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Sample records for autoimmune thyroiditis presenting

  1. Identifying a Small Molecule Blocking Antigen Presentation in Autoimmune Thyroiditis.

    Science.gov (United States)

    Li, Cheuk Wun; Menconi, Francesca; Osman, Roman; Mezei, Mihaly; Jacobson, Eric M; Concepcion, Erlinda; David, Chella S; Kastrinsky, David B; Ohlmeyer, Michael; Tomer, Yaron

    2016-02-19

    We previously showed that an HLA-DR variant containing arginine at position 74 of the DRβ1 chain (DRβ1-Arg74) is the specific HLA class II variant conferring risk for autoimmune thyroid diseases (AITD). We also identified 5 thyroglobulin (Tg) peptides that bound to DRβ1-Arg74. We hypothesized that blocking the binding of these peptides to DRβ1-Arg74 could block the continuous T-cell activation in thyroiditis needed to maintain the autoimmune response to the thyroid. The aim of the current study was to identify small molecules that can block T-cell activation by Tg peptides presented within DRβ1-Arg74 pockets. We screened a large and diverse library of compounds and identified one compound, cepharanthine that was able to block peptide binding to DRβ1-Arg74. We then showed that Tg.2098 is the dominant peptide when inducing experimental autoimmune thyroiditis (EAT) in NOD mice expressing human DRβ1-Arg74. Furthermore, cepharanthine blocked T-cell activation by thyroglobulin peptides, in particular Tg.2098 in mice that were induced with EAT. For the first time we identified a small molecule that can block Tg peptide binding and presentation to T-cells in autoimmune thyroiditis. If confirmed cepharanthine could potentially have a role in treating human AITD.

  2. [Non-autoimmune thyroiditis].

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    Rizzo, Leonardo F L; Mana, Daniela L; Bruno, Oscar D

    2014-01-01

    The term thyroiditis comprises a group of thyroid diseases characterized by the presence of inflammation, including autoimmune and non-autoimmune entities. It may manifest as an acute illness with severe thyroid pain (subacute thyroiditis and infectious thyroiditis), and conditions in which the inflammation is not clinically evident evolving without pain and presenting primarily thyroid dysfunction and/or goiter (drug-induced thyroiditis and Riedel thyroiditis). The aim of this review is to provide an updated approach on non-autoimmune thyroiditis and its clinical, diagnostic and therapeutic aspects.

  3. Autoimmune thyroiditis perdating the presentation of systemic lupus erythematosus: Two cases and a review of literature

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    Dhir Rajeev

    2002-01-01

    Full Text Available Autoimmune diseases are commonly encountered in dermatology practice. While the association of two autoimmune diseases in the same individual is not unknown, it is relatively rare for the second disease to be suspected based on cutaneous manifestations. We present two such cases wherein cutaneous manifestations were the first clue to the development of lupus erythematosus in a setting of autoimmune thyroiditis. Further, we have reviewed literature on this uncommon occurrence and discuss various aspects of this association.

  4. THE CLINICAL PRESENTATION OF AUTOIMMUNE THYROID DISEASE IN MEN IS ASSOCIATED WITH IL12B GENOTYPE

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    Walsh, John P; Berry, Jemma; Liu, Shu;

    2011-01-01

    hypothesized that IL12B genotype may influence the clinical presentation of autoimmune thyroid disease. Objective.  We tested for differences in IL12B genotype between Graves' disease and Hashimoto's disease. Patients.  We studied a discovery cohort of 203 Australian women and 37 men with autoimmune thyroid......' disease (P=0.005) and Hashimoto's disease (P=0.029). Conclusion.  In men with autoimmune thyroid disease, a common variant located upstream of the IL12B coding region may influence whether patients present with Graves' disease or Hashimoto's disease.......Background.  Common variants in the interleukin 12B (IL12B) gene are associated with predominantly inflammatory (Th1) or antibody-mediated (Th2) immune responses. Since Hashimoto's disease and Graves' disease are thought to arise from mainly Th1 and Th2 immune responses respectively, we...

  5. Lithium associated autoimmune thyroiditis.

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    Shimizu, M; Hirokawa, M.; T. Manabe; Shimozuma, K; Sonoo, H; Harada, T.

    1997-01-01

    A case of autoimmune thyroiditis after long term treatment with lithium is described in a 29 year old Japanese woman with manic depression. Positive serum antithyroglobulin and antimicrosomal antibodies, diffuse goitre, and microscopic chronic thyroiditis, as well as the clinical history of long term lithium treatment were suggestive of lithium associated autoimmune thyroiditis. Microscopically, there was a mild degree of interstitial fibrosis and a moderate degree of lymphocytic infiltration...

  6. Autoimmune thyroid diseases and Helicobacter pylori: The correlation is present only in Graves's disease

    Institute of Scientific and Technical Information of China (English)

    Vincenzo Bassi; Gennaro Marino; Alba Iengo; Olimpia Fattoruso; Crescenzo Santinelli

    2012-01-01

    AIM:To investigate the correlation between autoimmune thyroid diseases (ATDs) and the prevalence of Cag-A positive strains of Helicobacter pylori (H.pylon)in stool samples.METHODS:Authors investigated 112 consecutive Caucasian patients (48 females and 4 males with Graves' disease and 54 females and 6 males with Hashimoto's thyroiditis HT),at their first diagnosis of ATDs.Authors tested for H.pylori in stool samples using an amplified enzyme immunoassay and Cag-A in serum samples using an enzyme-linked immunoassay method (ELISA).The results were analyzed using the two-sided Fisher's exact test and the respective odds ratio (OR) was calculated.RESULTS:A marked correlation was found between the presence of H.pylori (P ≤ 0.0001,OR 6.3) and,in particular,Cag-A positive strains (P ≤ 0.005,OR 5.3)in Graves' disease,but not in Hashimoto's thyroiditis,where authors found only a correlation with Cag-A strains (P ≤ 0.005,OR 8.73) but not when H.pylori was present.CONCLUSION:The marked correlation between H.pylori and Cag-A,found in ATDs,could be dependent on the different expression of adhesion molecules in the gastric mucosa.

  7. The thyroid, iodine and autoimmunity

    NARCIS (Netherlands)

    P. Mooij (Petra)

    1993-01-01

    textabstractAn excessive dietary iodine intake has also been described to lead to thyroid autoimmune reactivity: a. in individuals with a preexisting thyroid abnormality, such as an iodine deficient goitre, an excessive dietary iodine intake results in a proportion of the individuals in the developm

  8. Autoimmune/Inflammatory Syndrome Induced by Adjuvants and Thyroid Autoimmunity

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    Watad, Abdulla; David, Paula; Brown, Stav; Shoenfeld, Yehuda

    2017-01-01

    The autoimmune/inflammatory syndrome induced by adjuvants (ASIA), presented by Shoenfeld and Agmon-Levin in 2011, is an entity that incorporates diverse autoimmune conditions induced by the exposure to various adjuvants. Adjuvants are agents that entail the capability to induce immune reactions. Adjuvants are found in many vaccines and used mainly to increase the response to vaccination in the general population. Silicone has also been reported to be able to induce diverse immune reactions. Clinical cases and series of heterogeneous autoimmune conditions including systemic sclerosis, systemic lupus erythematosus, and rheumatoid arthritis have been reported to be induced by several adjuvants. However, only a small number of cases of autoimmune thyroid disorder have been included under the umbrella of ASIA syndrome. Indeed, clinical cases of Hashimoto’s thyroiditis and/or subacute thyroiditis were observed after the exposure to vaccines as well as silicone implantation. In our review, we aimed to summarize the current knowledge on ASIA syndrome presented as endocrinopathies, focusing on autoimmune thyroid disorders associated with the various adjuvants. PMID:28167927

  9. Expression of tenascin in lymphocytic autoimmune thyroiditis.

    OpenAIRE

    Back, W; Heubner, C; Winter, J.; Bleyl, U

    1997-01-01

    AIMS: To study the distribution of tenascin by immunocytochemistry in autoimmune diseases of the thyroid. METHODS: Thyroids from patients with inflammatory lesions of the thyroid (lymphocytic thyroiditis Hashimoto, Grave's disease, thyroiditis DeQuervain) were studied by immunocytochemistry using antibodies against tenascin, collagen III, and collagen IV. RESULTS: In autoimmune lymphocytic thyroiditis Hashimoto there was a characteristic corona-like staining pattern of tenascin around all act...

  10. Autoimmune thyroiditis presenting as interstitial granulomatous dermatitis Dermatite intersticial granulomatosa como apresentação de tireoidite autoimune

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    Joana Antunes

    2012-10-01

    Full Text Available A 54-year-old female presented with recurrent, widespread, erythematous, painful plaques, over a 3-month period. Skin biopsy was compatible with interstitial granulomatous dermatitis. Additional investigation revealed hypothyroidism and positive anti-thyroid antibodies. Normalization of thyroid function and high-potency topical corticosteroids provided only transitory improvement of the dermatosis. Interstitial granulomatous dermatitis is a histologic inflammatory reaction, with variable cutaneous expression. It has been reported in association with several drugs, lymphoproliferative diseases and autoimmune disorders, such as rheumatoid arthritis, systemic lupus erythematosus and vasculitis, but association with autoimmune thyroiditis is rare. Optimal therapy for this condition is yet to be established, but topical corticosteroids have been a mainstay of treatment. In most cases, this disease is characterized by flares and remissions.Uma doente de 54 anos foi avaliada por placas eritematosas, dolorosas, disseminadas, recorrentes, com 3 meses de evolução. A biopsia cutânea foi compatível com dermatite intersticial granulomatosa. Os restantes exames laboratoriais revelaram hipotiroidismo e anticorpos anti-tiroideus positivos. Apesar da normalização da função tiroideia e de tratamento com corticóide tópico de alta potência, a dermatose melhorou apenas parcialmente. Dermatite intersticial inflamatória é um diagnóstico histopatológico, com expressão clínica variável. Tem sido associada a vários fármacos, doenças linfoproliferativas e autoimunes, nomeadamente artrite reumatóide, lupus eritematoso sistémico e vasculites, mas a associação com tireoidite autoimune é rara. Até ao momento, não foi definido nenhum tratamento específico, mas os corticóides tópicos são dos fármacos mais utilizados. A doença caracteriza-se por períodos de agravamento e remissão.

  11. Autoimmune thyroid disease and other non-endocrine autoimmune diseases

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    Todorović-Đilas Ljiljana

    2011-01-01

    Full Text Available Introduction, Autoimmune diseases are chronic conditions initiated by the loss of immunological tolerance to self-antigens. They constitute heterogeneous group of disorders, in which multiple alterations in the immune system result in a spectrum of syndromes that either target specific organs or affect the body systematically. Recent epidemiological studies have shown a possible shift of one autoimmune disease to another or the fact that more than one autoimmune disease may coexist in a single patient or in the same family. Numerous autoimmune diseases have been shown to coexist frequently with thyroid autoimmune diseases. Autoimmune thyroid disease and other organ specific non-endocrine autoimmune diseases. This part of the study reviews the prevalence of autoimmune thyroid disease coexisting with: pernicious anaemia, vitiligo, celiac disease, autoimmune liver disease, miastenia gravis, alopecia areata and sclerosis multiplex, and several recommendations for screening have been given. Autoimmune thyroid disease and other organ non-specific non-endocrine autoimmune diseases. Special attention is given to the correlation between autoimmune thyroid disease and rheumatoid arthritis, systemic lupus erythematosus, syndrome Sjögren, systemic sclerosis and mixed connective tissue disease. Conclusions. Screening for autoimmune thyroid diseases should be recommended in everyday clinical practice, in patients with primary organ-specific or organ non-specific autoimmune disease. Other­wise, in patients with primary thyroid autoimmune disease, there is no good reason of seeking for all other autoimmune diseases, although these patients have a greater risk of developing other autoimmune disease. Economic aspects of medicine require further analyzing of these data, from cost/benefit point of view to justified either mandatory screening or medical practitioner judgment.

  12. Susceptibility Genes in Thyroid Autoimmunity

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    Yoshiyuki Ban

    2005-01-01

    Full Text Available The autoimmune thyroid diseases (AITD are complex diseases which are caused by an interaction between susceptibility genes and environmental triggers. Genetic susceptibility in combination with external factors (e.g. dietary iodine is believed to initiate the autoimmune response to thyroid antigens. Abundant epidemiological data, including family and twin studies, point to a strong genetic influence on the development of AITD. Various techniques have been employed to identify the genes contributing to the etiology of AITD, including candidate gene analysis and whole genome screening. These studies have enabled the identification of several loci (genetic regions that are linked with AITD, and in some of these loci, putative AITD susceptibility genes have been identified. Some of these genes/loci are unique to Graves' disease (GD and Hashimoto's thyroiditis (HT and some are common to both the diseases, indicating that there is a shared genetic susceptibility to GD and HT. The putative GD and HT susceptibility genes include both immune modifying genes (e.g. HLA, CTLA-4 and thyroid specific genes (e.g. TSHR, Tg. Most likely, these loci interact and their interactions may influence disease phenotype and severity.

  13. Thyroid autoimmunity and polyglandular endocrine syndromes.

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    Wémeau, Jean-Louis; Proust-Lemoine, Emmanuelle; Ryndak, Amélie; Vanhove, Laura

    2013-01-01

    Even though autoimmune thyroiditis is considered as the most emblematic type of organ-specific autoimmune disorder of autoimmunity, autoimmune thyroid diseases can be associated with other autoimmune endocrine failures or non-endocrine diseases (namely vitiligo, pernicious anemia, myasthenia gravis, autoimmune gastritis, celiac disease, hepatitis). Thyroid disorders, which are the most frequent expression of adult polyendocrine syndrome type 2, occur concomitantly with or secondarily to insulinodependent diabetes, premature ovarian failure, Addison's disease (Schmidt syndrome, or Carpenter syndrome if associated with diabetes). Testicular failure and hypoparathyroidism are unusual. The disease is polygenic and multifactorial. Disorders of thyroid autoimmunity are, surprisingly, very rare in polyendocrine syndrome type 1 (or APECED) beginning during childhood. They are related to mutations of the AIRE gene that encodes for a transcriptional factor implicated in central and peripheral immune tolerance. Hypothyroidism can also be observed in the very rare IPEX and POEMS syndromes.

  14. Cerebral venous sinus thrombosis with autoimmune thyroiditis

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    Sameer Aggarwal

    2013-01-01

    Full Text Available Cerebral Venous Thrombosis ( CVT is a multifactorial condition which is described as idiopathic in 12.5% of patients. Hyperthyroidism has been associated with CVT in many case reports, and increased levels of factor VIII and von Willebrand factor (vWF have been proposed as the possible link in this association, but only few rare case reports have described an association of hypothyroidism with CVT. We report here a case of autoimmune thyroiditis presenting with CVT.

  15. Autoimmune thyroiditis associated with neuromyelitis optica (NMO).

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    Sudulagunta, Sreenivasa Rao; Sodalagunta, Mahesh Babu; Khorram, Hadi; Sepehrar, Mona; Gonivada, Jayadevappa; Noroozpour, Zahra; Prasad, Nagendra

    2015-01-01

    Neuromyelitis optica (NMO or Devic's syndrome) is a rare relapsing demyelinating disease of the central nervous system (CNS) that mainly affects the spinal cord and optic nerves and shares many clinical and radiological features with multiple sclerosis. The association of NMO with other autoimmune diseases was reported, but very few reports described association with autoimmune thyroid disease. Early differentiation between NMO and multiple sclerosis is very important as the natural course and treatment regimens differ significantly. We report a case of a 50-year-old woman who was admitted initially with vomiting, hiccups and paraesthesias but was not diagnosed with NMO and presented with a severe progression of the disease. The patient was also diagnosed to have autoimmune thyroiditis with lymphocytic infiltration of the thyroid which progressed from hyperthyroidism to hypothyroidism. NMO diagnosis was established with seropositivity for NMO-IgG and MRI showing longitudinally extensive spinal cord lesions (3 or more spinal segments). In spite of treatment, the response was poor due to lack of early diagnosis and aggressive immunosuppressant therapy.

  16. Autoimmune thyroiditis associated with neuromyelitis optica (NMO

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    Sudulagunta, Sreenivasa Rao

    2015-11-01

    Full Text Available Neuromyelitis optica (NMO or Devic’s syndrome is a rare relapsing demyelinating disease of the central nervous system (CNS that mainly affects the spinal cord and optic nerves and shares many clinical and radiological features with multiple sclerosis. The association of NMO with other autoimmune diseases was reported, but very few reports described association with autoimmune thyroid disease. Early differentiation between NMO and multiple sclerosis is very important as the natural course and treatment regimens differ significantly. We report a case of a 50-year-old woman who was admitted initially with vomiting, hiccups and paraesthesias but was not diagnosed with NMO and presented with a severe progression of the disease. The patient was also diagnosed to have autoimmune thyroiditis with lymphocytic infiltration of the thyroid which progressed from hyperthyroidism to hypothyroidism. NMO diagnosis was established with seropositivity for NMO-IgG and MRI showing longitudinally extensive spinal cord lesions (3 or more spinal segments. In spite of treatment, the response was poor due to lack of early diagnosis and aggressive immunosuppressant therapy.

  17. Autoimmune thyroid disease and chronic urticaria.

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    Monge, Cecilia; Demarco, Paul; Burman, Kenneth D; Wartofsky, Leonard

    2007-09-01

    We report six cases of autoimmune thyroid disease associated with chronic urticaria and briefly review the literature, including the histopathological nature of such lesions, and their aetiology and pathogenesis. In view of the prevalence of thyroid disease in patients with chronic urticaria, screening measurements of thyrotropin and anti-thyroperoxidase antibodies are recommended, although negative antibodies do not exclude a relationship between urticaria and thyroid autoimmunity. After failure of conventional therapy for urticaria, patients who are apparently clinically euthyroid may be considered for a trial with levothyroxine. Improvement of urticaria was seen with levothyroxine treatment in three of four patients with only marginal abnormalities in thyroid function.

  18. Environmental factors affecting autoimmune thyroid disease

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    Safran, M.; Paul, T.L.; Roti, E.; Braverman, L.E.

    1987-06-01

    A number of environmental factors affect the incidence and progression of autoimmune thyroid disease. Exposure to excess iodine, certain drugs, infectious agents and pollutants, and stress have all been implicated.

  19. Evaluation of autoimmune thyroid disease in melasma.

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    Rostami Mogaddam, Majid; Iranparvar Alamdari, Manouchehr; Maleki, Nasrollah; Safavi Ardabili, Nastaran; Abedkouhi, Selma

    2015-06-01

    Melasma is one of the most frequently acquired hyperpigmentation disorders clinically characterized by symmetrical brown patches on sun-exposed areas. To date, few studies have been conducted about the relationship between thyroid autoimmun-ity and melasma. To evaluate the thyroid dysfunction and autoimmunity in nonpregnant women with melasma. A total of 70 women with melasma and 70 age-matched healthy women with no history of melasma were enrolled in the study. We studied the thyroid hormone profile in both groups. The statistical analysis was performed using SPSS software. Patients with melasma had 18.5% frequency of thyroid disorders, and 15.7% had positive anti-TPO, while subjects from the control group had a 4.3% frequency of thyroid abnormalities, and only 5.7% had positive anti-TPO. There was a significantly higher prevalence of thyroid dysfunction in women with melasma compared with control group (P = 0.008). This study suggests that there is a relationship between thyroid autoimmunity and melasma. However, to make recommendations on screening for thyroid disease in patients with melasma, future research of good methodological quality is needed.

  20. Rheumatic and autoimmune thyroid disorders: a causal or casual relationship?

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    Bourji, Khalil; Gatto, Mariele; Cozzi, Franco; Doria, Andrea; Punzi, Leonardo

    2015-01-01

    A number of dysfunctions may affect the thyroid gland leading either to hyper- or hypothyroidism which are mediated by autoimmune mechanisms. Thyroid abnormalities may represent an isolated alteration or they may be the harbinger of forthcoming disorders as is the case of well-characterized polyendocrine syndromes. Also, they may precede or follow the appearance of rheumatic manifestations in patients affected with connective tissue diseases or rheumatoid arthritis. The mechanisms by which autoimmune thyroid disorders may be linked to systemic autoimmune diseases have not been fully unraveled yet, however alterations of common pathways are suggested by shared genetic variants affecting autoantigen presentation and regulation of the immune response. On the other hand, the higher prevalence of autoimmune thyroid disorders over rheumatic diseases compels the chance of a mere causal concomitancy in the same patient. The aim of our paper is to provide an overview of available data on thyroid involvement in different rheumatic diseases and to go over the main rheumatic manifestations in the context of autoimmune thyroid diseases.

  1. Thyroid volume in hypothyroidism due to autoimmune disease follows a unimodal distribution: evidence against primary thyroid atrophy and autoimmune thyroiditis being distinct diseases

    DEFF Research Database (Denmark)

    Carlé, Allan; Pedersen, Inge Bülow; Knudsen, Nils

    2009-01-01

    CONTEXT: Primary overt autoimmune hypothyroidism is often divided into primary idiopathic hypothyroidism with thyroid atrophy (Ord's disease) and hypothyroidism with goitre (Hashimoto's disease). OBJECTIVE: The aim of the present study was to characterize the two subtypes of disease. DESIGN...

  2. [Metabolic disorders and nutritional status in autoimmune thyroid diseases].

