunoglobulin E (IgE) is a type of antibody.  
"Elevated concentrations of IgE are generally thought of in the context of allergic disease. However, increases in the amount of circulating IgE can also be found in various other diseases, including primary immunodeficiencies, infections, inflammatory diseases, and malignancies. Total IgE measurements have limited utility for diagnostic evaluation of patients with suspected allergic disease, except for allergic bronchopulmonary aspergillosis (ABPA). ABPA is a hypersensitivity reaction against the fungi Aspergillus that occurs most frequently in patients with asthma or cystic fibrosis. An elevation of total IgE is part of the diagnostic criteria for ABPA, although the specific diagnostic concentration is dependent on certain patient characteristics."
Her dr did order the TPO and it was within normal range (14). She has been very fatigued lately and complaining of headaches. She is also a twin and over the past 6 months has an 8 lb weight difference with her sister.

Although her allergist said it appears to be hives, they are leaning more toward autoimmune as the hives are not itchy and are more hot to the touch. They do present all over her body but give her skin almost a sunburn appearance.

They are doing repeat kidney tests today to see if the BUN levels are still elevated and we are waiting for an appointment with a pediatric endocrinologist so fingers crossed we get some answers!
1756321 tn?1547095325
"Elevated thyroid antibodies are often associated with chronic urticaria, also called hives. Studies report that as many as 57.4% of patients with hives have the presence of anti-thyroid antibodies. An August 2010 paper suggests that treatment with T4 improves the itching associated with urticaria, but did not advise treatment with T4 unless the patient was hypothyroid." - excerpt from Life Extention - Thyroid Regulation
The odd thing is she doesn't itch! She will be covered head to toe in hot to the touch wheals and her skin looks sunburnt, but there is no itching at all. This is what originally caused them to think it was autoimmune associated. We do have a referral to endocrinology now so I guess it's a waiting game
1756321 tn?1547095325
My hives didn't itch either actually.
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649848 tn?1534633700
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1756321 tn?1547095325
Queensland, Australia
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