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    Kawicka, Anna; Regulska-Ilow, Bożena; Regulska-Ilow, Bożena

    2015-01-02

    In recent years, the authors of epidemiological studies have documented that autoimmune diseases are a major problem of modern society and are classified as diseases of civilization. Autoimmune thyroid diseases (ATDs) are caused by an abnormal immune response to autoantigens present in the thyroid gland - they often coexist with other autoimmune diseases. The most common dysfunctions of the thyroid gland are hypothyroidism, Graves-Basedow disease and Hashimoto's disease. Hashimoto's thyroiditis can be the main cause of primary hypothyroidism of the thyroid gland. Anthropometric, biochemical and physicochemical parameters are used to assess the nutritional status during the diagnosis and treatment of thyroid diseases. Patients with hypothyroidism are often obese, whereas patients with hyperthyroidism are often afflicted with rapid weight loss. The consequence of obesity is a change of the thyroid hormones' activity; however, weight reduction leads to their normalization. The activity and metabolic rate of thyroid hormones are modifiable. ATDs are associated with abnormalities of glucose metabolism and thus increased risk of developing diabetes mellitus type 1 and type 2. Celiac disease (CD) also increases the risk of developing other autoimmune diseases. Malnutrition or the presence of numerous nutritional deficiencies in a patient's body can be the cause of thyroid disorders. Coexisting deficiencies of such elements as iodine, iron, selenium and zinc may impair the function of the thyroid gland. Other nutrient deficiencies usually observed in patients suffering from ATD are: protein deficiencies, vitamin deficiencies (A, C, B6, B5, B1) and mineral deficiencies (phosphorus, magnesium, potassium, sodium, chromium). Proper diet helps to reduce the symptoms of the disease, maintains a healthy weight and prevents the occurrence of malnutrition. This article presents an overview of selected documented studies and scientific reports on the relationship of metabolic

  3. Expression of thyroid stimulating hormone β splice variant in thyroid of mouse with autoimmune thyroiditis

    Institute of Scientific and Technical Information of China (English)

    袁继红

    2014-01-01

    Objective To investigate the expression of marrowderived thyroid stimulating hormoneβ(TSHβ)splice variant in thyroid of mouse with autoimmune thyroiditis induced by thyroglobulin(Tg)immunization,and to analyze whether TSHβsplice variant participated in the pathological process of autoimmune thyroiditis.Methods Using random number table,forty-eight mice(24 females and 24 males)of 7 to 8 weeks old with body mass 20 to25 g were randomly divided into 4 groups(12 females

  4. Recent Advances in Autoimmune Thyroid Diseases

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    Won Sang Yoo

    2016-09-01

    Full Text Available Autoimmune thyroid disease (AITD includes hyperthyroid Graves disease, hypothyroid autoimmune thyroiditis, and subtle subclinical thyroid dysfunctions. AITD is caused by interactions between genetic and environmental predisposing factors and results in autoimmune deterioration. Data on polymorphisms in the AITD susceptibility genes, related environmental factors, and dysregulation of autoimmune processes have accumulated over time. Over the last decade, there has been progress in the clinical field of AITD with respect to the available diagnostic and therapeutic methods as well as clinical consensus. The updated clinical guidelines allow practitioners to identify the most reasonable and current approaches for proper management. In this review, we focus on recent advances in understanding the genetic and environmental pathogenic mechanisms underlying AITD and introduce the updated set of clinical guidelines for AITD management. We also discuss other aspects of the disease such as management of subclinical thyroid dysfunction, use of levothyroxine plus levotriiodothyronine in the treatment of autoimmune hypothyroidism, risk assessment of long-standing antithyroid drug therapy in recurrent Graves' hyperthyroidism, and future research needs.

  5. Recent Advances in Autoimmune Thyroid Diseases

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    Yoo, Won Sang

    2016-01-01

    Autoimmune thyroid disease (AITD) includes hyperthyroid Graves disease, hypothyroid autoimmune thyroiditis, and subtle subclinical thyroid dysfunctions. AITD is caused by interactions between genetic and environmental predisposing factors and results in autoimmune deterioration. Data on polymorphisms in the AITD susceptibility genes, related environmental factors, and dysregulation of autoimmune processes have accumulated over time. Over the last decade, there has been progress in the clinical field of AITD with respect to the available diagnostic and therapeutic methods as well as clinical consensus. The updated clinical guidelines allow practitioners to identify the most reasonable and current approaches for proper management. In this review, we focus on recent advances in understanding the genetic and environmental pathogenic mechanisms underlying AITD and introduce the updated set of clinical guidelines for AITD management. We also discuss other aspects of the disease such as management of subclinical thyroid dysfunction, use of levothyroxine plus levotriiodothyronine in the treatment of autoimmune hypothyroidism, risk assessment of long-standing antithyroid drug therapy in recurrent Graves' hyperthyroidism, and future research needs. PMID:27586448

  6. The immunogenetics of autoimmune diabetes and autoimmune thyroid disease.

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    Tomer, Y; Barbesino, G; Greenberg, D; Davies, T F

    1997-03-01

    Although medical genetics is a well-developed area of interest, relatively little is known about the diseases caused by the combination of many genes. These multiinfluenced diseases include the autoimmune endocrine diseases. Recent advances in the techniques for whole-genome screening have shown a variety of loci that are linked to the development of insulin-dependent diabetes mellitus, and similar data are likely to be soon generated in autoimmune thyroid disease. Here, the authors survey the current state of genetic knowledge in these two areas and describe the investigative and analytical techniques that are now available. (Trends Endocrinol Metab 1997;8:63-70). (c) 1997, Elsevier Science Inc.

  7. Noonan's Syndrome and Autoimmune Thyroiditis

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    Vesterhus, Per; Aarskog, Dagfinn

    1973-01-01

    Thyroid abnormalities were studies in seven boys and three girls, 4- to 17-years-old, with Noonan's syndrome, characterized by mental retardation, ocular anomalies (wide spaced eyes, drooped eye lids, or strabismus), heart lesions, characteristics of Turner's syndrome, and normal karyotypes (chromosome arrangement). (MC)

  8. [The role of hereditary and environmental factors in autoimmune thyroid diseases].

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    Balázs, Csaba

    2012-07-01

    Autoimmune thyroid diseases are the most common organ-specific autoimmune disorders affecting 5% to 10% of the population in Western countries. The clinical presentation varies from hyperthyroidism in Graves' disease to hypothyroidism in Hashimoto's thyroiditis. While the exact etiology of thyroid autoimmunity is not known, the interaction between genetic susceptibility and environmental factors appears to be of fundamental importance to initiate the process of thyroid autoimmunity. The identified autoimmune thyroid disease susceptibility genes include immune-modulating genes, such as the major histocompatibility complex, and thyroid-specific genes, including TSH receptor, thyroglobulin and thyroid peroxidase. The majority of the anti-TSH-receptor antibodies have a stimulating capacity and are responsible for hyperthyroidism. The anti-thyroglobulin- and anti-thyroid peroxidase antibodies belonging to the catalytic type of antibodies destroy the thyrocytes resulting in hypothyroidism. The appearance of anti-thyroid peroxidase antibodies precedes the induction of thyroiditis and the manifestation of hypothyroidism. The molecular analysis of thyroglobulin gene polymorphism is important in the mechanism of autoimmune thyroiditis. The autoantigen presentation by major histocompatibility complex molecules is a key point of the autoimmune mechanism. It has been shown that a HLA-DR variant containing arginine at position 74 of the DRβ1 chain confers a strong genetic susceptibility to autoimmune thyroid diseases, Graves' disease and Hashimoto's thyroiditis, while glutamine at position DRβ1-74 is protective. Human thyroglobulin 2098 peptide represents a strong and specific DRβ1-Arg74 binder, while a non-binding control peptide, thyroglobulin 2766 fails to induce this response. Moreover, thyroglobulin 2098 stimulated T-cells from individuals who were positive for thyroglobulin antibodies, demonstrating that thyroglobulin 2098 is an immunogenic peptide capable of being

  9. [Thyroiditis].

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    Buffet, Camille; Groussin, Lionel

    2013-02-01

    The diagnosis of thyroiditis encompasses a broad spectrum of thyroid disorders. Analysis of signs and symptoms, biochemical changes, neck ultrasound characteristics and radioactive iodine uptake values allows an accurate diagnosis. Recent studies of the whole genome have helped to identify many susceptibility genes for autoimmune thyroiditis. However, none of these genes contribute to a significant increase in risk of developing this thyroiditis. Clinical awareness of the characteristic presentations of exceptional thyroiditis (acute suppurative thyroiditis, Riedel's thyroiditis) is an important issue. Selenium administration seems to be beneficial for reducing the incidence of thyroiditis. Finally, certain drug-induced thyroiditis remains a therapeutic challenge for the physician.

  10. Relation between chronic urticaria and thyroid autoimmunity

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    M. Nabavi

    2008-01-01

    Full Text Available AbstractBackground and Purpose: chronic urticaria is a tormenter and does not have a known etiology. Association between chronic urticaria and thyroid auto-immunity has shown different results. The aim of this study is to evaluate the effect of Levo-thyroxine on the chronic urticaria and association between chronic urticaria with thyroid auto-immunity.Materials and Methods: In a prospective case-control study, we compared the frequency of thyroid auto antibodies in 60 patients (all females, with exception of six males, ages 15 to 60 years with chronic urticaria and compared with 60 mached age healthy volunteers. All cases with chronic urticaria and control group were normal CBC, antinuclear antibodies, rheumatoid factors, complement, stool exam, liver function test (LFT, kidney function and skin prick test, prior to being referred to us. We performed thyroid auto antibodies, thyroid hormones and IgE antibodies before treating all subjects. Half of them with positive anti-thyroid antibody (n=11, received Levo-thyroxine (100 μg daily for 1 month and the remaining half (n=11 were control group.Results: The frequency of thyroid auto antibodies was significantly higher in patients with chronic urticaria than in healthy control (36.6% vs. 9%; p<0.01.( All patients were euthyroid, however, one was found to have increased anti-thyroid antibody levels with sub clinical hypothyroidism (TSH increased, low T4. Total serum IgE increased in ten cases of patients group (16.6% compared with six control groups (10%. Nine patients (40% had complete response, five patients (30% had partial response and five patients (30% did not show any response to treatment compared with control group, in which complete and partial resolution was 30% and others with no resolution.Conclusion: chronic urticaria may be associated with thyroid disorders (positive anti- thyroid antibodies despite normal thyroid function test. For chronic urticaria despite increase serum IgE level

  11. Challenges in Interpretation of Thyroid Function Tests in Pregnant Women with Autoimmune Thyroid Disease

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    Ulla Feldt-Rasmussen

    2011-01-01

    Full Text Available Physiological changes during gestation are important to be aware of in measurement and interpretation of thyroid function tests in women with autoimmune thyroid diseases. Thyroid autoimmune activity is decreasing in pregnancy. Measurement of serum TSH is the first-line screening variable for thyroid dysfunction also in pregnancy. However, using serum TSH for control of treatment of maternal thyroid autoimmunity infers a risk for compromised foetal development. Peripheral thyroid hormone values are highly different among laboratories, and there is a need for laboratory-specific gestational age-related reference ranges. Equally important, the intraindividual variability of the thyroid hormone measurements is much narrower than the interindividual variation (reflecting the reference interval. The best laboratory assessment of thyroid function is a free thyroid hormone estimate combined with TSH. Measurement of antithyroperoxidase and/or TSH receptor antibodies adds to the differential diagnosis of autoimmune and nonautoimmune thyroid diseases.

  12. Age impact on autoimmune thyroid disease in females

    Science.gov (United States)

    Stoian, Dana; Craciunescu, Mihalea; Timar, Romulus; Schiller, Adalbert; Pater, Liana; Craina, Marius

    2013-10-01

    Thyroid autoimmune disease, a widespread phenomenon in female population, impairs thyroid function during pregnancy. Identifying cases, which will develop hypothyroidism during pregnancy, is crucial in the follow-up process. The study group comprised 108 females, with ages between 20-40 years; with known inactive autoimmune thyroid disease, before pregnancy that became pregnant in the study follow-up period. They were monitored by means of clinical, hormonal and immunological assays. Supplemental therapy with thyroid hormones was used, where needed. Maternal age and level of anti-thyroid antibodies were used to predict thyroid functional impairment.

  13. The chronic autoimmune thyroiditis quality of life selenium trial (CATALYST)

    DEFF Research Database (Denmark)

    Winther, Kristian Hillert; Watt, Torquil; Bjørner, Jakob Bue;

    2014-01-01

    BACKGROUND: Patients with chronic autoimmune thyroiditis have impaired health-related quality of life. The thyroid gland has a high selenium concentration, and specific selenoprotein enzyme families are crucial to immune function, and catalyze thyroid hormone metabolism and redox processes...... in thyroid cells. Previous randomized controlled trials have found that selenium supplementation decreases thyroid-disease-specific antibody levels. We hypothesize that selenium might be beneficial in the treatment of chronic autoimmune thyroiditis. METHODS/DESIGN: The CATALYST trial is an investigator......-initiated randomized, blinded, multicentre clinical trial of selenium supplementation versus placebo in patients with chronic autoimmune thyroiditis. Inclusion criteria: age ≥18 years; serum thyroid peroxidase antibody level ≥100 IU/ml within the previous 12 months; treatment with levothyroxine and written informed...

  14. Challenges in interpretation of thyroid function tests in pregnant women with autoimmune thyroid disease

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Bliddal, Sofie; Rasmussen, Åse Krogh;

    2011-01-01

    Physiological changes during gestation are important to be aware of in measurement and interpretation of thyroid function tests in women with autoimmune thyroid diseases. Thyroid autoimmune activity is decreasing in pregnancy. Measurement of serum TSH is the first-line screening variable for thyr......Physiological changes during gestation are important to be aware of in measurement and interpretation of thyroid function tests in women with autoimmune thyroid diseases. Thyroid autoimmune activity is decreasing in pregnancy. Measurement of serum TSH is the first-line screening variable......-related reference ranges. Equally important, the intraindividual variability of the thyroid hormone measurements is much narrower than the interindividual variation (reflecting the reference interval). The best laboratory assessment of thyroid function is a free thyroid hormone estimate combined with TSH...

  15. Case presentationthyroid lymphoma

    Directory of Open Access Journals (Sweden)

    Belkisa Izić

    2011-11-01

    Full Text Available Malignant tumors of the thyroid gland account for about 1% of thenewly diagnosed malignant tumors each year, and their incidence inwomen is twice the incidence in men. According to the WHO classification (2004 thyroid tumors are divided into: carcinoma of the thyroid, adenoma and similar tumors, and other thyroid tumors which include: teratomas, angiosarcomas, paragangliomas and others, as well as primary lymphomas and plasmacytomas. Primary thyroid lymphomasare defined as lymphomas which originate in the thyroid gland. This study presents the case of a 68-year-old patient with a thyroid lymphoma, which caused compression of the airways. In the patientpresented there was reduced activity of the thyroid gland. The dominant symptoms were: breathing difficulties, hoarse voice and the enlargement of the thyroid. An ultrasound examination was performedbefore surgery on the neck, which showed a multinodular thyroid,with compromised and compressed trachea to the right and rear. Anemergency surgical procedure was performed to reduce the tumor.Pathohistological diagnosis confirmed diffuse large B cell lymphoma.The aim of the study was to present a patient with a thyroid lymphoma, who had previously not had any immunological changes to the gland,that is, she had not had any chronic lymphocyte thyroiditis, but due to the compressive syndrome it was necessary to perform an emergencysurgical procedure to reduce the tumor.

  16. Autoimmunity in differentiated thyroid cancer: significance and related clinical problems

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Rasmussen, Ase Krogh

    2010-01-01

    Coexistence of differentiated thyroid cancer (DTC) and thyroid autoimmune diseases could represent a mere coincidence due to the frequent occurrence of autoimmunity, but there may also be a pathological and causative link between the two conditions. The coincidence of DTC with Hashimoto's disease...... has been variably reported at between 0.5 and 22.5% and of DTC with Graves' disease between 0 and 9.8%. In this review available evidence for thyroid autoimmunity in DTC is summarized and it is concluded that thyroid cancer does coexist with thyroid autoimmunity, implying that patients treated...... TgAb measurements may be used as a surrogate marker for recurrence of thyroid cancer during the long-term monitoring of DTC patients....

  17. Autoimmunity in differentiated thyroid cancer: significance and related clinical problems

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Rasmussen, Ase Krogh

    2011-01-01

    Coexistence of differentiated thyroid cancer (DTC) and thyroid autoimmune diseases could represent a mere coincidence due to the frequent occurrence of autoimmunity, but there may also be a pathological and causative link between the two conditions. The coincidence of DTC with Hashimoto's disease...... has been variably reported at between 0.5 and 22.5% and of DTC with Graves' disease between 0 and 9.8%. In this review available evidence for thyroid autoimmunity in DTC is summarized and it is concluded that thyroid cancer does coexist with thyroid autoimmunity, implying that patients treated...... TgAb measurements may be used as a surrogate marker for recurrence of thyroid cancer during the long-term monitoring of DTC patients....

  18. Primary biliary cirrhosis--autoimmune hepatitis overlap syndrome associated with dermatomyositis, autoimmune thyroiditis and antiphospholipid syndrome.

    Science.gov (United States)

    Pamfil, Cristina; Candrea, Elisabeta; Berki, Emese; Popov, Horațiu I; Radu, Pompilia I; Rednic, Simona

    2015-03-01

    Autoimmune liver diseases may be associated with extrahepatic autoimmune pathology. We report the case of a 52-year old woman who initially presented to the gastroenterology department for extreme fatigue, pale stools, dark urine and pruritus. Laboratory tests showed significant cholestasis and elevation of aminotransferase levels. Immunological tests revealed positive antinuclear (ANA=1:320) and antimitochondrial antibodies (AMA=1:40) with negative anti-smooth muscle and liver kidney microsomal type 1 antibodies. The biopsy was compatible with overlap syndrome type 1. The patient was commenced on immunosuppressive therapy according to standard of care (azathioprine 50mg, ursodeoxycholic acid and prednisone 0.5mg/kg), with moderate biochemical improvement. She subsequently developed proximal symmetrical weakness and cutaneous involvement and was diagnosed with biopsy-proven dermatomyositis. The immunosuppressive regimen was intensified to 150 mg azathioprine. At the three-month follow-up, her symptoms subsided and aminotransferases and muscle enzymes normalized. Upon further investigation the patient was diagnosed with autoimmune thyroiditis and antiphospholipid syndrome. To our knowledge, this is the first case of primary biliary cirrhosis - autoimmune hepatitis overlap syndrome associated with dermatomyositis, autoimmune thyroiditis and antiphospholipid syndrome.

  19. Prevalence and clinical features of celiac disease in patients with autoimmune thyroiditis: cross-sectional study

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    Aline Ventura

    Full Text Available CONTEXT AND OBJECTIVE: Celiac disease is an autoimmune disorder with an average prevalence of 1% in Europe and the United States. Because of strong European ancestry in southern Brazil, this study aimed to evaluate the seroprevalence of celiac disease among autoimmune thyroiditis patients.DESIGN AND SETTING: Cross-sectional study in a public university hospital.METHODS: This cross-sectional prevalence study included autoimmune thyroiditis patients who were tested for anti-endomysial and anti-transglutaminase antibodies between August 2010 and July 2011.RESULTS: Fifty-three patients with autoimmune thyroiditis were included; 92.5% were women, with mean age of 49.0 ± 13.5 years. Five patients (9.3% were serologically positive for celiac disease: three of them (5.6% were reactive for anti-endomysial antibodies and two (3.7% for anti-transglutaminase. None of them exhibited anemia and one presented diarrhea. Endoscopy was performed on two patients: one with normal histology and the other with lymphocytic infiltrate and villous atrophy.CONCLUSION: The prevalence of celiac disease among patients with autoimmune thyroid disease was 9.3%; one patient complained of diarrhea and none presented anemia. Among at-risk populations, like autoimmune thyroiditis patients, the presence of diarrhea or anemia should not be used as a criterion for indicating celiac disease investigation. This must be done for all autoimmune thyroiditis patients because of its high prevalence.

  20. Celiac Disease Autoimmunity in Patients with Autoimmune Diabetes and Thyroid Disease among Chinese Population.

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    Zhiyuan Zhao

    Full Text Available The prevalence of celiac disease autoimmunity or tissue transglutaminase autoantibodies (TGA amongst patients with type 1 diabetes (T1D and autoimmune thyroid disease (AITD in the Chinese population remains unknown. This study examined the rate of celiac disease autoimmunity amongst patients with T1D and AITD in the Chinese population. The study included 178 patients with type 1 diabetes and 119 with AITD where 36 had both T1D and AITD, classified as autoimmune polyglandular syndrome type 3 variant (APS3v. The study also included 145 patients with type 2 diabetes (T2D, 97 patients with non-autoimmune thyroid disease (NAITD, and 102 healthy controls. Serum islet autoantibodies, thyroid autoantibodies and TGA were measured by radioimmunoassay. TGA positivity was found in 22% of patients with either type 1 diabetes or AITD, much higher than that in patients with T2D (3.4%; p< 0.0001 or NAITD (3.1%; P < 0.0001 or healthy controls (1%; p<0.0001. The patients with APS3v having both T1D and AITD were 36% positive for TGA, significantly higher than patients with T1D alone (p = 0.040 or with AITD alone (p = 0.017. T1D and AITD were found to have a 20% and 30% frequency of overlap respectively at diagnosis. In conclusion, TGA positivity was high in the Chinese population having existing T1D and/or AITD, and even higher when both diseases were present. Routine TGA screening in patients with T1D or AITD will be important to early identify celiac disease autoimmunity for better clinical care of patients.

  1. Family History of Autoimmune Thyroid Disease

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    O D Rymar

    2013-12-01

    Full Text Available The aim of this study was estimate the clinical characteristics of Graves' disease (GD and Hashimoto's thyroiditis (HT in first@degree relatives of persons in families with autoimmune thyroid diseases (AITD. Patients: Eighty one patients with AITD of 40 families, mean age (+/@s.d. 41.9 ± 1.8; range 18-73 years. In 10 families (25% AITD traced among siblings, whose average age was 33.6 ± 3.5 years, 29 families (72.5% - of two generations (parent@ descendant 57.4 ± 1.6 and 32.2 ± 1.5 years, p = 0.001, respectively. In one family (2.5% the disease was traced in both parents and their offspring. Results. Among patients with a positive family history for AITD is dominated by a pair of parent - descendant with a diagnosis of hypothyroidism (55%. Preliminary evidence of genetic anticipation in GD and HT. Patients with a family history of AITD ill of GD and HT to 50 years (84%, half - up to 30 years (47%. In familial forms of GD, a decrease in compensated patients for two generations. Among parents and descendant with hypothyroidism, there is a low percentage of persons over the medical euthyroidism (42%.

  2. Chronic thyroiditis (Hashimoto disease)

    Science.gov (United States)

    Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis; Chronic autoimmune thyroiditis; Lymphadenoid goiter - Hashimoto; Hypothyroidism - Hashimoto; Type 2 polyglandular autoimmune ...

  3. Clinical and Pathological Implications of Concurrent Autoimmune Thyroid Disorders and Papillary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    L. L. Cunha

    2011-01-01

    Full Text Available Cooccurrences of chronic lymphocytic thyroiditis (CLT and thyroid cancer (DTC have been repeatedly reported. Both CLT and DTC, mainly papillary thyroid carcinoma (PTC, share some epidemiological and molecular features. In fact, thyroid lymphocytic inflammatory reaction has been observed in association with PTC at variable frequency, although the precise relationship between the two diseases is still debated. It also remains a matter of debate whether the association with a CLT or even an autoimmune disorder could influence the prognosis of PTC. A better understanding about clinical implications of autoimmunity in concurrent thyroid cancer could raise new insights of thyroid cancer immunotherapy. In addition, elucidating the molecular mechanisms involved in autoimmune disease and concurrent cancer allowed us to identify new therapeutic strategies against thyroid cancer. The objective of this article was to review recent literature on the association of these disorders and its potential significance.

  4. The immunopathogenesis of chronic autoimmune thyroiditis one century after hashimoto.

    Science.gov (United States)

    Weetman, Anthony P

    2013-01-01

    Hakaru Hashimoto described 4 patients with a hitherto unknown cause for goitre, struma lymphomatosa, a century ago. He was careful to distinguish this from Riedel thyroiditis but it has become clear that fibrosis and atrophy of the thyroid are indeed components of Hashimoto thyroiditis, and in rare cases IgG4-related sclerosing disease may be an outcome. Although the cause of the lymphocytic infiltration was unknown to Hashimoto, we now know through the pioneering studies of N.R. Rose and E. Witebsky [J Immunol 1956;76:417-427] that this condition is the archetype for autoimmune destruction as a disease mechanism. In the last two decades in particular, there has been huge interest in unravelling the genetic basis for this and related autoimmune disorders. The list of polymorphisms associated with autoimmune thyroid disease grows each year, and in the case of vitiligo, which is frequently found in association with thyroid autoimmunity, we know that 27 separate susceptibility loci account for less than 20% of the heritability of this condition. Environmental and existential factors may turn out to be just as complex in number and in interactions. We can thus imagine a 'Swiss cheese' model for the causation of autoimmune thyroid disease, in which the effects of cumulative weaknesses line up - like the holes in slices of cheese - to allow the catastrophic event of autoimmune destruction to occur.

  5. Reactivity of anti-thyroid antibodies to thyroglobulin tryptic fragments: comparison of autoimmune and non-autoimmune thyroid diseases

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    Boechat L.H.B.

    1999-01-01

    Full Text Available Studies concerning the antigenicity of thyroglobulin fragments allow the characterization of the epitopes but do not consider the role of heavier antigenic fragments that could result in vivo from the action of endoproteases. Here we assess the relative importance of the fragments obtained from thyroglobulin by limited proteolysis with trypsin and compare by immunoblotting their reactivity to serum from patients with autoimmune (Graves' disease and Hashimoto's thyroiditis and non-autoimmune (subacute thyroiditis disease. The results showed no difference in frequency of recognition of any peptide by sera from patients with autoimmune thyroiditis. In contrast, sera from patients with subacute thyroiditis reacted more frequently with a peptide of 80 kDa. These results suggest the presence of antibody subpopulations directed at fragments produced in vivo by enzymatic cleavage of thyroglobulin. This fragment and antibodies to it may represent markers for subacute thyroiditis.

  6. Thyroid nodules and thyroid autoimmunity in the context of environmental pollution.

    Science.gov (United States)

    Benvenga, Salvatore; Antonelli, Alessandro; Vita, Roberto

    2015-12-01

    Evidence suggests that in most industrialized countries autoimmune disorders, including chronic lymphocytic thyroiditis, are increasing. This increase parallels the one regarding differentiated thyroid cancer, the increment of which is mainly due to the papillary histotype. A number of studies have pointed to an association between chronic lymphocytic thyroiditis and differentiated thyroid cancer. The upward trend of these two thyroid diseases is sustained by certain environmental factors, such as polluting substances acting as endocrine disrupting chemicals. Herein we will review the experimental and clinical literature that highlights the effects of environmental and occupational exposure to polluting chemicals in the development of autoimmune thyroid disease or differentiated thyroid cancer. Stakeholders, starting from policymarkers, should become more sensitive to the consequences for the thyroid resulting from exposure to EDC. Indeed, the economic burden resulting from such consequences has not been quantified thus far.

  7. Pitfalls in cytological diagnosis of autoimmune thyroiditis.

    Science.gov (United States)

    Kumarasinghe, M P; De Silva, S

    1999-02-01

    The aims of this study are to document pitfalls in cytologic diagnosis of autoimmune thyroiditis (AT) and highlight possible ways to minimize them. One hundred consecutive thyroid aspirates with features diagnostic or suggestive of AT, performed and reported by the first author, were included in the study. Follow-up was traced and cytologic features responsible for indecisiveness were re-assessed in those reported as suggestive of AT. The features were then correlated with the results of serologic and thyroid function tests and clinical features, and an attempt was made to amend the final diagnosis using an integrated approach. Seventy eight were diagnostic and 22 were suggestive of AT. In the latter 22, features responsible for the indecisiveness were: cytologic atypia, in the form of nuclear enlargement, irregularity and grooves and altered chromatin texture, in 14 (64%); nucleoli with suspicion of a coexisting neoplasm in three (13.6%), two of which showed epithelial preponderance, crowding and discohesion; sparse inflammation in four (18%); a predominant lymphoid population without epithelial cells resembling a reactive lymph node in one (4.5%); co-existing toxic features in two (9%); and scanty smears in one (4.5%). Eighteen of the 22 suspected of AT had follow-up. Six had been assessed histologically; three with features suspicious of a neoplasm were diagnosed respectively as a papillary carcinoma (PC), Hurthle cell carcinoma (HCC) and a multinodular goitre (MNG) with degenerate changes. The other three were confirmed as AT; one with cytologic atypia, one with sparse inflammation and the third as cytologically resembling a reactive lymphnode. In ten of the remaining 12, the final diagnosis could be revised following an integrated approach with possible reduction of the indecisiveness. Potential pitfalls are: cytologic atypia occurring in AT; abundance or scarcity of background inflammation; low cell yield; and co-existing toxicity and malignancies. Epithelial

  8. Presumed Isotretinoin-Induced, Concomitant Autoimmune Thyroid Disease and Ocular Myasthenia Gravis: A Case Report

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    Huseyin Gursoy

    2012-11-01

    Full Text Available Introduction: There are many adverse effects that have been described for isotretinoin. To the best of our knowledge, this is the first report of a possible association of oral isotretinoin intake with autoimmune thyroiditis and ocular myasthenia gravis (OMG. Case Presentation: A 19-year-old Caucasian male, who had used oral isotretinoin for severe acne disease for the previous six months, was referred to our clinic. He had a three-week history of diplopia and variable bilateral ptosis. Physical examination showed moderate periorbital edema and limitations of up- and down-gaze in the left eye. Laboratory findings and thyroid ultrasound were consistent with autoimmune thyroiditis. Antithyroid therapy did not relieve the clinical symptoms. Concomitant OMG was suspected. Variable ptosis and a positive response to oral prednisolone of 40 mg/day and pyridostigmine of 360 mg/day supported the diagnosis of concomitant autoimmune thyroiditis and OMG. Conclusion: Autoimmune disorders may be triggered by oral isotretinoin treatment. Clinicians prescribing isotretinoin should be aware of the possible association between isotretinoin intake and concomitant autoimmune thyroiditis and OMG.

  9. Dendritic cells and veiled accessory macrophages : hormonal influences and autoimmune thyroid disease

    NARCIS (Netherlands)

    M.O. Canning (Martha)

    2005-01-01

    textabstractImmune responses to thyroid specific autoantigens form the basis of autoimmune thyroid disease pathogenesis. Two polar forms of autoimmune reactivity of the thyroid gland exist in this disease spectrum: a catabolic form characterized by gradual inflammatory destruction of thyroid parench

  10. Time for the endocrinologists to expand their awareness of and contribution to the diagnosis and management of encephalopathy associated with autoimmune thyroid disease.

    LENUS (Irish Health Repository)

    Tamagno, Gianluca

    2011-01-01

    Encephalopathy associated with autoimmune thyroid disease is a rare condition presenting in the setting of autoimmune thyroid disease and characterized by unspecific neurological and\\/or psychiatric symptoms. Bearing in mind the currently prevailing lack of consensus on the most appropriate nomenclature and diagnostic criteria for this condition and the implications that this lack undeniably has on clinical practice, it is obvious that an international and multidisciplinary agreement among clinicians should arrive at the most appropriate definition and terminology of encephalopathy occurring in patients with autoimmune thyroid disease. Concomitantly, efforts must be made to uncover the pathogenetic link between thyroid autoimmunity and the occurrence of encephalopathy.

  11. Time for the endocrinologists to expand their awareness of and contribution to the diagnosis and management of encephalopathy associated with autoimmune thyroid disease.

    LENUS (Irish Health Repository)

    Tamagno, Gianluca

    2012-02-01

    Encephalopathy associated with autoimmune thyroid disease is a rare condition presenting in the setting of autoimmune thyroid disease and characterized by unspecific neurological and\\/or psychiatric symptoms. Bearing in mind the currently prevailing lack of consensus on the most appropriate nomenclature and diagnostic criteria for this condition and the implications that this lack undeniably has on clinical practice, it is obvious that an international and multidisciplinary agreement among clinicians should arrive at the most appropriate definition and terminology of encephalopathy occurring in patients with autoimmune thyroid disease. Concomitantly, efforts must be made to uncover the pathogenetic link between thyroid autoimmunity and the occurrence of encephalopathy.

  12. THYROID ASSOCIATED ORBITOPATHY – UNILATERAL PRESENT ATION

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    Padmini

    2013-04-01

    Full Text Available ABSTRACT: Thyroid-associated orbitopathy (TAO, frequently te rmed Graves ophthalmopathy, is part of an autoimmune process that can affect the orbital and periorbital tissue, the thyroid gland, and, rarely, the pretibial skin or digits (th yroid acropachy, Although the use of the term thyroid ophthalmopathy is pervasive, the disease proce ss is actually an orbitopathy in which the orbital and periocular soft tissues are primarily af fected with secondary effects on the eye. Thyroid orbitopathy (TO is most prevalent among fema les in the fourth and fifth decades and is usually associated with thyroid dysfunction. Thyroi d-associated orbitopathy may precede, coincide, or follow the systemic complications of dy sthyroidism. The ocular manifestations of thyroid-associated orbitopathy include eyelid retrac tion, proptosis, chemosis, periorbital edema, and altered ocular motility with significant functional, social, and cosmetic consequences. we describe a unique case of unilater al exophthalmos in a young male patient.

  13. Ultrasound sonoelastography in the evaluation of thyroiditis and autoimmune thyroid disease.

    Science.gov (United States)

    Ruchała, Marek; Szmyt, Krzysztof; Sławek, Sylwia; Zybek, Ariadna; Szczepanek-Parulska, Ewelina

    2014-01-01

    Sonoelastography (USE) is a constantly evolving imaging technique used for the noninvasive and objective estimation of tissue stiffness. Several USE methods have been developed, including Quasi-Static or Strain Elastography and Shear Wave Elastography. The utility of USE has been demonstrated in differentiating between malignant and benign thyroid lesions. Recently, USE has been applied in the evaluation of thyroiditis and autoimmune thyroid disease (AITD).Thyroid inflammatory illnesses constitute a diverse group of diseases and may manifest various symptoms. These conditions may share some parallel clinical, biochemical, and ultrasonographic features, which can lead to diagnostic difficulties. USE may be an additional tool, supporting other methods in the diagnosis and treatment monitoring of thyroid diseases, other than thyroid nodular disease.The aim of this article was to analyse and summarise the available literature on the applicability of different elastographic techniques in the diagnosis, differentiation and monitoring of various types of thyroiditis and AITD. Advantages and limitations of this technique are also discussed.

  14. IL-1β and TSH disturb thyroid epithelium integrity in autoimmune thyroid diseases.

    Science.gov (United States)

    Rebuffat, Sandra A; Kammoun-Krichen, Maha; Charfeddine, Ilhem; Ayadi, Hammadi; Bougacha-Elleuch, Noura; Peraldi-Roux, Sylvie

    2013-03-01

    Pro-inflammatory cytokines such as IL-1β and TNFα are known to affect thyroid function. They stimulate IL-6 secretion and modify epithelium integrity by altering junction proteins. To study the role of cytokines on thyroid epithelia tightness in autoimmune thyroid diseases (AITD), we analyzed the expression profiles of junction proteins (ZO-1, Claudin, JAM-A) and cytokines in human thyroid slices and also investigated the effect of IL-1β on the epithelium integrity in primary cultures of human thyrocytes. Junction proteins expression (ZO-1, Claudin, JAM-A) has been analyzed by immunohistochemistry on thyroid slices and by Western blot on membrane proteins extracted from thyrocytes of patients suffering from Graves and Hashimoto diseases. The high expression of junction proteins we found on Graves' disease thyroid slices as well as in cell membrane extracts acknowledges the tightness of thyroid follicular cells in this AITD. In contrast, the reduced expression of JAM and ZO-1 in thyroid cells from patients suffering from Hashimoto thyroiditis is in agreement with the loss of thyroid follicular cell integrity that occurs in this pathology. Concerning the effects on epithelium integrity of TSH and of the pro-inflammatory cytokine IL-1β in primary cultures of human thyroid cells, TSH appeared able to modify JAM-A localization but without any change in the expression levels of JAM-A, Claudin and ZO-1. Inversely, IL-1β provoked a decrease in the expression of- and a redistribution of both, Claudin and ZO-1 without modifying the expression and sub-cellular distribution patterns of JAM-A in thyroid cells. These results demonstrate (i) that Hashimoto's- and Graves' diseases display different junction proteins expression patterns with a loss of epithelium integrity in the former and (ii) that IL-1β modifies thyroid epithelial tightness of human thyrocytes by altering the expression and localization of junction proteins. Therefore, IL-1β could play a role in the

  15. Long-term follow-up of seven patients with ophthalmopathy not associated with thyroid autoimmunity: heterogeneity of autoimmune ophthalmopathy

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    McCorquodale T

    2012-07-01

    smokers (eight out of 13 versus none out of seven.Conclusions: Earlier studies suggesting that patients with EGD eventually develop thyroid dysfunction have not been confirmed here, although follow-up continues, and the possibility that such patients have had thyroid autoimmunity in the past, or that they will develop it in the future cannot be excluded. Overall, it is likely that the ophthalmopathy associated with Graves' hyperthyroidism is the same disease as that observed in patients – such as those reported here – in whom thyroid dysfunction and thyroid autoimmunity are not present during the period of follow-up. The role of autoimmunity against the TSH-r in euthyroid patients with ophthalmopathy has not been proven and the significance of the orbital antibodies is unclear.Keywords: ophthalmopathy, thyroid eye disease, collagen XIII, calsequestrin, euthyroid Graves' disease

  16. Postpartum thyroiditis and autoimmune thyroiditis in women of childbearing age: recent insights and consequences for antenatal and postnatal care

    NARCIS (Netherlands)

    A.F. Muller (Alex); H.A. Drexhage (Hemmo); A. Berghout (Arie)

    2001-01-01

    textabstractPostpartum thyroiditis is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery and based on an autoimmune inflammation of the thyroid. The prevalence ranges from 5-7%. We discuss the role of antibodies (especially thyroid p

  17. Pre-autoimmune thyroid abnormalities in the biobreeding diabetes-prone (BB-DP) rat: a possible relation with the intrathyroid accumulation of dendritic cells and the initiation of the thyroid autoimmune response

    NARCIS (Netherlands)

    P.J. Simons (Peter); F.G. Delemarre; P.H. Jeucken; H.A. Drexhage (Hemmo)

    1998-01-01

    textabstractThyroid autoimmune reactions start with an accumulation of mainly dendritic cells in the thyroid. There is increasing evidence that, apart from being antigen-presenting cells, they are also able to control the growth and hormone synthesis of neighbouring end

  18. High Prevalence of Antinuclear Antibodies in Children with Thyroid Autoimmunity

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    Maria Segni

    2014-01-01

    Full Text Available Background. Antinuclear antibodies (ANA are a hallmark of many autoimmune diseases and can be detected many years before disease onset. Autoimmune thyroid diseases (AITD are frequently associated with other organ- and non-organ-specific autoimmune disorders. Objectives. To assess the prevalence of ANA in pediatric patients with AITD and their clinical correlations. Methods. Ninety-three consecutive pediatric patients with AITD were enrolled (86 children with chronic lymphocytic thyroiditis and 7 with Graves’ disease. ANA, anti-double DNA (anti-dsDNA antibodies, anti-extractable nuclear antigen (anti-ENA, anti-cyclic citrullinated peptide antibodies (anti-CCP, and rheumatoid factor (RF was obtained. Signs and symptoms potentially related to rheumatic diseases in children were investigated by a questionnaire. Results. ANA positivity was found in 66/93 children (71%, anti-ENA in 4/93 (4.3%, anti-dsDNA in 1/93 (1.1%, RF in 3/93 (3.2%, and anti-CCP in none. No significant differences were found between the ANA-positive and ANA-negative groups with respect to age, sex, L-thyroxine treatment, or prevalence of other autoimmune diseases. Overall, parental autoimmunity was found in 23%. Conclusions. ANA positivity was demonstrated in 71% of children with AITD. ANA positivity was not related to overt immune-rheumatic diseases. However, because the positivity of ANA can occur even many years before the onset of systemic autoimmune diseases, prospective studies are warranted.

  19. Granuloma Annulare, Autoimmune Thyroiditis, and Lichen Sclerosus in a Woman: Randomness or Significant Association?

    OpenAIRE

    Mariele De Paola; Anastasia Batsikosta; Luca Feci; Mattia Benedetti; Roberta Bilenchi

    2013-01-01

    We report a 60-year-old Caucasian female with a 2-year history of diffused granuloma annulare (GA), who presented for the simultaneous occurrence of genital lichen sclerosus (LS) and autoimmune thyroiditis (AT). In our opinion this combination is not just coincidental but may share similar immunopathological mechanisms.

  20. Granuloma Annulare, Autoimmune Thyroiditis, and Lichen Sclerosus in a Woman: Randomness or Significant Association?

    Directory of Open Access Journals (Sweden)

    Mariele De Paola

    2013-01-01

    Full Text Available We report a 60-year-old Caucasian female with a 2-year history of diffused granuloma annulare (GA, who presented for the simultaneous occurrence of genital lichen sclerosus (LS and autoimmune thyroiditis (AT. In our opinion this combination is not just coincidental but may share similar immunopathological mechanisms.

  1. Association of Chronic Urticaria and / or Angioedema with Thyroid Autoimmunity

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    M Amini

    2004-10-01

    Full Text Available Introduction: Auto – immune disorders have been implicated as a cause for chronic uricaria and/ or angioedema and thyroid autoimmunity has been increasingly introduced to be associated with that. This study explores the association of thyroid autoimmunity with chronic urticaria and / or angioedema in Isfahani patients. Methods: Anti – thyroperoxidase (Ani – TPO and anti – thyroglobulin (Anti – Tg antibodies, T4 and TSH were detected in 57 patients with chronic urticaria and / or angioedema and were compared with that of normal subjects without chronic urticaria or other autoimmune diseases. Results: Anti – TPO and Anti – Tg antibodies had been increased in 26 (45.6% and 28 (49% of patients in case group, as compared to 8 (13.2% and 10 (16.7% of subjects in control group, respectively. In total, raised titers of thyroid autoantibodies were found in 34 (60% and 12 (20% of subjects in case and control groups, respectively. Conclusion: Considering the high prevalence of thyroid autoantibodies in patients with chronic urticaria and / or angioedema, these antibodies should be detected in affected patients, specially in young and middle– aged women.

  2. Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes

    Directory of Open Access Journals (Sweden)

    Lee Byung I

    2010-04-01

    Full Text Available Abstract Background The encephalopathy associated with autoimmune thyroid disease (EAATD is characterized by neurological/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto's thyroiditis (HT, although fourteen EAATD patients with Graves' disease (GD have been also reported. Methods We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. Results Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. Conclusions GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

  3. Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes.

    LENUS (Irish Health Repository)

    Tamagno, Gianluca

    2012-02-01

    BACKGROUND: The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological\\/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto\\'s thyroiditis (HT), although fourteen EAATD patients with Graves\\' disease (GD) have been also reported. METHODS: We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. RESULTS: Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. CONCLUSIONS: GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

  4. Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes

    LENUS (Irish Health Repository)

    Tamagno, Gianluca

    2010-04-28

    Abstract Background The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological\\/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto\\'s thyroiditis (HT), although fourteen EAATD patients with Graves\\' disease (GD) have been also reported. Methods We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. Results Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. Conclusions GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

  5. Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes.

    LENUS (Irish Health Repository)

    Tamagno, Gianluca

    2010-01-01

    BACKGROUND: The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological\\/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto\\'s thyroiditis (HT), although fourteen EAATD patients with Graves\\' disease (GD) have been also reported. METHODS: We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. RESULTS: Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. CONCLUSIONS: GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.

  6. Fetal microchimeric cells in autoimmune thyroid diseases: harmful, beneficial or innocent for the thyroid gland?

    Science.gov (United States)

    Lepez, Trees; Vandewoestyne, Mado; Deforce, Dieter

    2013-01-01

    Autoimmune thyroid diseases (AITD) show a female predominance, with an increased incidence in the years following parturition. Fetal microchimerism has been suggested to play a role in the pathogenesis of AITD. However, only the presence of fetal microchimeric cells in blood and in the thyroid gland of these patients has been proven, but not an actual active role in AITD. Is fetal microchimerism harmful for the thyroid gland by initiating a Graft versus Host reaction (GvHR) or being the target of a Host versus Graft reaction (HvGR)? Is fetal microchimerism beneficial for the thyroid gland by being a part of tissue repair or are fetal cells just innocent bystanders in the process of autoimmunity? This review explores every hypothesis concerning the role of fetal microchimerism in AITD.

  7. Increased carotid IMT in overweight and obese women affected by Hashimoto's thyroiditis: an adiposity and autoimmune linkage?

    Directory of Open Access Journals (Sweden)

    Pietro Guida

    2010-05-01

    Full Text Available Abstract Background Hashimoto's thyroiditis is the most important cause of hypothyroidism. It is a systemic disease that can even affect the cardiovascular system, by accelerating the atherosclerotic process. Aim of this study was to examine whether autoimmune thyroiditis has an effect on the intima-media thickness of the common carotid artery (IMT-CCT, independently of the thyroid function and well-known cardiovascular risk factors. Hashimoto's thyroiditis is a systemic disease. The aim is to examine whether autoimmune thyroiditis and adiposity can effect carotid IMT independently of thyroid hormones and cardiovascular risk factors. Methods A total of 104 obese women (BMI ≥ 25.0 kg/m-2, with FT3 and FT4 serum levels in the normal range and TSH levels Results Of the 104 women, 30 (28.8% were affected by autoimmune thyroiditis. Significantly higher values of IMT-CCT (p Conclusions The present study shows that Hashimoto's thyroiditis is associated to an increased IMT only in overweight and obese, independently of the thyroid function, BMI and cardiovascular risk factors. These results suggest that Hashimoto's thyroiditis is a marker of evolution of the atherosclerosis if combined to adiposity.

  8. [Subclinical and manifested hypothyroidism as a consequence of thyroid autoimmune disease].

    Science.gov (United States)

    Milosević, Dragoslav P; Djurica, Snezana; Davidović, Mladen; Stević, Radmila; Rajić, Miodrag; Marković, Natasa

    2005-10-01

    Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflamation of the thyroid gland, which frequently leads to hypothyroidism. Some of the up-to-date knowledge about hypothyroidism, both subclinical and manifested, caused by autoimmune disease, was presented. Autoimmune thyroid gland disease can occur at any age, but predominantly affects women after periods of high emotional and physical stress or accidents, as well as during periods of hormonal changes. It can also develop in families, and having an autoimmune disease slightly increases the risk of developing another. This paper showed an increasing incidence of subclinical hypothyroidism (4.17%) in elderly, and, at the same time, the incidence of primary hypothyroidism accounting for 1%. It is very usefull to estimate the stimulated thyrotropin (TSH) response, as well as the value of fast, short time thyroid gland reserves, analyzed by T3 and T4 serum level at 60th minute after TRH stimulation. Treatment of choice for HT (hypothyroidism of any cause) is thyroid hormone replacement. Drug of choice is orally administered levothyroxine sodium, usually for life-time. The standard dose is 1.6-1.8 mcg/kg body weight per day, but is in most cases patient dependent. Elderly patients usually require smaller replacement dose of levothyroxine, sometimes less than 1 mcg/kg body weight per day with coronary dilatator at the same time.

  9. Thyroid autoantibodies in autoimmune diseases Anticuerpos antitiroideos en enfermedades autoinmunes

    Directory of Open Access Journals (Sweden)

    Regina M. Innocencio

    2004-06-01

    Full Text Available Abnormalities in the thyroid function and thyroid autoantibodies have been frequently described in patients with autoimmune diseases but seldom in antiphospholipid syndrome patients. In order to determine the prevalence of thyroid function and autoimmune abnormalities, we compared serum thyrotropin (TSH, serum free thyroxine (T4 levels, thyroid antithyroglobulin (TgAb and antithyroperoxidase (TPOAb levels of 25 patients with systemic sclerosis, 25 patients with rheumatoid arthritis and 13 patients with antiphospholipid syndrome to a control group of 113 healthy individuals. Evaluation included a thorough clinical examination with particular attention to thyroid disease and a serologic immune profile including rheumatoid factor, antinuclear and anticardiolipin antibody measurements. Subclinical hypothyroidism (4.2Ciertas anormalidades en la función tiroidea y anticuerpos antitiroideos han sido frecuentemente descriptos en pacientes con enfermedades autoinmunes, y más raramente en pacientes con el síndrome antifosfolipídico. Para determinar la prevalencía de anormalidades en la función tiroidea y de autoinmunidad, comparamos los niveles séricos de tirotropina (TSH tiroxina libre en suero (T4 anticuerpos antitiroglobulina (TgAb y antitiroperoxidasa (TPOAb en 25 pacientes con esclerosis sistémica, 25 pacientes con artritis reumatoidea y 13 pacientes con el síndrome antifosfolipídico con un grupo control de 113 individuos aparentemente sanos. La evaluación incluyó un completo examen clínico con particular atención para las enfermedades de la tiroides y una evaluación inmunológica incluyendo dosaje del factor reumatoideo, anticuerpos antinucleares y anticardiolipina. Hipotiroidismo subclínico (4.2presentes en 21/63 (33% de los

  10. Immunoregulatory T cells, LFA-3 and HLA-DR in autoimmune thyroid diseases

    Directory of Open Access Journals (Sweden)

    Aml Mohamed Nada

    2014-01-01

    Full Text Available Several reports have claimed a role for T regulatory cells (Tregs in the pathogenesis of various autoimmune diseases, including autoimmune thyroid diseases (AITD. Naturally occurring CD4+ regulatory T cells, the majority of which express CD25, are engaged in dominant control of self-reactive T cells, contributing to the maintenance of immunologic self-tolerance. Their depletion or functional alteration leads to the development of autoimmune diseases. CD8+ Tcells are also claimed to have a suppressive effect on autoimmune diseases. Lymphocyte function antigen-3 and human leucocyte antigen (HLA-DR are involved in antigen presentation, initiation, and maintenance of autoimmune processes. Aim: The aim of the present study was to examine the changes in the expression of T-cell activation markers, namely CD4+ CD25+ and CD8+ in patients with AITD, namely Graves′ disease and Hashimoto′s thyroiditis as well as colloid nodular goitre. HLA-DR, LFA-3, and peripheral total lymphocytic count are also measured. Materials and Methods: We compared the expression of CD4, CD25, and CD8 surface markers in peripheral blood lymphocyte in Graves′ disease and Hashimoto′s thyroiditis as autoimmune thyroid diseases, as well as colloid goitre in comparison with healthy controls. Also, LFA-3 and HLA-DR were measured in the same groups using three-color flow cytometry. Total lymphocytic count in peripheral blood, thyroid function tests, antithyroid antibodies were also included in the laboratory investigations. The total number of participants was 65. All were recruited from endocrine clinics in a tertiary care hospital in the southern region of Saudi Arabia. All participants underwent history taking, clinical examination, laboratory workup, and radiological investigations. Neck ultrasound, technecium pertechnetateψψ thyroid uptake, and fine-needle aspiration and cytology (FNAC of the thyroid were done when indicated. The study was approved by the Hospital

  11. Interrelation specific autoimmune pathologies of a thyroid gland with inorganic autoimmune rheumatic diseases

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    O V Paramonova

    2012-03-01

    Full Text Available The problem of a pathology of a thyroid gland at rheumatic diseases, in particular at rheumatoid arthritis, remains actual and to this day. The work purpose was studying antitelogenesis to thyroid hormones at patients with mixt autoimmune pathology. In whey of blood of patients with RA and autothyroid pathology are found out antibodies (AB to Т3 and Т4, their concentration correlates with activity of pathological process. It is shown, that level AB to Т3 and Т4 authentically differs from the maintenance of the given antibodies in whey of blood of healthy faces. Level of antibodies to thyroid hormones can be considered as the criterion predicting development of pathology of a thyroid gland at patients with RA.

  12. The Essential Role of Circulating Thyroglobulin in Maintaining Dominance of Natural Regulatory T Cell Function to Prevent Autoimmune Thyroiditis.

    Science.gov (United States)

    Kong, Y M; Brown, N K; Morris, G P; Flynn, J C

    2015-09-01

    Several key findings from the late 1960s to mid-1970s regarding thyroid hormone metabolism and circulating thyroglobulin composition converged with studies pertaining to the role of T lymphocytes in autoimmune thyroiditis. These studies cemented the foundation for subsequent investigations into the existence and antigenic specificity of thymus-derived natural regulatory T cells (nTregs). These nTregs prevented the development of autoimmune thyroiditis, despite the ever-present genetic predisposition, autoantigen (thyroglobulin), and thyroglobulin-reactive T cells. Guided by the hypothalamus-pituitary-thyroid axis as a fixed set-point regulator in thyroid hormone metabolism, we used a murine model and compared at key junctures the capacity of circulating thyroglobulin level (raised by thyroid-stimulating hormone or exogenous thyroglobulin administration) to strengthen self-tolerance and resist autoimmune thyroiditis. The findings clearly demonstrated an essential role for raised circulating thyroglobulin levels in maintaining the dominance of nTreg function and inhibiting thyroid autoimmunity. Subsequent identification of thyroglobulin-specific nTregs as CD4(+)CD25(+)Foxp3(+) in the early 2000s enabled the examination of probable mechanisms of nTreg function. We observed that whenever nTreg function was perturbed by immunotherapeutic measures, opportunistic autoimmune disorders invariably surfaced. This review highlights the step-wise progression of applying insights from endocrinologic and immunologic studies to advance our understanding of the clonal balance between natural regulatory and autoreactive T cells. Moreover, we focus on how tilting the balance in favor of maintaining peripheral tolerance could be achieved. Thus, murine autoimmune thyroiditis has served as a unique model capable of closely simulating natural physiologic conditions.

  13. Low birth weight is not associated with thyroid autoimmunity

    DEFF Research Database (Denmark)

    Brix, Thomas Heiberg; Hansen, Pia Skov; Rudbeck, Annette Beck;

    2006-01-01

    .002 (-0.010 to 0.014); P = 0.77]. When restricting the analysis to twin pairs with a within-pair difference in birth weight of 500 g or greater or to twin pairs born 4 wk or more before term, the regression coefficients were almost unchanged. Controlling for potential confounders (sex, zygosity......CONTEXT: Low birth weight has been proposed as a risk factor for the development of antibodies toward thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) in adult life. However, the association could also be due to genetic or environmental factors affecting both birth weight and the development...... of thyroid autoantibodies. The effect of these confounders can be minimized through investigation of twin pairs. OBJECTIVE AND DESIGN: To examine the impact of low birth weight on the development of thyroid autoimmunity, we studied whether within-twin-cohort and within-twin-pair differences in birth weight...

  14. Significance of (sub) clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy : a systematic review

    NARCIS (Netherlands)

    van den Boogaard, Emmy; Vissenberg, Rosa; Land, Jolande A.; van Wely, Madelon; van der Post, Joris A. M.; Goddijn, Mariette; Bisschop, Peter H.

    2011-01-01

    BACKGROUND: Thyroid dysfunction and thyroid autoimmunity are prevalent among women of reproductive age and are associated with adverse pregnancy outcomes. Preconception or early pregnancy screening for thyroid dysfunction has been proposed but is not widely accepted. We conducted a systematic review

  15. "PREVALENCE OF AUTOANTIBODIES TO THYROID PEROXIDASE AND AUTOIMMUNE THYROID DISEASE IN TYPE I DIABETES MELLITUS"

    Directory of Open Access Journals (Sweden)

    H. Moayeri A. Rabbani

    2004-09-01

    Full Text Available Type I diabetes mellitus (DM is frequently associated with autoimmune thyroid disease (ATD. Association of ATD and type I DM has been described with varying frequencies but there is still debate about the situation in the Iranian population. We investigated the prevalence of anti thyroid peroxidase (anti-TPO antibodies and ATD in children and adolescents with type I DM. A total of 145 patients with type I DM were participated in this study. They were screened for anti-TPO antibodies and TSH levels. Signs and symptoms of hypothyroidism and hyperthyroidism and the presence of goiter were sought. A group of 50 healthy unrelated girls and boys aged 11-16 years served as controls. Anti-TPO antibodies were found in 34 (23.4% diabetic patients and 1 subject (2% in the control group (P<0.001. Frequency of anti TPO antibodies was significantly higher in girls than boys (P<0.05. We failed to show any significant correlation between thyroid autoimmunity and duration of DM. We found that younger patients at diagnosis are more likely to be anti-TPO negative (P<0.001. Out of 145 diabetic patients, 32 (22% had visible goiter. Subclinical hypothyroidism, hypothyroidism and thyrotoxicosis occurred in 1, 9 and 1 patients, respectively. Visible goiter was found in 2 subjects (4% of the control group, but all of them were euthyroid. In conclusion, the evaluation of thyroid autoimmunity in type I diabetic patients may improve the diagnosis of thyroid disease in early stages. Yearly examination of anti-TPO antibodies allows identifying diabetic patients with thyroid autoimmunity.

  16. Association between thyroid autoimmunity and Helicobacter pylori infection

    Science.gov (United States)

    Choi, Yun Mi; Kim, Tae Yong; Kim, Eui Young; Jang, Eun Kyung; Jeon, Min Ji; Kim, Won Gu; Shong, Young Kee; Kim, Won Bae

    2017-01-01

    Background/Aims There have been controversial reports linking Helicobacter pylori infection to autoimmune thyroid disease (AITD). However, data regarding the relationship are limited for Asian populations, which have an extremely high prevalence of H. pylori infection. We performed this study to investigate the association between H. pylori infection and AITD in Koreans. Methods This study involved adults aged 30 to 70 years who had visited a health promotion center. A total of 5,502 subjects were analysed. Thyroid status was assessed by free thyroxine, thyroid stimulating hormone, and anti-thyroid peroxidase antibody (TPO-Ab). Immunoglobulin G (IgG) antibodies to H. pylori were measured as an indication of H. pylori infection. We compared the prevalence of TPO-Ab in subjects with and without H. pylori infection. Results H. pylori IgG antibodies were found in 2,875 subjects (52.3%), and TPO-Ab were found in 430 (7.8%). Individuals positive for H. pylori Ab were older than those negative for H. pylori Ab (p thyroiditis. PMID:28092700

  17. Struma ovarii presenting with Hashimoto's thyroiditis: a case report

    Directory of Open Access Journals (Sweden)

    Bozkurt Nujen

    2011-12-01

    Full Text Available Abstract Introduction We report the case of a patient diagnosed with a struma ovarii with lymphocytic thyroiditis of her ectopic thyroid tissue. We believe that this case presents an unusual variation of a struma ovarii and a rare presentation of subclinical hyperthyroidism. Case presentation A 17-year-old Caucasian female patient who had undergone an ovariectomy and been diagnosed with a struma ovarii was subsequently found to have persistent subclinical hyperthyroidism with a low radioiodine uptake. Abdominal magnetic resonance imaging and iodine-131 whole body scanning showed no residue or recurrence and a thyroid ultrasonography was normal. Laboratory and histopathological findings suggested Hashimoto's thyroiditis as the cause of the subclinical thyrotoxicosis, which had presumably started at the ectopic tissue. Conclusion Struma ovarii is a rare cause of thyrotoxicosis, and can be difficult to diagnose in the presence of co-existing thyroid disorders. In patients with a struma ovarii who have not undergone thyroidectomy, there is no common consensus on management in terms of residue, recurrence or metastasis. Autoimmune thyroiditis must be kept in mind for a differential diagnosis.

  18. Unusual Presentation of Tuberculous Thyroid Abscess in a Background of Hashimoto's Thyroiditis in a Chronic Hepatitis B Carrier

    Science.gov (United States)

    Kumar, Sunil; Sangwan, Anubhav; Sahani, Neelam; Gunasekaran, Gopalakrishnan; Kumar Meena, Sunil; Singh Kushwaha, Swapnil

    2016-01-01

    Tuberculosis of thyroid gland is a very rare disease. It has variable presentations and may be sometimes associated with autoimmune thyroiditis. We report a case of 45-year-old male, with left sided painless neck swelling, with a purulent discharging sinus over it associated with night sweats and loss of appetite. Thyroid imaging disclosed heterogeneous enhancement of left lobe of thyroid gland with internal vascularity and coarse calcifications. Core needle biopsy revealed caseous necrosis and AFB positivity. Patient had thyroid peroxidase antibody and thyroglobulin antibody positivity and the rest of thyroid function tests were normal. Patient had positive Mantoux test, hepatitis B surface Ag, and low viral DNA. The patient was diagnosed as being a case of tuberculous abscess of thyroid gland and was put on antitubercular therapy for 2 months. Patient subsequently underwent left hemithyroidectomy when there was no response. Histopathological examination revealed tuberculosis of thyroid gland. A final diagnosis of tuberculous abscess of thyroid gland in a background of Hashimoto's thyroiditis in a chronic HBV carrier was made. Therefore, although rare tuberculosis of thyroid should be kept in mind as a differential diagnosis of thyroid swelling. PMID:28101393

  19. Cytokine production in patients with papillary thyroid cancer and associated autoimmune Hashimoto thyroiditis.

    Science.gov (United States)

    Zivancevic-Simonovic, Snezana; Mihaljevic, Olgica; Majstorovic, Ivana; Popovic, Suzana; Markovic, Slavica; Milosevic-Djordjevic, Olivera; Jovanovic, Zorica; Mijatovic-Teodorovic, Ljiljana; Mihajlovic, Dusan; Colic, Miodrag

    2015-08-01

    Hashimoto thyroiditis (HT) is the most frequent thyroid autoimmune disease, while papillary thyroid cancer (PTC) is one of the most common endocrine malignancies. A few patients with HT also develop PTC. The aim of this study was to analyze cytokine profiles in patients with PTC accompanied with autoimmune HT in comparison with those in patients with PTC alone or HT alone and healthy subjects. Cytokine levels were determined in supernatants obtained from phytohemagglutinin (PHA)-stimulated whole blood cultures in vitro. The concentrations of selected cytokines: Th1-interferon gamma (IFN-γ); Th2-interleukin 4 (IL-4), interleukin 5 (IL-5), interleukin 6 (IL-6), interleukin 10 (IL-10) and interleukin 13 (IL-13); Th9-interleukin 9 (IL-9); and Th17-interleukin 17 (IL-17A) were measured using multiplex cytokine detection systems for human Th1/Th2/Th9/Th17/Th22. We found that PTC patients with HT produced significantly higher concentrations of IL-4, IL-6, IL-9, IL-13 and IFN-γ than PTC patients without HT. In conclusion, autoimmune HT affects the cytokine profile of patients with PTC by stimulating secretion of Th1/Th2/Th9 types of cytokines. Th1/Th2 cytokine ratios in PTC patients with associated autoimmune HT indicate a marked shift toward Th2 immunity.

  20. A case of Kearns-Sayre sindrome with autoimmune thyroiditis and complete atrio-ventricular block.

    Science.gov (United States)

    Berio, A; Piazzi, A

    2006-06-01

    The Kearns-Sayre syndrome, (characterized by its onset before the age of 20 years, chronic ophthalmoplegia, pigmentary retinal degeneration and at least one of the following symptoms: ataxia, heart block and high protein content in the cerebrospinal fluid) is a severe variant of chronic progressive external ophthalmoplegia with frequent rearrangements of the mitochondrial DNA (mtDNA). The aim of this paper is to report a sporadic paediatric case of Kearns-Sayre syndrome with mtDNA heteroplasmic deletion, absence of cytochrome c-oxidase in many muscle fibers, autoimmune thyroiditis, complete atrio-ventricular heart block in which the diagnosis of subclinical hypothyroiditis associated with autoimmune thyroid disease was made. The subclinical hypothyroidism, more severe in the presence of thyroid antibodies, may have contributed to the pathogenesis of cardiovascular disease. We hypothesized that in this patient, predisposed by mitochondrial deletion, anti-thyroid antibodies may have interfered with the mitochondrial function of conduction heart system, causing atrio-ventricular heart block. It seems important to study anti-thyroid antibodies in every case of Kearn-Sayre syndrome, specially if cardiac rhythm disturbances are present.

  1. Shock: A possible presenting manifestation of autoimmune polyendocrine syndrome type II

    Directory of Open Access Journals (Sweden)

    Subodh Banzal

    2014-01-01

    Full Text Available Autoimmune polyendocrine syndrome Type II (APS II, also known as polyglandular autoimmune syndrome Type II or Schmidt syndrome, is constellations of multiple endocrine gland insufficiencies. It is a rare, but most common of the immunoendocrinopathy syndrome. It is characterized by the obligatory occurrence of autoimmune Addison′s disease in combination with thyroid autoimmune diseases and/or Type I diabetes, hypogonadism, hypophysitis, myasthenia gravis, vitiligo, alopecia, pernicious anemia, and celiac disease. Here, we report a case of 38-year-old female patient presented with shock, further diagnosed to have APS II.

  2. Thyroid uptake of {sup 67}Ga-citrate is associated with thyroid autoimmunity and hypothyroidism in patients with sarcoidosis

    Energy Technology Data Exchange (ETDEWEB)

    Antonelli, Alessandro; Fallahi, Poupak; Ferrari, Silvia Martina; Ferrannini, Ele [University of Pisa and CNR Institute of Clinical Physiology, Metabolism Unit, Department of Internal Medicine, Pisa (Italy); Fazzi, Piera [University of Pisa, Respiratory Pathophysiology Section, Cardiac and Thoracic Department, Pisa (Italy); Grosso, Mariano; Boni, Giuseppe; Mariani, Giuliano [University of Pisa, Regional Center of Nuclear Medicine, Medical School, Pisa (Italy)

    2009-01-15

    To evaluate the association of gallium-67 ({sup 67}Ga)-citrate thyroid uptake with the presence of thyroid disorders in patients with sarcoidosis (S patients). Eighty-four S patients were evaluated by a complete thyroid work-up (neck ultrasound, circulating thyroid hormones and anti-thyroid antibodies, fine-needle aspiration). In S patients with {sup 67}Ga thyroid uptake (respect those without): serum thyroid-stimulating hormone, the titre of anti-thyroid peroxidase (AbTPO) and/or anti-thyroglobulin antibodies (AbTg), and the prevalence of S patients with hypothyroidism or with positive AbTg or AbTPO was significantly higher; a thyroid hypoechoic pattern was more frequent. The prevalence of thyroid nodules was not significantly different between the two groups. Two cases of papillary thyroid cancer were observed in S patients without {sup 67}Ga thyroid uptake, whilst no case in those with {sup 67}Ga thyroid uptake. {sup 67}Ga thyroid uptake is associated with the presence of aggressive autoimmune thyroiditis and hypothyroidism in S patients; thyroid function and ultrasonography should be performed in the presence of {sup 67}Ga thyroid uptake. (orig.)

  3. Signs of a higher prevalence of autoimmune thyroiditis in female offspring of bipolar parents

    NARCIS (Netherlands)

    Hillegers, Manon H. J.; Reichart, Catrien G.; Wals, Marjolein; Verhulst, Frank C.; Ormel, Johan; Nolen, Willem A.; Drexhage, Hemmo A.

    2007-01-01

    Background: Studies are inconsistent as to whether patients with bipolar disorder are more frequently affected by autoimmune thyroiditis. Aim: To study the prevalence of autoimmune thyroiditis in offspring of bipolar patients. Method: In 1998 140 children (age 12-21 years) of bipolar parents were ev

  4. Seven newly identified loci for autoimmune thyroid disease.

    Science.gov (United States)

    Cooper, Jason D; Simmonds, Matthew J; Walker, Neil M; Burren, Oliver; Brand, Oliver J; Guo, Hui; Wallace, Chris; Stevens, Helen; Coleman, Gillian; Franklyn, Jayne A; Todd, John A; Gough, Stephen C L

    2012-12-01

    Autoimmune thyroid disease (AITD), including Graves' disease (GD) and Hashimoto's thyroiditis (HT), is one of the most common of the immune-mediated diseases. To further investigate the genetic determinants of AITD, we conducted an association study using a custom-made single-nucleotide polymorphism (SNP) array, the ImmunoChip. The SNP array contains all known and genotype-able SNPs across 186 distinct susceptibility loci associated with one or more immune-mediated diseases. After stringent quality control, we analysed 103 875 common SNPs (minor allele frequency >0.05) in 2285 GD and 462 HT patients and 9364 controls. We found evidence for seven new AITD risk loci (P < 1.12 × 10(-6); a permutation test derived significance threshold), five at locations previously associated and two at locations awaiting confirmation, with other immune-mediated diseases.

  5. Utility of Shear Wave Elastography for Diagnosing Chronic Autoimmune Thyroiditis

    Directory of Open Access Journals (Sweden)

    Takahiro Fukuhara

    2015-01-01

    Full Text Available The aims of this study were to evaluate the utility of shear wave elastography (SWE using acoustic radiation force impulse (ARFI for diagnosing chronic autoimmune thyroiditis (CAT and to verify the effect of fibrotic thyroid tissue on shear wave velocity (SWV. The subjects were 229 patients with 253 normal thyroid lobes (controls and 150 CAT lobes. The SWV for CAT (2.47 ± 0.57 m/s was significantly higher than that for controls (1.59 ± 0.41 m/s (P<0.001. The area under the receiver operating characteristics (ROC curve for CAT was 0.899, and the SWV cut-off value was 1.96 m/s. The sensitivity, specificity, and diagnostic accuracy were 87.4%, 78.7%, and 85.1%, respectively. Levels of anti-thyroperoxidase antibodies and thyroid isthmus thickness were correlated with tissue stiffness in CAT. However, there was no correlation between levels of anti-thyroglobulin antibodies and tissue stiffness. Quantitative SWE is useful for diagnosing CAT, and it is possible that SWE can be used to evaluate the degree of fibrosis in patients with CAT.

  6. Autoimmune thyroiditis in antinuclear antibody positive children without rheumatologic disease

    Directory of Open Access Journals (Sweden)

    Arkachaisri Thaschawee

    2010-05-01

    Full Text Available Abstract Background Children are commonly referred to a pediatric rheumatology center for the laboratory finding of an Anti-nuclear antibody (ANA of undetermined significance. Previous studies regarding adult rheumatology patients have supported an association between ANA and anti-thyroid antibodies, with the prevalence of thyroid antibodies being significantly higher in patients referred to a rheumatology center for an ANA without evidence of connective tissue disease compared to the general population. The purpose of the present study was to determine the frequency of thyroid antibodies in children referred to a pediatric rheumatology center for a positive ANA without evidence of a connective tissue disease. Methods A retrospective chart review was performed on children who were referred to our pediatric rheumatology center between August 2003 and March 2007 for positive ANA with concurrent thyroid antibody and thyroid function tests performed who did not fulfill criteria for a specific connective tissue disease. Laboratory and clinical features were recorded and analyzed. Mean and standard deviation were used to describe continuous data. Chi-square or Fisher's exact tests were used to compare proportions between variables. Results One-hundred and four ANA-positive patients with concurrent thyroid studies were evaluated (88% female, 93% Caucasian, mean age 11.9 ± 4.0 years. Half of patients had an ANA titer ≥ 1:320. The ANA pattern was speckled in 60% of the patients. Thyroid antibodies were detected in 30% of the patients. Anti-Thyroglobulin (ATG was detected in 29% and Anti-thyroid peroxidase (ATPO in 21% of the patients; of these children, 14% had hypothyroidism. ANA pattern and titer were not associated with anti-thyroid antibody positivity. Conclusion Thyroid antibodies associated with chronic lymphocytic thyroiditis, ATG and ATPO, were detected significantly higher in ANA-positive children without a rheumatologic condition (30% as

  7. CXCR4 antagonist AMD3100 ameliorates thyroid damage in autoimmune thyroiditis in NOD.H‑2h⁴ mice.

    Science.gov (United States)

    Liu, Xin; Mao, Jinyuan; Han, Cheng; Peng, Shiqiao; Li, Chenyan; Jin, Ting; Fan, Chenling; Shan, Zhongyan; Teng, Weiping

    2016-04-01

    CXC chemokine ligand 12 (CXCL12) and its receptor, CXC chemokine receptor 4 (CXCR4), are upregulated in mice with autoimmune thyroid diseases. However, whether this interaction is involved in the pathophysiology of autoimmune thyroiditis (AIT) remains to be elucidated. In the present study, the effects of the CXCR4 antagonist, AMD3100, in an iodine‑induced autoimmune thyroiditis model were investigated. NOD.H‑2h4 mice were randomly separated into a control, AIT and AIT+AMD3100 groups. The mice were fed with 0.05% sodium iodide water for 8 weeks to induce AIT. The AMD3100‑treated mice were administered with the CXCR4 antagonist at a dose of 10 mg/kg intraperitoneally three times a week during the experimental period. The percentages of CD19+interleukin (IL)10+ B cells and CD4+IL10+ T cells, and the mRNA expression levels of IL10 in the splenocytes were reduced in the AIT group, compared with the control group, however, they increased following AMD3100 treatment, compared with the untreated AIT group. The percentages of CD4+ T cells, CD8+ T cells, CD19+ B cells and CD8+ interferon (IFN)γ+ T cells, and the mRNA expression levels of IFNγ increased in the AIT group, compared with the control group, however, these were reduced in the AMD3100 group, compared with the AIT group. The AMD3100‑treated mice also had lower serum thyroglobulin antibody titers and reduced lymphocytic infiltration in the thyroid, compared with the untreated AIT mice. These results suggested that inhibition of this chemokine axis may offer potential as a therapeutic target for the treatment of AIT.

  8. [Membranous nephropathy associated to autoimmune thyroiditis, chronic pancreatitis and suprarrenal insufficiency].

    Science.gov (United States)

    Merino, J L; Fernández Lucas, M; Teruel, J L; Valer, P; Moreira, V; Arambarri, M; Ortuño, J

    2004-01-01

    A 33 year old female was admitted to the hospital to study aedema and bocio, A nephrotic syndrome was diagnosed and the renal biopsy demonstrated membranous glomerulonephritis, stage II. She was also diagnosed of Hashimoto's autoinmmune thyroiditis: TSH (41.5 uUl/ml), T4 (0.07 ng/dl), antithyroglobuline (1/2560) and antimicrosome (1/6400). Four year latter she was diagnosed of autoinmmune pancreatitis, without evidence of diabetes mellitus or exocrine pancreatic insufficiency. Eight years latter she was diagnosed of primary autoimmune suprarrenal insufficiency: basal cortisol: 2.7 mcg/dl, post ACTH estimulated cortisol: 5.6 mcg/dl, antinuclear antibody (1/160) and antiparietal (1/320). We present a pluriglandular autoimmune syndrome with membranous glomerulonephritis, thyroiditis, pancreatitis and suprarrenal insufficiency. To the best of our knowledge this complex syndrome has not been previously described.

  9. Estrogen receptor alpha dinucleotide repeat polymorphism in Japanese patients with autoimmune thyroid diseases

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    Tozaki Teruaki

    2000-11-01

    Full Text Available Abstract Background The autoimmune thyroid diseases (AITDs, comprising Graves' disease (GD and Hashimoto's thyroiditis (HT, appear to develop as a result of complex interactions between predisposing genes and environmental triggers. Susceptibility to AITDs is conferred by genes in the human leukocyte antigen (HLA and genes unlinked to HLA, including the CTLA-4 gene. Recently, an association to some estrogen receptor (ERα genotypes with breast cancer, hypertension, osteoporosis, generalized osteoarthritis, and some autoimmune diseases such as rheumatoid arthritis has been reported. We have analyzed a dinucleotide (TAn repeat polymorphism lying upstream of the human ERα gene in patients with AITDs and in normal subjects. Results Seventeen different alleles were found in 130 patients with GD, 93 patients with HT, and 190 control subjects. There was no significant difference in the distributions of ERα alleles between patients and controls. Conclusions The present results do not support an association between the ERα gene and AITD in the Japanese population.

  10. Early manifestations of gastric autoimmunity in patients with juvenile autoimmune thyroid diseases.

    Science.gov (United States)

    Segni, Maria; Borrelli, Osvaldo; Pucarelli, Ida; Delle Fave, Gianfranco; Pasquino, Anna Maria; Annibale, Bruno

    2004-10-01

    Juvenile patients affected with autoimmune thyroid disorders showed a 14-21% prevalence of parietal cell antibodies (PCA) reacting against the H+/K+-ATPase of the gastric parietal cells. PCA are the principal immunological markers of atrophic body gastritis (ABG).ABG is characterized by loss of oxyntic glands, achlorhydria, and hypergastrinemia. The aim of this study was to determine whether PCA positivity could be associated with biochemical and histological manifestations of gastric autoimmunity in juvenile patients with autoimmune thyroid disease (AITD). We studied 129 children (96 females and 33 males) with chronic lymphocytic thyroiditis (n = 115) or Graves' disease (n = 14). Mean age at diagnosis of AITD was 9.7 +/- 3.3 yr, and mean age at sampling was 12.3 +/- 3.7 yr. We determined PCA and Helicobacter pylori antibodies, gastrin, and pepsinogen I plasma levels. Gastroscopy with multiple biopsies was carried out in a subgroup of patients with PCA positivity. We found that 30% of children had detectable PCA. Hypergastrinemia was found in 45% of the PCA-positive children (range, 40-675 pg/ml) vs. 12% of PCA-negative children (range, 35-65 pg/ml; P < 0.001). Eighteen patients with PCA positivity underwent gastroscopy; eight of these children had normogastrinemia, which showed no signs of ABG, and 10 children had hypergastrinemia, of whom five had mild to severe ABG. Our study shows that autoimmune gastritis is an early event in juvenile AITD with detectable PCA. Gastrin plasma level is a reliable marker of gastric atrophy.

  11. Pendrin and NIS antibodies are absent in healthy individuals and are rare in autoimmune thyroid disease

    DEFF Research Database (Denmark)

    Brix, Thomas H; Hegedüs, Laszlo; Weetman, Anthony P;

    2014-01-01

    prevalence than the controls: NISAb: 17% vs 0% (P Hashimoto's thyroiditis (HT) had NISAb, (P ...OBJECTIVE: Antibodies against thyroglobulin, thyroid peroxidase and the TSH receptor are accepted as pathophysiological and diagnostic biomarkers in autoimmune thyroid disease (AITD). In contrast, the prevalence, aetiology and clinical relevance of autoantibodies against the human sodium...

  12. Mechanisms in endocrinology: autoimmune thyroid disease: old and new players.

    Science.gov (United States)

    Effraimidis, Grigoris; Wiersinga, Wilmar M

    2014-06-01

    The last 10 years have seen some progress in understanding the etiology of autoimmune thyroid disease (AITD). The female preponderance can now be explained - at least in part - by fetal microchimerism and X-chromosome inactivation. The number of identified susceptibility genes for AITD is increasing (among others now including TSHR, TG, HLA, CTLA4, PTPN22, CD40, FCRL3, IL2RA, and FOXP3), but these genes together probably do not explain more than about 10% of the heritability of AITD. As twin studies indicate that genes contribute for 70% of AITD, it follows that there must be many more loci, each of them contributing a little. While the genetic studies have clarified why various autoimmune diseases so often cluster in the same patient, the molecular mechanism of action of these genetic polymorphisms (frequently located in introns) has hardly been explained. Polymorphisms in AITD susceptibility genes may become helpful in clinical practice, e.g. in assessing risk of recurrent Graves' hyperthyroidism (GH) after a course of antithyroid drugs. Moderate alcohol intake decreases the risk on overt GH and overt Hashimoto's hypothyroidism. Current smokers - as well known - are at increased risk for Graves' disease, but - surprisingly - at diminished risk for Hashimoto's thyroiditis. Low selenium and low vitamin D levels might increase the risk of developing AITD, but data are still inconclusive. Current options for preventive interventions in subjects at risk to develop AITD are very limited.

  13. Celiac-Associated Autoimmune Thyroid Disease: A Study of 16 Patients with Overt Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    1995-01-01

    Full Text Available Previous reports have suggested that autoimmune thyroid disorders (including Hashimoto’s or lymphocytic thyroiditis may occur in patients with celiac disease. In this study, the prevalence of thyroid disease was explored in a series of 96 consecutive patients seen with biopsy-defined adult celiac disease (average age 47.3 years. Sixteen celiac patients (average age 58.1 years were detected with hypothyroidism, including four treated with radio-iodine ablation or thyroidectomy for Grave’s disease. In addition to celiac disease, almost half had dermatitis herpetiformis, a small intestinal neoplasm (particularly lymphoma or both. Diagnosis of thyroid disease preceded diagnosis of celiac disease in 13 patients or was made concurrently in two patients. In only one patient was thyroid disease detected after celiac disease was diagnosed. This indicates that thyroid diseases occur more commonly in celiac disease than is currently appreciated, possibly due to shared embryological origins or common immunopathological features, and may be the presenting clinical manifestation in adults especially if there is coexistent dermatitis herpetiformis. Careful monitoring of this subgroup may be warranted because of the frequency of neoplastic intestinal diseases, particularly lymphoma.

  14. Prevalence of thyroiditis and immunohistochemistry study searching for a morphologic consensus in morphology of autoimmune thyroiditis in a 4613 autopsies series.

    Science.gov (United States)

    Vecchiatti, Stella M P; Lin, Chin Jia; Capelozzi, Vera L; Longatto-Filho, Adhemar; Bisi, Hélio

    2015-07-01

    We sought to verify the prevalence of lymphocytic thyroiditis (LT) and Hashimoto's thyroiditis (HT) in autopsy materials. Cases examined between 2003 and 2007 at the Department of Pathology of Faculty of Medicine of São Paulo University were studied. Immunohistochemical analyses were conducted in selected cases to characterize the type of infiltrating mononuclear cells; in addition, we evaluated the frequency of apoptosis by TUNEL assay technique and caspase-3 immunostaining. Significant increase in overall thyroiditis frequency was observed in the present series when compared with the previous report (2.2978% vs. 0.0392%). Thyroiditis was more prevalent among older people. Selected cases of LT and HT (40 cases each) had their infiltrating lymphocytes characterized by immunohistochemical analyses. Both LT and HT showed similar immunostaining patterns for CD4, CD8, CD68, thus supporting a common pathophysiology mechanism and indicating that LT and HT should be considered different presentations of a same condition, that is, autoimmune thyroiditis. Moreover, apoptosis markers strongly evidenced that apoptosis was present in all studied cases. Our results demonstrated an impressive increase in the prevalence of thyroiditis during recent years and our data support that the terminology of autoimmune thyroiditis should be used to designate both LT and HT. This classification would facilitate comparison of prevalence data from different series and studies.

  15. Sonographic decreased echogenicity of thyroid parenchyma in asymptomatic population: Correction with thyroid function and thyroid autoimmune activity

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Yeon; Park, Noh Hyuck; Park, Chan Sub; Lee, Ji Ye [Dept. of Radiology, Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of); Chun, Kyung Ah [Dept. of Radiology, Catholic Kwandong University School of Medicine, Gangneung (Korea, Republic of); Yi, Seong Yoon [Div. of Hematology-Oncology, Dept. of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang (Korea, Republic of); Park, Hee Jin [Dept. of of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

    2016-09-15

    The aim of the study was to evaluate the correlation between decreased echogenicity of thyroid and thyroid hormones or autoantibodies. From January 2009 to December 2011, 543 patients with decreased parenchymal echogenicity [M:F = 133:410, median age: 42 years (range: 9-82 years)], who did not have solid nodule, symptom or medication related to thyroid and underwent thyroid function test were retrospectively reviewed. Images were classified based on the degree of hypoechogenicity, heterogenicity or thyroid size. 1) Group A: mild decreased echogenicity, group B: marked decreased echogenicity, 2) group Ho: homogeneous echogenicity, group He: heterogeneous echogenicity, 3) group 1: decreased size, group 2: normal size, group 3: increased size. Differences in triiodiothyronyne (T3), free-thyroxine (fT4), thyrotropin (TSH), anti-thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and anti-TSH receptor antibody (TSH-rAb) were evaluated among groups. T3, fT4, and TSH levels differed between groups A and B (p < 0.001, p = 0.001, p < 0.001). TgAb and TPOAb of group B were higher than group A (p = 0.006, p < 0.001). TPOAb of group He was higher than group Ho (p < 0.001). TSH-rAb and TPOAb of group 3 were higher than group 2 (p = 0.017, p < 0.001). The patients with findings of markedly decreased, heterogeneous echogenicity or thyroid enlargement may have abnormal thyroid function and autoantibodies. These may facilitate the physicians' decision to order tests for thyroid function and autoimmune activity.

  16. Multiple Autoimmune Syndromes Associated with Psoriasis: A Rare Clinical Presentation

    Directory of Open Access Journals (Sweden)

    Sadia Masood

    2014-03-01

    Full Text Available Autoimmune diseases are known to have association with each other but it is very rare to see multiple autoimmune diseases in one patient. The combination of at least three autoimmune diseases in the same patient is referred to as multiple autoimmune syndrome. The case we are reporting features multiple autoimmune syndrome with five different conditions. The patient had type 1 diabetes mellitus, autoimmune hemolytic anemia, systemic lupus erythematosus, vitiligo, and psoriasis. Psoriasis has rarely been reported previously under the spectrum of autoimmune syndrome. Although the relationship of autoimmune conditions with each other has been explored in the past, this case adds yet another dimension to the unique evolution of autoimmune pathologies. The patient presented with a combination of five autoimmune diseases, which makes it consistent type three multiple autoimmune syndromes with the addition of psoriasis. The current case is unique in this aspect that the combination of these five autoimmune disorders has never been reported in the past.

  17. Endocrine Ophthalmopathy in Autoimmune Thyroid Diseases

    OpenAIRE

    Pashkovska, N.V.

    2014-01-01

    The article presents modern data about risk factors, mechanisms of development, clinical features of endocrine ophthalmopathy, as well as information regarding current approaches to diagnosis, treatment and prevention of this disease according to the latest global recommendations developed from the position of evidence-based medicine.

  18. Pertinence of kappa and lambda recombinant antibodies directed against thyroid peroxidase in thyroid autoimmune disease.

    Science.gov (United States)

    Bresson, D; Chardès, T; Chapal, N; Bès, C; Cerutti, M; Devauchelle, G; Bouanani, M; Mani, J C; Péraldi-Roux, S

    2001-01-01

    Forty-one single-chain variable region fragments (scFvs) directed against thyroid peroxidase (TPO) were obtained by phage display libraries constructed from thyroid-infiltrating B cells of Graves' disease patients. Among these scFvs, 24.4% used a Vkappa light chain whereas 75.6% shows a light chain of Vlamda origin. Study of light chain gene usage in the TPO antibody repertoire demonstrated a dominance of the Vkappa 1-39 and Vlambda 1-51 genes. Thyroid peroxidase probing of overlapping peptides covering the amino acid sequences of anti-TPO T2/kappa and T13/lambda variable regions demonstrated a more restricted antigen recognition on T13/lambda than on T2/kappa. These two recombinant antibodies, expressed as whole IgG1 in the baculovirus/insect cell system, inhibited the binding to TPO of serum TPO autoantibodies whatever the light chain. Our study indicates that lambda as well as kappa light chain usage are found in the TPO antibody repertoire of thyroid-infiltrating B cells and are pertinent in the pathogenesis of autoimmune thyroid disease.

  19. Thrombotic thrombocytopenic purpura concomitant with autoimmune thyroiditis

    Directory of Open Access Journals (Sweden)

    Ali Bay

    2011-12-01

    Full Text Available Thrombotic thrombocytopenic purpura (TTP is characterized by disseminated thrombotic occlusions located in the microcirculation, microangiopathic hemolytic anemia, thrombocytopenia, fever, and renal and neurologic abnormalities. A 14 year old girl admitted to our hospital complaining bruising on her body and prolonged menstrual bleeding. On her physical examination there were very common bruising on four extremities. On the laboratory studies, Hemoglobin was 9 g/dL; Hematocrit, 24%; white blood count 11600/mm3 and thrombocyte count, 9.000/mm3. According to these findings our first diagnose was idiopatic thrombocytopenic purpura so intravenous immunoglobulin was given to patient for two days. Bone marrow aspiration was performed because of persisting thrombocytopenia despite two days IVIG therapy. Increased number of megakaryocytes was seen in bone marrow. Some accompanying symptoms like headache, numbness in per oral region and extremities, difficulty in speaking, and fluctuation in consciousness for short time occurred. The patient was reevaluated; because thrombocytopenia persisted and some neurological symptoms was observed. Due to these findings we thought that TTP was the diagnosed and plasma exchange was started. Increase was seen in platelet count in the second days of treatment. TTP should be considered in children presenting with atypical thrombocytopenia.

  20. Familial clustering of juvenile thyroid autoimmunity: higher risk is conferred by human leukocyte antigen DR3-DQ2 and thyroid peroxidase antibody status in fathers.

    Science.gov (United States)

    Segni, Maria; Pani, Michael A; Pasquino, Anna Maria; Badenhoop, Klaus

    2002-08-01

    Thyroid autoimmunity is one of the most common immune disorders in females, and its polygenic background remains to be elucidated. The human leukocyte antigen (HLA) DQ region of chromosome 6 has been shown to confer susceptibility to thyroid autoimmune disease. The aim of our present investigation was to determine whether the transmission of high risk HLA DQ to patients with thyroid autoimmunity differs when transmission is from fathers as opposed to when transmission is from mothers. We studied 91 juvenile patients with chronic lymphocytic thyroiditis (68 females and 23 males; mean age, 10.5 +/- 3.9 yr), 12 patients with Graves' disease (all females; mean age, 8.8 +/- 4.0 yr), 53 healthy siblings, and their parents for thyroid function, antibodies, ultrasound, and DNA typing for HLA DQ susceptibility alleles. We observed an increased rate of transmission for the DQA1*0501-DQB1*0201 (DQ2) haplotype [35 of 53 transmitted (66%); P = 0.02]. This allele was preferentially transmitted by fathers [21 of 27 (78%); P < 0.004], whereas the maternal DQ2 haplotypes were not transmitted more often than expected. Subsequently, families were stratified as follows according to the parental thyroid peroxidase antibody (TPOAb) status: no parent, only mothers, only fathers, and both parents positive. There was no significant maternal transmission disequilibrium in any subset, but the paternal HLA DQ2 was preferentially transmitted [11 of 14 cases (79%); P = 0.03] in the group of TPOAb-positive mothers, and we observed a similar trend in the group of TPOAb- positive fathers (P = 0.08). Also, the portion of offspring affected by Graves' disease was significantly higher in TPOAb-positive than in TPOAb-negative fathers (P < 0.02). In conclusion, our findings demonstrate a significant effect of paternal HLA DQ alleles as well as antibody status on susceptibility to thyroid autoimmune disease in juvenile patients.

  1. Black Cohosh Hepatotoxicity with Autoimmune Hepatitis Presentation

    Science.gov (United States)

    Franco, Diana L.; Kale, Santosh; Lam-Himlin, Dora M.; Harrison, M. Edwyn

    2017-01-01

    Herbal medicines have been used for the treatment of various ailments since time immemorial. Black cohosh (BC) is well known for the treatment of postmenopausal symptoms, with conflicting evidence supporting its safety and benefits. We present a rare case of BC-induced autoimmune hepatitis (AIH) with hepatotoxicity in a 69-year-old female. To our knowledge, this represents the third case of BC-induced AIH. PMID:28203134

  2. Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis

    Energy Technology Data Exchange (ETDEWEB)

    Piga, M.; Serra, A.; Loi, G.L.; Satta, L. [University of Cagliari, Nuclear Medicine - Department of Medical Sciences ' ' M. Aresu' ' , Cagliari (Italy); Deiana, L.; Liberto, M. Di; Mariotti, S. [University of Cagliari, Endocrinology - Department of Medical Sciences ' ' M. Aresu' ' , Cagliari (Italy)

    2004-12-01

    abnormalities in euthyroid HT. These abnormalities are similar to those observed in cases of severe Hashimoto's encephalopathy and may suggest a higher than expected involvement of CNS in thyroid autoimmune disease. (orig.)

  3. Autoimmune Thyroid Disease in Rheumatoid Arthritis: A Global Perspective

    Directory of Open Access Journals (Sweden)

    Jorge Cárdenas Roldán

    2012-01-01

    Full Text Available Objective. To determine the prevalence and impact of autoimmune thyroid disease (AITD in patients with rheumatoid arthritis (RA. Methods. Eight-hundred patients were included. The association between AITD and RA was analyzed was analyzed by bivariate and multivariate analysis. In addition, a literature review was done focusing on geographical variations. Results. In our cohort the prevalence of AITD was 9.8% while the presence of antibodies was 37.8% for antithyroperoxidase enzyme (TPOAb and 20.8% for antithyroglobulin protein (TgAb. The presence of type 2 diabetes, thrombosis, abnormal body mass index, and a high educational level was positively associated with AITD. The literature review disclosed a geographical variation of AITD in RA ranging from 0.5% to 27%. Autoantibody prevalence ranges from 6% to 31% for TgAb, 5% to 37% for TPOAb, and from 11.4% to 32% for the presence of either of the two. Conclusion. AITD is not uncommon in RA and should be systematically assessed since it is a risk factor for developing diabetes and cardiovascular disease. These results may help to further study the common mechanisms of autoimmune diseases, to improve patients’ outcome, and to define public health policies. An international consensus to accurately diagnose AITD is warranted.

  4. Autoimmune Thyroid Disease in Rheumatoid Arthritis: A Global Perspective

    Science.gov (United States)

    Cárdenas Roldán, Jorge; Amaya-Amaya, Jenny; Castellanos-de la Hoz, Juan; Giraldo-Villamil, Juliana; Montoya-Ortiz, Gladys; Cruz-Tapias, Paola; Rojas-Villarraga, Adriana; Mantilla, Rubén D.; Anaya, Juan-Manuel

    2012-01-01

    Objective. To determine the prevalence and impact of autoimmune thyroid disease (AITD) in patients with rheumatoid arthritis (RA). Methods. Eight-hundred patients were included. The association between AITD and RA was analyzed was analyzed by bivariate and multivariate analysis. In addition, a literature review was done focusing on geographical variations. Results. In our cohort the prevalence of AITD was 9.8% while the presence of antibodies was 37.8% for antithyroperoxidase enzyme (TPOAb) and 20.8% for antithyroglobulin protein (TgAb). The presence of type 2 diabetes, thrombosis, abnormal body mass index, and a high educational level was positively associated with AITD. The literature review disclosed a geographical variation of AITD in RA ranging from 0.5% to 27%. Autoantibody prevalence ranges from 6% to 31% for TgAb, 5% to 37% for TPOAb, and from 11.4% to 32% for the presence of either of the two. Conclusion. AITD is not uncommon in RA and should be systematically assessed since it is a risk factor for developing diabetes and cardiovascular disease. These results may help to further study the common mechanisms of autoimmune diseases, to improve patients' outcome, and to define public health policies. An international consensus to accurately diagnose AITD is warranted. PMID:23209899

  5. Twins as a tool for evaluating the influence of genetic susceptibility in thyroid autoimmunity

    DEFF Research Database (Denmark)

    Brix, T H; Hegedüs, L

    2011-01-01

    irrefutable evidence of a genetic component in the aetiology of both Graves' disease and Hashimoto's thyroiditis, as well as for harbouring thyroid autoantibodies. Biometric modelling shows that approximately 75% of the total phenotypic variance in autoimmune thyroid disease is due to genetic effects. Despite......By means of large twin cohorts, it has been possible to provide relatively valid and unbiased data regarding the influence of genetic and to some extent epigenetic factors in the aetiology of thyroid autoimmunity. The comparison of concordance rates between monozygotic and dizygotic twins provides...... the well known gender difference in the prevalence of autoimmune thyroid disease, the analyzes suggest that it is the same set of genes that operate in males and females. The lack of complete phenotypic concordance in monozygotic twin pairs indicates that also environmental and/or epigenetic factors...

  6. The sphingosine 1-phosphate receptor modulator FTY720 prevents iodide-induced autoimmune thyroiditis in non-obese diabetic mice.

    Science.gov (United States)

    Morohoshi, Kazuki; Osone, Michiko; Yoshida, Katsumi; Nakagawa, Yoshinori; Hoshikawa, Saeko; Ozaki, Hiroshi; Takahashi, Yurie; Ito, Sadayoshi; Mori, Kouki

    2011-09-01

    FTY720 is an immunomodulator that alters migration and homing of lymphocytes via sphingosine 1-phosphate receptors. This compound has been shown to be effective in suppressing autoimmune diseases in experimental and clinical settings. In the present study, we tested whether FTY720 prevented autoimmune thyroiditis in iodide-treated non-obese diabetic (NOD) mice, a model of Hashimoto's thyroiditis (HT) in humans. Mice were given 0.05% iodide water for 8 weeks, and this treatment effectively induced thyroiditis. Iodide-treated mice were injected intraperitoneally with either saline or FTY720 during the iodide treatment. FTY720 clearly suppressed the development of thyroiditis and reduced serum anti-thyroglobulin antibody levels. The number of circulating lymphocytes and spleen cells including CD4(+) T cells, CD8(+) T cells, and CD4(+)Foxp3(+) T cells was decreased in FTY720-treated mice. Our results indicate that FTY720 has immunomodulatory effects on iodide-induced autoimmune thyroiditis in NOD mice and may be a potential candidate for use in the prevention of HT.

  7. The relative importance of genetic and environmental effects for the early stages of thyroid autoimmunity

    DEFF Research Database (Denmark)

    Hansen, Pia S; Brix, Thomas H; Iachine, Ivan;

    2006-01-01

    OBJECTIVE: In euthyroid individuals, autoantibodies to thyroid peroxidase (TPOab) and thyroglobulin (Tgab) are regarded as early markers of thyroid autoimmunity. Family and twin studies suggest that development of thyroid autoantibodies in first-degree relatives of patients with autoimmune thyroid...... disease is under genetic influence. We aimed to estimate the relative importance of genetic and environmental effects for the presence of thyroid autoantibodies in euthyroid subjects. METHODS: A representative sample of healthy twin pairs was identified through the Danish Twin Registry; 1372 individuals...... concordance and intraclass correlations were consistently higher for MZ than for DZ twin pairs indicating genetic influence. Genetic components (with 95% confidence intervals) accounted for 73% (46-89%) of the liability of being thyroid antibody positive. Adjusting for covariates (age, TSH and others...

  8. The chronic autoimmune thyroiditis quality of life selenium trial (CATALYST)

    DEFF Research Database (Denmark)

    Winther, Kristian Hillert; Watt, Torquil; Bjørner, Jakob Bue

    2014-01-01

    . Exclusion criteria: previous diagnosis of toxic nodular goitre, Graves' hyperthyroidism, postpartum thyroiditis, Graves' orbitopathy; previous antithyroid drug treatment, radioiodine therapy or thyroid surgery; immune-modulatory or other medication affecting thyroid function; pregnancy, planned pregnancy...

  9. Genes and environment as predisposing factors in autoimmunity: acceleration of spontaneous thyroiditis by dietary iodide in NOD.H2(h4) mice.

    Science.gov (United States)

    Kolypetri, Panayota; King, Justin; Larijani, Mani; Carayanniotis, George

    2015-01-01

    In the field of autoimmune thyroiditis, NOD.H2(h4) mice have attracted significant and increasing attention since they not only develop spontaneous disease but they present thyroiditis with accelerated incidence and severity if they ingest iodide through their drinking water. This animal model highlights the interplay between genetic and dietary factors in the triggering of autoimmune disease and offers new opportunities to study immunoregulatory parameters influenced by both genes and environment. Here, we review experimental findings with this mouse model of thyroiditis.

  10. Diagnostic value of antithyroid peroxidase antibody for incidental autoimmune thyroiditis based on histopathologic results.

    Science.gov (United States)

    Rho, Myung Ho; Kim, Dong Wook; Hong, Hyun Pyo; Park, Young Mi; Kwon, Min Jeong; Jung, Soo Jin; Kim, Young Wook; Kang, Taewoo

    2012-12-01

    Detection of antithyroid peroxidase antibody (TPOAb) is widely used in the diagnosis of autoimmune thyroiditis (AIT), but no research has evaluated the diagnostic accuracy of TPOAb detection using histopathologic reference standards. To fill this research gap, this study assessed the diagnostic accuracy of detection of TPOAb and that of other serological markers in asymptomatic patients who had been diagnosed with AIT by histopathologic analysis after thyroid surgery. After review of patient records, 598 patients who had undergone thyroid nodule surgery were enrolled for examination for thyroid parenchyma by a pathologist and classification into no co-existing lymphocytic thyroiditis, Hashimoto thyroiditis, or non-Hashimoto type of lymphocytic thyroiditis (NHLT). The correlation between patient serological data and thyroid parenchyma pathology was analyzed. Statistically significant differences (P lymphocytic thyroiditis and no co-existing lymphocytic thyroiditis groups regarding thyroid-stimulating hormone (TSH) and TPOAb levels. And, TPOAb titer was significantly associated with the degree of inflammation. An abnormal TPOAb titer was found in 86 of the 598 patients (14.4 %) and the specificity of TPOAb detection for AIT diagnosis was found to be 96.9 %. The prevalence of Hashimoto thyroiditis and NHLT in the 560 papillary thyroid cancer (PTC) patients was found to be 7.9 and 17.9 %, respectively. The results indicate that TPOAb titer is associated with the degree of thyroid inflammation and that detection of TPOAb is a very specific means of diagnosing AIT. The results also indicate that the incidence of AIT and PTC coexistence is relatively high.

  11. The Expression and Distribution of S-100 Protein and CD83 in Thyroid Tissues of Autoimmune Thyroid Diseases

    Institute of Scientific and Technical Information of China (English)

    Wencan Xu; Shenren Chen; Jiexiong Huang; Zhichao Zheng; Linxing Chen; Wei Zhang

    2004-01-01

    To investigate the expression and distribution of S-100 protein and CD83 in the thyroid tissues of autoimmune thyroid diseases (ATDs), and to study the role of the dendritic cells in the pathogenesis of ATDs,immunohistochemical staining was used on pathological tissues of 20 patients with Hashimoto's thyroiditis (HT)and 20 patients with Graves' disease (GD) to check the expression and distribution of S-100 protein and CD83.Compared with control group (20 cases of thyroid follicular adenoma, TFA), the higher expressions of S-100 in HT (139.38±5.92 vs 59.47±11.69) and GD (119.42±14.48 vs 59.47±11.69) were observed respectively (p<0.001). The increased positive expressions of CD83 which is known as a marker of mature and activated DCs in HT (22.58±13.96 vs 5.19±8.08) and GD (29.92±14.43 vs 5.19±8.08) were also found respectively (p<0.001).Serum TPO antibody (TPO-Ab, 67.3 ± 11.6%) and Tg antibody (Tg-Ab, 59.8±10.1%) in HT were higher than that in GD (28.4±5.7%, 23.1±4.9%) and that in TFA (6.1±3.4%, 7.2±4.6%)(p<0.01). Serum TR-Ab in GD(16.3±5.6 U/L) was higher than that in HT (4.8±2.3 U/L) and that in TFA (2.5±1.2 U/L) (p<0.01). Our findings suggest that the high expression of DCs' markers may be related to the pathogenesis of HT and GD.The upregulation of both number and matured functions of DCs, may lead to present more antigens and to produce more auto-antibodies (such as TgAb and TPOAb in HT, TRAb in GD), which may be involved in pathogenesis of the autoimmune thyroid diseases. Cellular & Molecular Immunology. 2004; 1(5):378-382.

  12. Skin disease and thyroid autoimmunity in atopic South Italian children

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    Pedullà, Marcella; Fierro, Vincenzo; Marzuillo, Pierluigi; Capuano, Francesco; Miraglia del Giudice, Emanuele; Ruocco, Eleonora

    2016-01-01

    AIM To verify the prevalence of thyroid autoimmunity (TA) and the possible association between atopy and TA in children affected by skin disease. METHODS Three hundred and twenty-four children consecutively referred due to skin disease symptoms to our Pediatric Department were enrolled. One hundred and eighty-seven were diagnosed with atopic dermatitis (AD), 95 with acute urticaria, 40 with chronic urticaria (CU), and 2 with alopecia areata (AA). According to the work-up for atopy, the children were divided into two groups: Atopics and non-atopics. TA was diagnosed by serum thyroid peroxidase autoantibodies and/or thyroglobulin autoantibodies levels more than twice normal values over a period of two months by immunoassay. RESULTS In all children with skin disease, a significant prevalence of TA in atopics compared with non-atopics (13.67% vs 2.67%, P = 0.0016) and a significant association between TA and atopy (OR = 5.76, 95%CI: 1.71-19.35) were observed. These findings were confirmed as significant in children with AD: TA in atopics was 11.5%, while TA in non-atopics was 2.7% (P = 0.03, OR = 4.68, 95%CI: 1.02-21.38). In addition, atopics with CU showed a significantly higher prevalence of TA (26.9%), but none of the non-atopics showed CU (P = 0.0326). On the other hand, atopics with AA showed a 100% (2 out of 2) prevalence of TA, compared with none of the non-atopics. CONCLUSION In children with skin disease, atopy seems to be associated with an increased risk of TA. PMID:27610344

  13. Possible activation of auto-immune thyroiditis from continuous subcutaneous infusion of genapol-containing insulin.

    Science.gov (United States)

    Chantelau, E

    2000-09-01

    A case of a type 1 diabetic woman with auto-immune thyroiditis is reported, in whom repeated exposure to insulin containing Genapol(R) (polyethylen-polypropylenglycol) over 3 years reproducibly parallels with an increase of serum TSH (thyroid-stimulating hormone) above the normal limit. Previously, adverse effects of Genapol(R) insulin have been related to its intraperitoneal application, and thought to be restricted to anti-insulin-immunity; activating effects on thyroid auto-immunity have been repeatedly disputed. We suggest that Genapol(R) insulin should be replaced by other insulin preparations with a better safety record.

  14. Unusual pediatric co-morbility: autoimmune thyroiditis and cortico-resistant nephrotic syndrome in a 6-month-old Italian patient.

    Science.gov (United States)

    Urbano, Flavia; Acquafredda, Angelo; Aceto, Gabriella; Penza, Rosa; Cavallo, Luciano

    2012-10-23

    We report on a case of autoimmune thyroiditis in a 6-month-old patient with cortico-resistant nephrotic syndrome. Normal serum levels of thyroid hormons and thyroid-stimulating hormone were detected with high titers of circulant antithyroid antibodies and a dysomogeneous ultrasound appearance of the gland, typical of autoimmune thyroiditis. The research of maternal thyroid antibodies was negative. This is the first case of autoimmune thyroiditis found in such a young patient with pre-existing nephrotic syndrome ever described in literature. This association is random because nephrotic syndrome does not have an autoimmune pathogenesis and the genes involved in autoimmune thyroiditis are not related to those of nephrotic syndrome.

  15. POSSIBLE ROLE OF PROBIOTIC MICROORGANISMS OF BIFIDOBACTERIUM AND LACTOBACILLUS GENUS IN PATHOGENESIS OF AUTOIMMUNE THYROID DISEASES

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    E. P. Kiseleva

    2010-01-01

    Full Text Available It was revealed, that, in blood samples of the patients with autoimmune thyroid diseases, serum antibodies against cell-free fraction of Bifidobacterium bifidum 791 and Lactobacillus plantarum B-01 were detected, respectively, in 71 and 63% of cases, that being two-fold higher than appropriate frequencies in healthy blood donors. An evidence was obtained that presence of some components specifically reacting with autoantibodies against thyroid peroxidase and thyroglobulin on the surface of the microorganisms cells and competing for binding of these immunoglobulins with thyroid antigens. One may also suggest a presence of bacterial components, interacting with thyroid peroxidase. The data obtained let us suggest that probiotic microorganisms of Bifidobacterium and Lactobacillus genus could take part in pathogenesis of autoimmune thyroid diseases, by means of molecular mimicry mechanisms.

  16. Impacts of pegylated interferon-ribavirin combination treatment on thyroid functions and thyroid autoimmunity in patients with chronic hepatitis C

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    Ferhat Yılmaz

    2010-09-01

    Full Text Available Objectives: Hepatitis C and interferon may trigger autoimmunity. We aimed to investigate the effects of combination treatment of peginterferon alpha (peg-IFN + ribavirin in patients with chronic hepatitis C (CHC on thyroid function tests and thyroid auto antibodies.Materials and Methods: The study included 45 outpatients with proven CHC having normal thyroid functions and previously not treated. The patients received combination of Peg-IFN+ribavirin. Values of fT3, fT4, TSH, antitiroglobu-lin (Anti-Tg and thyroid peroxidase antibody (Anti-TPO were measured at initial, first, third and sixth months of treatment. Frequency of thyroid dysfunction was evaluated according to age and gender of patients.Results: Thyroid dysfunction emerged in 15 (%33.3 of 45 patients at the end of the six month of antiviral treatment. Symptomatic thyroid disease was confirmed in 2 patients. Subclinical hyperthyroidism was determined in four pa-tients (%8.9, and subclinical hypothyroidism in 3 patients (%6.7 at the end of third month.At the end of sixth month; symptomatic hyperthyroidism was observed in one patient (%2.2, subclinical hyperthyroid-ism in six (%13.3 and subclinical hypothyroidism in 7 patients (%15.6, and symptomatic hypothyroidism was deter-mined in one patient (%2.2.At the end of the sixth month of antiviral treatment; Anti-Tg antibodies were positive in 12 patients (%26.7 and anti-TPO in 11 patients (4 male and 7 female (%24.5. No significant relationship was found between thyroid dysfunction and age, gender and ALT levels of patients (p>0.05.Conclusion: Periodic follow-up examinations should be done for thyroid autoimmunity and thyroid functions in CHC patients receiving combination treatment of Peg-INF+ribavirin.

  17. Prevalence of macroprolactinaemia in regularly menstruating women with non-toxic goitre or autoimmune thyroid disease

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    Lewandowski Krzysztof C

    2012-12-01

    Full Text Available Abstract Background The so called “big-big” prolactin (Prl, also known as macroprolactin is formed by Prl-immunoglobulin (Prl-IgG complexes and may cause elevation of serum Prl concentrations measured by standard assays, potentially leading to unnecessary investigations and/or treatment. In our study, we have endeavoured to assess the prevalence of macroprolactinaemia in euthyroid, regularly menstruating women with thyroid disease, as well as to assess whether autoimmune thyroid disease may result in an increased prevalence of macroprolactinaemia. Material and methods We measured serum Prl in 182 regularly menstruating women aged 32.7 ± 7.5 years (mean ± SD, range 17–46 years who attended endocrine clinic either for investigation of non-toxic goitre (n = 86, age 33.2 ± 7.8 years or with autoimmune thyroid disease (n = 96, age 32.3 ± 7.2 years. Autoimmune thyroid disease was defined as raised titre of at least one anti-thyroid antibody [anti-thyroid peroxidase (anti-TPO, anti-thyroglobulin (anti-Tg and/or anti-TSH-receptor (anti-TSH-R antibodies]. All women were clinically and biochemically euthyroid, either without or on treatment with L-thyroxine. In those with raised Prl (i.e., above 530 mIU/l we ruled out the presence of macroprolactinaemia by polyethylene glycol (PEG precipitation method. Results There was no significant age difference between women with and without autoimmune thyroid disease (p = 0.84. Raised Prl concentrations were found in 10 women with thyroid disease (5.5%, and of those a significant macroprolactinaemia (i.e., reduction of Prl concentrations of more than 60% after PEG precipitation was found in 9 subjects (4.94%. There were no differences in the prevalence of macroprolactinaemia between women with autoimmune thyroid disease (4 out of 96, and without autoimmune thyroid disease (5 out of 86, p = 0.75. Conclusions Approximately one out of twenty women with regular menses is likely

  18. Is vitamin D a player or not in the pathophysiology of autoimmune thyroid diseases?

    Science.gov (United States)

    D'Aurizio, Federica; Villalta, Danilo; Metus, Paolo; Doretto, Paolo; Tozzoli, Renato

    2015-05-01

    1,25-Dihydroxyvitamin D is a steroid hormone derived from vitamin D, playing an important role in maintaining an adequate serum level of calcium and phosphorus. It is now clear that vitamin D exerts an endocrine action on the cells of the immune system, generating anti-inflammatory and immunoregulatory effects. The mechanisms underlying the role of vitamin D in autoimmunity are not completely understood. Lower vitamin D levels have been found in several autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, type 1 diabetes mellitus, multiple sclerosis, inflammatory bowel diseases, autoimmune thyroid diseases (i.e. Hashimoto's thyroiditis and Graves' disease) and autoimmune gastritis. Several genetic studies have demonstrated an association between thyroid autoimmunity susceptibility and gene polymorphisms of vitamin D receptor, vitamin D binding protein, 1-alpha-hydroxylase and 25-hydroxylase. Of note, some papers do not confirm this connection. With regard to the role of vitamin D in autoimmune thyroid diseases, available data remain controversial. Only few reports have analyzed the supposed association between autoimmune thyroid diseases and vitamin D concentration with inconclusive results. In our experience, low serum levels of vitamin D do not correlate either with Hashimoto's thyroiditis or with Graves' disease. The inability to achieve an unambiguous conclusion is in part due to the limitations in study design. In fact, most of the studies are cross-sectional surveys with a small number of subjects. In addition, the heterogeneity of the study population, seasonal variation of blood sampling, inter-method analytical variability of vitamin D assays and different definitions of vitamin D deficiency/insufficiency contribute to contradicting results. Therefore, further randomized, controlled, prospective trials are needed in order to demonstrate the causality of vitD in AITD and consequently the role of vitamin D

  19. Chronic urticaria in patients with autoimmune thyroiditis: Significance of severity of thyroid gland inflammation

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    Mustafa Gulec

    2011-01-01

    Full Text Available Background: There is a clear association between autoimmune thyroiditis (AT and chronic urticaria/angioedema (CUA. However, not all patients with AT demonstrate urticaria. Aims: The aim of the study was to investigate in which patients with AT did CUA become a problem. A sensitive inflammation marker, neopterine (NP was used to confirm whether the severity of inflammation in the thyroid gland was responsible for urticaria or not. Methods: Neopterine levels were assessed in patients with AT with urticaria and without urticaria. Furthermore, levels were compared in relation to pre and post levothyroxine treatment. Twenty-seven patients with urticaria (Group 1 and 28 patients without urticaria (Group 2 were enrolled in the study. A course of levothyroxine treatment was given to all patients, and urine neopterine levels before and after the trial were obtained. Results: All patients completed the trial. Mean age in Group 1 and Group 2 was similar (35.70 ± 10.86 years and 38.36 ± 10.38 years, respectively (P=0.358. Pre-treatment urine neopterine levels were significantly higher in Group 1 (P=0.012. Post-treatment levels decreased in each group, as expected. However, the decrease in the neopterine level was insignificant in the patients of Group 2 (P=0.282. In Group 1, a significant decrease in post-treatment neopterine levels (P=0.015 was associated with the remission of urticaria. Conclusion: In patients with CUA and AT, pre-treatment elevated levels of NP, and its decrease with levothyroxine treatment along with symptomatic relief in urticaria, may be evidence of the relationship between the degree of inflammation in thyroid and presence of urticaria.

  20. Newborn of mothers affected by autoimmune thyroiditis: the importance of thyroid function monitoring in the first months of life

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    Mosca Fabio

    2010-03-01

    Full Text Available Abstract Background evaluation of thyroid function in neonates born from mothers affected by autoimmune thyroiditis in order to define if a precise follow-up is necessary for these children. The influence of maternal thyroid peroxidase antibody (TPOAb and L-thyroxine therapy during pregnancy on neonatal thyroid function was also investigated. Methods 129 neonates were tested for thyroid function by measurement of free thyroxine (FT4 and thyroid stimulating hormone (TSH in 3th day, 15th day and at one month of life. TPOAb were measured in all patients; periodical control of thyroid function were performed until 6 months of life if Ab were positive. Data concerning etiology of maternal hypothyroidism and maternal replacement therapy with L-thyroxine during pregnancy were retrospectively collected. Results 28% neonates showed at least a mild increase of TSH value at the different determinations. In the majority of them, a spontaneous completely normalisation of TSH value was observed within the first month life. L-thyroxine replacement therapy was started in 3 neonates. TPOAb titer and maternal L-thyroxine replacement therapy were not related to alteration of thyroid hormone function in our study population. Conclusions transient mild elevation of serum TSH above the normal reference value for age is frequently observed in the first month of life in infants born from mothers affected by autoimmune thyroiditis. Persistent hyperthyrotropinemia requiring replacement therapy is observed in 2.2% of these neonates. According to our experience, follow-up is recommended in these newborns; the most accurate and not invasive way to carefully monitor these infants after neonatal screening for CH seems to be serum-testing TSH between 2ndand 4th week of life.

  1. Increased interleukin-4-positive lymphocytes in patients with Hashimoto's thyroiditis and concurrent non-endocrine autoimmune disorders.

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    Santaguida, M G; Nardo, S; Del Duca, S C; Lococo, E; Virili, C; Gargano, L; Lenti, L; Centanni, M

    2011-08-01

    A prevalent T helper type 1 (Th1) subset of lymphocytes has been described in Hashimoto's thyroiditis (HT), but whether a similar polarization may characterize HT when associated with non-endocrine autoimmune disorders (NEAD) is not known. The aim of the present study was to analyse the intracellular Th1 and Th2 distinctive cytokines in patients with isolated HT or associated with non-endocrine autoimmune disorders. Intracellular cytokine expression was assessed in peripheral blood lymphocytes (PBL) of 68 out-patients (females = 55; males = 13; median age = 6 years) with HT : 33 had isolated HT and 35 had a concurrent NEAD. The percentage of interferon (IFN)-γ and interleukin (IL)-2 Th1- and IL-4 Th2-positive cells was measured by flow cytometric analysis. We found an increased percentage of IL-2-positive cells in all patients, without differences between patients with isolated HT or associated with NEAD. IFN-γ(+) cells were also increased in both groups, but the median percentage of those with isolated HT was lower than in patients with HT+NEAD (19·0 versus 29·9%; P = 0·0082). An increased number of IL-4-positive cells was observed in three of 33 (9·1%) patients with isolated HT and in 25 of 35 patients with NEAD [71%; P lymphocytes characterizes patients with autoimmune thyroiditis who have associated non-endocrine autoimmune disorders. These findings may represent an initial tool to detect patients with autoimmune thyroiditis in which additional non-endocrine autoimmune disorders may be awaited.

  2. Autoimmune Polyglandular Syndrome Type 2: An Unusual Presentation

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    Hamdollah Karamifar

    2010-05-01

    Full Text Available "nAutoimmune polyglandular syndrome (APS type 2 is characterized by the presence of Addison's disease, in association with autoimmune thyroid disease and/or type 1 diabetes mellitus. APS type 2 occurs most often in middle aged females and is rare in children. Here an 11 year old boy is reported with Addison's disease who developed symptom's of diabetes mellitus, goiter, malabsorption, macrocytic anemia and keratitis. APS type 2 occurs most often in middle aged females and is quite rare in children but one should think to autoimmune poly glandular syndrome type II in patient at any age especially in patients with Addison's disease.

  3. [Diagnosis of osteoporosis occurring in autoimmune thyroid gland disease].

    Science.gov (United States)

    Radojković, Ivan; Radojković, Jana; Djurica, Snezana

    2005-10-01

    Osteoporosis or porotic bone is a general, systemic bone disease, which is manifested by fracture as its consequence. The main characteristic of this disease is the loss of bone microarchitecture, bone mass reduction, and its increased fragility. The result, thereof, is susceptibility to fracture. Etiology of osteoporosis is polymorph. Its socio-medical importance is enormous, since there is one osteoporotic fracture every 20 sec. worldwide. Million and six hundred thousand osteoporotic fractures occur annualy throughout the world. Thyroid gland is susceptible to autoimmune reactions that lead to autoimmune diseases, just like many other organs. The autoimmune disorder is a final consequence of a failure, in some instance, within the crucial mechanism of regulation of self tissue tolerance. The main goal is to prove the presence of osteoporosis, its inexpensive and quick diagnostics; to make a distinction among the causes that lead to it. In addition, to indicate the importance of osteoporosis that is caused by normal, metabolic processes which are an inevitable part of ageing. Diagnosis of osteoporosis can be done through laboratory, which is a tiresome, time consuming task. Measurements of BMD could be also performed by using new devices. Osteometers could be constructed on the basis of X-ray photon energy or US. Utilization most contemporary one uses laser beam, and it approximates the distance of additional tissue that also absorbs part of energy changing absorption of the reception unit and thus making the measurement results accurate. In diagnosing BMD by osteometer, one faces with certain difficulties. When axial quantitative CT is used, the value may be falsely lower, because of the loss of energy absorbed by aorta which is often calcified in elderly people. In devices with transversal scanning, of the same nature and technology, a part of the energy is being absorbed by transversal and spinal vertebrals. After the research, one may conclude that the most

  4. Subacute thyroiditis (de Quervain) presenting as a painless cold nodule

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    Bartels, P.C.; Boer, R.O.

    1987-09-01

    A 49-yr-old woman presented with a solid, painless, nontender nodule in the left thyroid lobe. Thyroid scintigraphy revealed a solitary cold area in the left lobe and a slightly decreased 24-hr radioactive iodine thyroid uptake (9%). Although there were no specific clinical or biochemical signs suggesting thyroiditis needle aspiration cytology showed the presence of a subacute thyroiditis. Approximately 1 mo later the entire thyroid gland was affected leading to a completely suppressed thyroid radioiodine uptake and elevated serum thyroid hormone concentrations. This case illustrates that in the early phase of the disease, subacute thyroiditis may present as a solitary, painless, cold nodule and should be considered in the differential diagnosis of such lesions.

  5. Regulatory B and T cell responses in patients with autoimmune thyroid disease and healthy controls

    DEFF Research Database (Denmark)

    Kristensen, Birte

    2016-01-01

    ). HT is primarily a T-cell mediated disease, and whether B cells play a pathogenic role in the pathogenesis is still unclear. Both GD and HT are characterized by infiltration of the thyroid gland by self-reactive T cells and B cells. In the first paper of this thesis, the role of regulatory B cells......Autoimmune diseases occur due to faulty self-tolerance. Graves' disease (GD) and Hashimoto's thyroiditis (HT) are classic examples of organ-specific autoimmune diseases. GD is an auto-antibody-mediated disease where autoantibodies are produced against the thyroid stimulating hormone receptor (TSHR...... (Bregs) and regulatory T cells (Tregs) were investigated in the context of GD and HT. First, we studied the role of the thyroid self-antigen, thyroglobulin (TG) in healthy donors. The self-antigen TG, but not the foreign recall antigen tetanus toxoid (TT), was able to induce interleukin 10 (IL-10...

  6. High prevalence of thyroid dysfunction and autoimmune thyroiditis in adolescents after elimination of iodine deficiency in the Eastern Black Sea Region of Turkey.

    Science.gov (United States)

    Bastemir, Mehmet; Emral, Rifat; Erdogan, Gurbuz; Gullu, Sevim

    2006-12-01

    In the present study we evaluated the effects of iodine intake on the prevalence of thyroid dysfunction, autoimmunity, and goiter in two regions with different iodine status after two years of iodization in Turkey. In total 1733 adolescent subjects were enrolled into the study (993 from an iodine-sufficient area--the Eastern Black Sea Region (group 1) and 740 from an iodine-deficient area--Middle Anatolia (group 2)). We measured free thyroxine (FT(4)), thyrotropin (TSH), antithyroid peroxidase antibodies (Anti-TPO), antithyroglobulin antibodies (Anti-Tg), and urinary iodine (UI), and examined the thyroid gland by ultrasound. Median urinary iodine excretion was found to be significantly different in group 1 and group 2 (139 micro/l vs 61micro/l, p 0.05). The percentage of anti-Tg positive subjects was found to be 17.6% in group 1 and 6.4% in group 2; that of anti-TPO positive subjects was 4.3% in group 1 and 1.5% in group 2. The prevalence of antithyroid antibody (anti-Tg and/or anti-TPO) positivity was significantly higher in group 1 than in group 2 (18.52% vs 6.62%; p iodine supplementation in Turkey has resulted in the elimination of iodine deficiency in the Eastern Black Sea Region, and this has been accompanied by an increase in the prevalence of autoimmune thyroiditis and thyroid dysfunction.

  7. An unusual association of three autoimmune disorders: celiac disease, systemic lupus erythematosus and Hashimoto's thyroiditis.

    Science.gov (United States)

    Boccuti, Viera; Perrone, Antonio; D'Introno, Alessia; Campobasso, Anna; Sangineto, Moris; Sabbà, Carlo

    2016-12-01

    Autoimmune disorders are known to be more frequent in women and often associated each others, but it is rare to see multiple autoimmune diseases in a single patient. Recently, the concept of multiple autoimmune syndrome has been introduced to describe patients with at least three autoimmune diseases. We describe a case of a young man with a clinical history of psychiatric symptoms and celiac disease (CD) who was diagnosed to have other two autoimmune disorders: systemic lupus erythematosus (SLE) and Hashimoto's thyroiditis. This case is unusual upon different patterns: the rare combination of the three autoimmune diseases, their appearance in a man and the atypical onset of the diseases with psychiatric symptoms likely to be related either to CD or to SLE.

  8. Clinical Update in Aspects of the Management of Autoimmune Thyroid Diseases

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    Duncan J. Topliss

    2016-12-01

    Full Text Available Aspects of autoimmune thyroid disease updated in this review include: immunoglobulin G4 (IgG4-related thyroid disease (Riedel's thyroiditis, fibrosing variant of Hashimoto's thyroiditis, IgG4-related Hashimoto's thyroiditis, and Graves' disease with elevated IgG4 levels; recent epidemiological studies from China and Denmark indicating that excess iodine increases the incidence of Hashimoto's thyroiditis and hypothyroidism; immunomodulatory agents (ipilimumab, pembrolizumab, nivolumab activate immune response by inhibiting T-cell surface receptors which down-regulate immune response, i.e., cytotoxic T-lymphocyte antigen 4 and programmed cell death protein 1 pathways; alemtuzumab is a humanised monoclonal antibody to CD52 which causes immune depletion and thyroid autoimmune disease especially Graves' hyperthyroidism; small molecule ligand (SML agonists which activate receptors, SML neutral antagonists, which inhibit receptor activation by agonists, and SML inverse agonists which inhibit receptor activation by agonists and inhibit constitutive agonist independent signaling have been identified. SML antagonism of thyroid-stimulating hormone-receptor stimulatory antibody could treat Graves' hyperthyroidism and Graves' ophthalmopathy; and thyroxine treatment of subclinical hypothyroidism can produce iatrogenic subclinical hyperthyroidism with the risk of atrial fibrillation and osteoporosis. The increased risk of harm from subclinical hyperthyroidism may be stronger than the potential benefit from treatment of subclinical hypothyroidism.

  9. Clinical Update in Aspects of the Management of Autoimmune Thyroid Diseases

    Science.gov (United States)

    2016-01-01

    Aspects of autoimmune thyroid disease updated in this review include: immunoglobulin G4 (IgG4)-related thyroid disease (Riedel's thyroiditis, fibrosing variant of Hashimoto's thyroiditis, IgG4-related Hashimoto's thyroiditis, and Graves' disease with elevated IgG4 levels); recent epidemiological studies from China and Denmark indicating that excess iodine increases the incidence of Hashimoto's thyroiditis and hypothyroidism; immunomodulatory agents (ipilimumab, pembrolizumab, nivolumab) activate immune response by inhibiting T-cell surface receptors which down-regulate immune response, i.e., cytotoxic T-lymphocyte antigen 4 and programmed cell death protein 1 pathways; alemtuzumab is a humanised monoclonal antibody to CD52 which causes immune depletion and thyroid autoimmune disease especially Graves' hyperthyroidism; small molecule ligand (SML) agonists which activate receptors, SML neutral antagonists, which inhibit receptor activation by agonists, and SML inverse agonists which inhibit receptor activation by agonists and inhibit constitutive agonist independent signaling have been identified. SML antagonism of thyroid-stimulating hormone-receptor stimulatory antibody could treat Graves' hyperthyroidism and Graves' ophthalmopathy; and thyroxine treatment of subclinical hypothyroidism can produce iatrogenic subclinical hyperthyroidism with the risk of atrial fibrillation and osteoporosis. The increased risk of harm from subclinical hyperthyroidism may be stronger than the potential benefit from treatment of subclinical hypothyroidism. PMID:28029020

  10. Type 1 Diabetes Mellitus Associated With Autoimmune Thyroid Disorders in Iranian Children: A Review

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    Daniel Zamanfar

    2015-01-01

    Full Text Available Context: Type one diabetes mellitus (T1DM is an autoimmune disorder that is yet the most common type of diabetes in children and adolescents. Several genetic risk factors have been associated with T1DM, auto immune thyroiditis and other autoimmune disorder. Among autoimmune disorders, autoimmune thyroid disease (ATD is the most frequent disorder associated with T1DM. Its prevalence varies depending on age, sex and ethnic origin of the subjects and is considerably higher than the general population and increases with duration of T1DM. The aim of this study was to review the prevalence of ATD in Iranian children with T1DM compared with other countries. Evidence Acquisition: We conducted a review on all papers published on the association between autoimmune thyroiditis and T1DM, which was available on Google Scholar, Scientific Information Database (SID, Magiran and Iran Medex databases up to June 2014. Both Persian and English articles were checked. The searched terms were: diabetes mellitus, autoimmune thyroiditis, prevalence, frequency, Iranian children and adolescents. All papers which were done on patients with age under 20 years old and have used Anti-TPO and Anti-TG to evaluate patients were included. Results: Six papers met all the criteria. A total of 736 participants were included in this review. After review of all the papers, the prevalence of Anti-TPO was reported between 8% and 30% and Anti-TG was reported 6.06% to 23.6% in diabetic children in Iran. Conclusions: Autoimmune thyroid disorders are the most prevalent immunological diseases in patients with type 1 diabetes. All these studies have shown a higher prevalence of the disorder in patients with T1DM compared to the Iranian healthy population. Anti-TPO reported between 8% and 30% and Anti-TG reported 6.06% to 23.6% in diabetic children in Iran that was similar to the studies in other countries.

  11. The clinical features of 17 patients with steroid-responsive encephalopathy associated with autoimmune thyroiditis

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    CHEN Hai

    2013-06-01

    Full Text Available Objective To investigate the onset pattern, clinical manifestations, laboratory findings and imaging features of 17 Chinese patients with steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT. Methods The clinical data of 17 SREAT patients were collected. Retrospective analysis of their clinical features, as well as their serum levels of anti-thyroid, cerebrospinal fluid (CSF biochemical indicators, MRI and therapy was performed. Results The initial symptoms of those patients were seizures (4 cases, psychiatric symptoms (4 cases, hypomnesis (4 cases, walking unsteadiness (2 cases, headache (2 cases and dysarthria (1 case. Three cases were acute onset, 5 cases subacute onset and 9 cases chronic onset. The anti-thyroid peroxidase antibody (anti-TPO of 17 cases were significantly increased, average (928.63 ± 406.28 × 10 3 IU/L. The anti?thyroglobulin antibody (anti-TG of 15 cases was increased, average (601.27 ± 1014.12 × 10 3 IU/L. The protein in CSF was mildly increased, average (513.75 ± 283.15 mg/L. The EEG of 5 patients presented slow wave and the EEG of 2 patients showed epileptiform discharge. The brain MRI of 11 patients showed multifocal lesions in frontal lobe, temporal lobe, parietal lobe, basal ganglia, centrum ovale, corpus callosum, thalamus, cerebellum, and brain stem. The findings of clinical immunological index and tumor markers were normal. Besides, the prognosis of 11 patients treated with methylprednisolone and 3 patients treated with dexamethasone were good. Recurrence occurred in 2 patients. Conclusion Basically, the clinical features of Chinese SREAT patients present seizures, hypomnesis and psychiatric symptoms associated with increased anti-thyroid and multifocal lesions in gray and white matter of brain.

  12. Combined Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Subclinical Hypothyroidism Patients with Autoimmune Thyroiditis

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    Maurizio Nordio

    2013-01-01

    Full Text Available Background. Hashimoto's thyroiditis (HT, also known as chronic lymphocytic thyroiditis or chronic autoimmune thyroiditis, is the most common form of thyroiditis affecting more than 10% of females and 2% of males. The present study aims to evaluate the beneficial effect of a combined treatment, Myo-Inositol plus selenomethionine, on subclinical hypothyroidism. Methods. The study was designed as a double-blind randomized controlled trial. Eligible patients were women diagnosed with subclinical hypothyroidism having Tg antibodies (TgAb titer higher than 350 IU/mL. Outcome measures were Thyroid Stimulating Hormone (TSH levels, thyroid peroxidase antibodies (TPOAb and TgAb titer, selenium, and Myo-Inositol plasma concentration. Results. In the present paper, we demonstrated that the beneficial effects obtained by selenomethionine treatment on patients affected by subclinical hypothyroidism, likely due to the presence of autoantibody (TPOAb and TgAb, are further improved by cotreatment with Myo-Inositol. Conclusions. Indeed, due to its action as TSH second messenger, Myo-Inositol treatment reduces TSH levels closer to physiological concentrations.

  13. Paraplegia as initial presentation of follicular thyroid carcinoma.

    Science.gov (United States)

    Haghpanah, Vahid; Abbas, Syed Imran; Mahmoodzadeh, Hossein; Shojaei, Abdolreza; Soleimani, Ali; Larijani, Bagher; Tavangar, Seyed Mohammad

    2006-03-01

    Follicular thyroid carcinoma with metastasis rarely presents with clinical picture of spinal cord compression. This report describes a 53 years old patient with follicular thyroid carcinoma who presented with paraplegia and urinary incontinence. Magnetic resonance imaging (MRI) of neck revealed a mass with destruction of C5 and extension to C6. Histopathology study demonstrated metastatic carcinoma of thyroid.

  14. The chronic autoimmune thyroiditis quality of life selenium trial (CATALYST)

    DEFF Research Database (Denmark)

    Winther, Kristian Hillert; Watt, Torquil; Bjørner, Jakob Bue;

    2014-01-01

    . Exclusion criteria: previous diagnosis of toxic nodular goitre, Graves' hyperthyroidism, postpartum thyroiditis, Graves' orbitopathy; previous antithyroid drug treatment, radioiodine therapy or thyroid surgery; immune-modulatory or other medication affecting thyroid function; pregnancy, planned pregnancy...... or breastfeeding; allergy towards any intervention or placebo component; intake of selenium supplementation >55 mug/day; inability to read or understand Danish or lack of informed consent. The trial will include 2 x 236 participants. The experimental intervention and control groups will receive 200 mug selenium...

  15. A study of CD4~+ T lymphocyte infiltration level in the thyroid of experimental autoimmune thyroiditis rat

    Institute of Scientific and Technical Information of China (English)

    崔丝露

    2014-01-01

    Objective To establish an experimental autoimmune thyroiditis(EAT)rat model and to observe pathological change levels of CD4+T lymphocyte infiltration in thyroid tissues under different iodine nutrient conditions.Methods One hundred and thirty-five four weeks old female Lewis rats(body weight about 80 g)were divided into control(NC),model(TG),high iodine-Ⅰ(HⅠ),high iodine and model-Ⅰ(HⅠ+TG),high iodine-Ⅱ(HⅡ),high iodine and model-Ⅱ(HⅡ+TG)groups

  16. Autoantibodies in autoimmune thyroid disease promote immune complex formation with self antigens and increase B cell and CD4+ T cell proliferation in response to self antigens

    DEFF Research Database (Denmark)

    Nielsen, Claus Henrik; Hegedüs, Laszlo; Leslie, Robert Graham Quinton

    2004-01-01

    B cells are centrally involved as antigen-presenting cells in certain autoimmune diseases. To establish whether autoantibodies form immune complexes (IC) with self-antigens in autoimmune thyroid disease (AITD) and promote B cell uptake of self-antigen, sera from patients with Hashimoto......'s thyroiditis (HT), Graves' disease (GD) and healthy controls were incubated with human thyroglobulin (Tg) before adding normal peripheral blood mononuclear cells. The deposition of immunoglobulins and C3 fragments on B cells was then assessed. Inclusion of Tg in serum from HT patients promoted B cell capture...

  17. 355 Ocular Muscles Myopathy Associated with Autoimmune Thyroiditis. Case Reports

    Science.gov (United States)

    Vargas-Camaño, Eugenia; Castrejon-Vázquez, Isabel; Plazola-Hernández, Sara I.; Moguel-Ancheita, Silvia

    2012-01-01

    Background Thyroid-associated orbitopathy is commonly associated with Graves' disease with lid retraction, exophthalmos, and periorbital swelling, but rarely with autoimmune thyroiditis or euthyroid state. We reviewed 3 cases from our hospital whose antibodies to anti-receptor of TSH were normal. Methods Case 1: 60 year-old non-diabetic woman with bilateral glaucoma in treatment, recurrent media otitis and euthyroidism, acute onset of painless diplopia, and lid ptosis in the left eye. MRI of orbit showed increased size of the III right cranial pair and high levels of thyroid autoantibodies (Tab) anti-tiroglobulin (ATG) 115.1, anti-thyroid peroxidase (ATPO) 1751 U/mL. She started oral deflazacort 30 mg each 3 days. Sixty days later, complete remission of eye symptoms correlated with lower auto-antibodies level (ATG 19 ATPO 117). Case 2: 10 year-old girl. At age 8, she had diplopia, lid ptosis and limitations of upper gaze in the left eye. The neurological study discarded ocular myasthenia; with thyroid goitier, and hypothyrodism, she started oral levothyroxin. At age 10 with normal IRM Botulinic toxin was injected, without change. High levels of Tab were found, ATG 2723, ATPO 10.7. She started oral deflazacort 30 mg each 3 days, azathioprin 100 mg, daily. Actually, Tab levels are almost normal, but she remains with ocular alterations. Case 3: 56 year-old woman, Grave´s disease with exophtalmos in 1990, treated with I131 and immunosupression, with good outcome; obesity, hypertension and bilateral glaucoma in treatment. She suddenly presented diplopia and IV pair paresia of the right eye. A year later, ATb were found slightly elevated, ATG 100 years ATPO 227; despite prednisone 50 mg, each 3 days and azathioprin 150 mg/daily treatment, a surgical procedure was required for relieve the ocular symptoms. Results We found only 3 cases previously reported with this type of eye thyroid disease. Is important to note that awareness of this atypical form of orbitopathy

  18. Pathogenesis of thyroid-associated ophthalmopathy: does autoimmunity against calsequestrin and collagen XIII play a role?

    Directory of Open Access Journals (Sweden)

    Hooshang Lahooti

    2010-04-01

    Full Text Available Hooshang Lahooti, Kishan R Parmar, Jack R WallThe Department of Medicine, University of Sydney, Nepean Clinical School, Penrith, NSW, AustraliaAbstract: Thyroid-associated ophthalmopathy (TAO, or thyroid eye disease, is a complex inflammatory disorder of the eye that, as its name implies, is associated with thyroid disease. TAO can be divided into three subtypes: ocular myopathy, congestive myopathy and mixed congestive and myopathic ophthalmopathy. Although the precise pathophysiology of TAO remains unclear it is likely to reflect an autoimmune reaction involving sensitized T-cells and autoantibodies directed against a thyroid and orbital tissue shared antigen. One well studied candidate in this immune reaction is the thyroid-stimulating hormone receptor (TSH-r, expressed in the orbital fibroblast and pre adipocyte. In our studies of TAO, we have investigated the nature and significance of antibodies targeting other eye muscle and orbital connective tissue (OCT antigens. Our findings suggest that autoimmunity against the eye muscle antigen calsequestrin and the OCT antigen collagen XIII plays a role in the pathogenesis of TAO. We propose that ocular myopathy and chronic eyelid retraction are due to autoimmunity against skeletal muscle calsequestrin in the extraocular and eyelid muscles, respectively. This may be initiated in the thyroid where calsequestrin expression is upregulated, possibly due to a stimulatory effect of TSH-r antibodies. We also propose that congestive ophthalmopathy results from a reaction against the TSH-r or collagen XIII in orbital fibroblast cell membranes. Further insight into the role of eye muscle and OCT antigens in the pathogenesis of TAO may allow for the development of new therapies to treat the eye disorder and reduce patient morbidity.Keywords: thyroid-associated ophthalmopathy, autoimmunity, t calsequestrin, collagen XIII

  19. The Expression and Distribution of S-100 Protein and CD83 in Thyroid Tissues of Autoimmune Thyroid Diseases

    Institute of Scientific and Technical Information of China (English)

    WencanXu; ShenrenChen; JiexiongHuang; ZhichaoZheng; LinxingChen; WeiZhang

    2004-01-01

    To investigate the expression and distribution of S-100 protein and CD83 in the thyroid tissues of autoimmunethyroid diseases (ATDs), and to study the role of the dendritic cells in the pathogenesis of ATDs,immunohistochemical staining was used on pathological tissues of 20 patients with Hashimoto's thyroiditis (HT)and 20 patients with Graves' disease (GD) to check the expression and distribution of S-100 protein and CD83.Compared with control group (20 cases of thyroid follicular adenoma, TFA), the higher expressions of S-100 inHT (139.38 _+ 5.92 vs 59.47 + 11.69) and GD (119.42 _+ 14.48 vs 59.47 +_ 11.69) were observed respectively (p <0.001). The increased positive expressions of CD83 which is known as a marker of mature and activated DCs inHT (22.58 + 13.96 vs 5.19 +_ 8.08) and GD (29.92 _+ 14.43 vs 5.19 +_ 8.08) were also found respectively (p < 0.001).Serum TPO antibody (TPO-Ab, 67.3 +_ 11.6%) and Tg antibody (Tg-Ab, 59.8 + 10.1%) in HT were higher thanthat in GD (28.4 +_ 5.7%, 23.1 +_ 4.9%) and that in TFA (6.1 +_ 3.4%, 7.2 + 4.6%) (p < 0.01). Serum TR-Ab in GD(16.3 _+ 5.6 U/L) was higher than that in HT (4.8 +_ 2.3 U/L) and that in TFA (2.5 +_ 1.2 U/L) (p < 0.01). Ourfindings suggest that the high expression of DCs' markers may be related to the pathogenesis of HT and GD.The upregulation of both number and matured functions of DCs, may lead to present more antigens and toproduce more auto-antibodies (such as TgAb and TPOAb in HT, TRAb in GD), which may be involved inpathogenesis of the autoimmune thyroid diseases. Cellular & Molecular Immunology. 2004; 1(5):378-382.

  20. A selective memory deficit caused by autoimmune encephalopathy associated with Hashimoto thyroiditis.

    Science.gov (United States)

    Koros, Christos; Economou, Alexandra; Mastorakos, George; Bonakis, Anastasios; Kalfakis, Nikolaos; Papageorgiou, Sokratis G

    2012-09-01

    We report a longstanding selective memory deficit in a euthyroid 45-year-old woman who was being treated with levothyroxine for Hashimoto thyroiditis. The patient had complained of memory problems and deterioration of her concentration skills for about 2 years. Her endocrinologist thought that she was depressed. The patient's physical examination was normal. She scored a full 30 points on the Mini-Mental State Examination, but neuropsychological evaluation showed a significant deficit in her verbal memory. Routine blood tests and cerebrospinal fluid analysis showed only antithyroid peroxidase antibodies. Brain magnetic resonance imaging was normal. Electroencephalogram showed scarce intermittent bilateral multifocal theta waves. We increased the patient's daily dose of levothyroxine and started her on dexamethasone therapy. Five months later, we repeated the entire evaluation and found both her cognitive function and her electroencephalogram to be normal. Autoimmune encephalopathy associated with Hashimoto thyroiditis is already known to present with either stroke-like episodes or diffuse progressive deterioration. Our patient shows that the encephalopathy can present as a chronic selective memory deficit that can spare executive functions and short-term memory. This presentation can be missed or mistaken for depression, but can be diagnosed with a detailed neuropsychological evaluation.

  1. Is autoimmune thyroiditis part of the genetic vulnerability (or an endophenotype) for bipolar disorder?

    NARCIS (Netherlands)

    Vonk, Ronald; van der Schot, Astrid C.; Kahn, Rene S.; Nolen, Willem A.; Drexhage, Hemmo A.

    2007-01-01

    Background: Both genetic and environmental factors are involved in the etiology of bipolar disorder; however, biological markers for the transmission of the bipolar genotype ("endophenotypes") have not been found. Autoimmune thyroiditis with raised levels of thyroperoxidase antibodies (TPO-Abs) is r

  2. Socioeconomic Disparities in the Presentation and Treatment of Graves' Disease and Thyroid Eye Disease.

    Science.gov (United States)

    Vargason, Caroline W; Chelnis, James G; Barahimi, Behin I; Mawn, Louise A

    2016-01-01

    Thyroid eye disease (TED) is an inflammatory, autoimmune orbitopathy with multifactorial etiology. Clinical presentation of TED spans a range from mild surface irritation to vision threatening compressive optic neuropathy. Potential vision loss underscores the importance of understanding genetic and environmental factors influencing the severity of TED presentation. This review will describe the classic risk factors for TED, outline treatments for Graves' disease (GD) and TED, and describe newer evidence of socioeconomic disparities in TED presentation.

  3. Peripheral blood and intrathyroidal T cell clones from patients with thyroid autoimmune diseases.

    Science.gov (United States)

    Massart, C; Caroff, G; Maugendre, D; Genetet, N; Gibassier, J

    1999-01-01

    For a better understanding of the pathogenesis of thyroid autoimmune diseases, we have studied morphological and functional properties of T clones from peripheral blood lymphocytes (PBL) and from intrathyroidal lymphocytes (ITL) obtained from 3 patients with Graves' disease or 1 Hashimoto's thyroiditis. Investigations were carried out on clones cultured alone or cocultured with autologous thyrocytes. Clonage efficiency ranged from 30% to 33% for PBL and 10% to 36% for ITL. A predominance of CD4-positive clones was observed whatever the origin of the lymphocytes or the autoimmune pathology. Gamma interferon (IFN-gamma) was detected in the majority (17/19) of the clones tested. Intracytoplasmic interleukin (IL-4) was secreted in 7/19 clones and both cytokines were produced in 5/19 clones. In coculture a proliferative response and tumour necrosis factor (TNF-alpha) production were observed with 6 clones (4 from Graves thyrocytes and 2 from thyroiditis). No cytotoxic clone was derived from Graves or thyroiditis tissues. These data demonstrate that the large majority of T clones are principally CD4-T cells; all the clones secreted TNF-alpha and a large majority produced IFN-gamma. Only a few clones produced IL-4 alone or associated with IFN-gamma. Six T clones induced proliferative response and of TNF-alpha secretion in coculture. Further investigations must be performed on these antigen-reactive T clones to analyse their role in the pathogenesis of the human thyroid autoimmune diseases.

  4. Autoimmune polyglandular syndrome type 2 manifested as Hashimoto's thyroiditis and adrenocortical insufficiency, in Turner syndrome woman, with onset following introduction of treatment with recombinant human growth hormone.

    Science.gov (United States)

    Cyniak-Magierska, Anna; Lasoń, Agnieszka; Smyczyńska, Joanna; Lewiński, Andrzej

    2015-01-01

    Autoimmune polyglandular syndrome is a constellation of signs and symptoms of simultaneous insufficiencies of several endocrine glands. Autoimmune polyglandular syndrome type 2 (APS 2) may be diagnosed when the adrenocortical insufficiency is associated with an autoimmune thyroid disease (Hashimoto's thyroiditis or Graves' disease), and/or insulin-dependent diabetes mellitus. Turner syndrome is the most common chromosomal disorder in females, caused by complete or partial X chromosome monosomy. We present the case of a 20-year-old woman with Turner syndrome, in whom APS 2 (Hashimoto's thyroiditis and adrenocortical insufficiency) has been diagnosed after introduction of recombinant human growth hormone (rhGH) therapy. In Turner syndrome, examination of the patient must regularly be conducted in order to diagnose a possible onset of autoimmune diseases; respective treatment must be applied as soon as the diagnosis is established. In particular, therapy of rhGH, used for short stature treatment, may be a trigger factor of adrenal insufficiency. The cortisol level in blood should be assessed before rhGH administration and carefully monitored during the therapy, especially in case of autoimmune thyroid disease coexistence.

  5. Papillary thyroid carcinoma presenting as an asymptomatic pelvic bone metastases

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    Siddiq S

    2010-05-01

    Full Text Available Thyroid carcinoma is rare comprising 1% of all malignancies and commonly presents as a neck lump. Papillary thyroid carcinoma unlike follicular thyroid carcinoma tends not to metastasise to distant sites.We present a case of papillary thyroid carcinoma presenting as a solitary asymptomatic pelvic bone metastases and highlight current management of bone metastases. A 59-year old female was found on abdominal computerised tomography to have an incidental finding of a 4.5 cm soft tissue mass in the right iliac bone. Biopsy of the lesion confirmed metastatic thyroid carcinoma. There was no history of a neck lump, head and neck examination was normal. Further imaging confirmed focal activity in the right lobe of the thyroid. A total thyroidectomy and level VI neck dissection was performed and histology confirmed follicular variant of papillary carcinoma.Early detection of bone metastases have been shown to improve prognosis and thyroid carcinoma should be considered as a potential primary malignancy.

  6. Color Doppler measurement of blood flow in the inferior thyroid artery in patients with autoimmune thyroid diseases

    Energy Technology Data Exchange (ETDEWEB)

    Caruso, Giuseppe; Attard, Marco; Caronia, Aurelio; Lagalla, Roberto

    2000-10-01

    Purpose: The aim of the study is to find out whether the measurement of peak systolic velocity in the inferior thyroid artery (ITA) is a valuable parameter to differentiate autoimmune thyroid diseases (hyper-, normo- or hypofunctional) and to evaluate the efficacy of medical treatment. Material and methods: The ITA of 31 patients (eight with Graves' disease, 23 with subclinical hypothyroidism) was examined with color Doppler and pulsed Doppler. The final diagnosis was obtained by citology and by hormonal and antibodies assays. The patients were monitorized by ultrasound for a period of 8 months. Results: In all the patients with Graves' disease the peak systolic velocity was always over 150 cm/s, while in other autoimmune thyroiditis the peak systolic velocity was within the normal range, and never exceeding 65 cm/s. In the first group, the measurement taken in the ITA showed also the efficacy of the pharmacological treatment earlier and more reliably than the color Doppler pattern obtained in the parenchyma. Conclusions: The color Doppler measurement of the ITA seems to be a promising technique with low-cost and easy approach. In our experience, the color Doppler of the ITA could have a clinical role in the differential diagnosis of diffuse thyroid diseases and in the follow-up of the Graves' disease during medical treatment.

  7. The Frequency of Autoimmune Thyroid Disease in Alopecia Areata and Vitiligo Patients

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    Gulcan Saylam Kurtipek

    2015-01-01

    Full Text Available Aim. Many studies demonstrated that alopecia areata (AA and vitiligo are commonly associated with autoimmune thyroid diseases. We aimed to investigate the frequency of thyroid dysfunctions and autoimmunity related with vitiligo and AA. Material and Methods. 200 patients, 92 AA and 108 vitiligo diagnosed, were surveyed retrospectively. The control population was in reference range and from Konya, central Anatolian region of Turkey. Thyroid function tests (free T3, free T4, and TSH and serum thyroid autoantibody (anti-TG, anti-TPO levels were evaluated in all patients. Results. In vitiligo patients, 9 (8.3% had elevated anti-TG levels and 16 (14.8% had elevated anti-TPO, and in 17 patients (15.7% TSH levels were elevated and 3 (2.8% patients had elevated fT4 levels and 5 (4.6% had elevated fT3 levels. Within AA patients, 2 (2.2% had anti-TG elevation and 13 (14.1% had anti-TPO elevation, in 7 patients (7.6% TSH were elevated, and in 1 patient (1.1% fT4 were elevated and 5 (5.4% patients had elevated fT3 levels. Conclusion. In our study, impaired thyroid functions and thyroid autoantibodies in vitiligo and AA patients were identified at lower rates than the previous studies. According to results of this study there is no need for detailed examination in alopecia areata and vitiligo patients without clinical history.

  8. Thyroid Autoimmunity and Gluten-Sensitive Enteropathy in Children with Type 1 Diabetes Mellitus

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    Gafur Doğdu

    2012-06-01

    Full Text Available Introduction: To determine the seroprevalence of autoimmune thyroiditis and gluten-sensitive enteropathy (GSE in patients with type 1 diabetes mellitus (T1DM and to emphasize the importance of early diagnosis. Patients and Methods: Fifty-five children and adolescents (age ranged 3-18 years with T1DM were included in the study. Hemoglobin A1c (HbA1c, free T3 (fT3, free T4 (fT4, thyroid stimulating hormone (TSH, anti-tiroglobulin (anti-TG, anti-thyroid peroxidase (anti-TPO, anti-gliadin IgA and IgG, and anti-endomisyum IgA antibody (antiEMA were investigated. Results: Eight of our cases (14.5% were positive for anti-TPO, 9/55 (16.3% for anti-TG, 8/55 (14.5% for anti-EMA, 8/55 (14.5% for anti-gliadin IgA, and 5/55 (9.0% for anti-gliadin IgG. None of these antibodies were detected in healthy controls. In eight patients, who had positive anti-TPO and anti-TG, thyroid ultrasound results confirmed thyroiditis. Anti-EMA and anti-gliadin IgA were positive in five patients. Four of them were diagnosed with GSE. Conclusion: In patients with T1DM, the seroprevalences of autoimmune thyroiditis and GSE were higher than that in healthy controls. Therefore, regardless of the symptoms of patients, autoimmune thyroiditis and GSE should be investigated in all patients with T1DM. Thus, the most rapid and meaningful method is to investigate the presence of autoantibodies using serological tests. (The Me di cal Bul le tin of Ha se ki 2012; 50: 39-42

  9. The Effect of Vitamin D on Thyroid Autoimmunity in Levothyroxine-Treated Women with Hashimoto's Thyroiditis and Normal Vitamin D Status.

    Science.gov (United States)

    Krysiak, Robert; Szkróbka, Witold; Okopień, Bogusław

    2017-01-10

    Background: Low vitamin D status is associated with autoimmune thyroid disease. Oral vitamin D supplementation was found to reduce titers of thyroid antibodies in levothyroxine-treated women with postpartum thyroiditis and low vitamin D status. Methods: The study included 34 women with Hashimoto's thyroiditis and normal vitamin D status (serum 25-hydroxyvitamin D levels above 30 ng/mL) who had been treated for at least 6 months with levothyroxine. On the basis of patient preference, women were divided into 2 groups, receiving (n=18) or not receiving (n=16) oral vitamin D preparations (2000 IU daily). Serum levels of thyrotropin, free thyroxine, free triiodothyronine and 25-hydroxyvitamin D, as well as titers of thyroid peroxidase and thyroglobulin antibodies were measured at the beginning of the study and 6 months later. Results: There were no significant differences in baseline values between both study groups. 25-hydroxyvitamin D levels inversely correlated with titers of thyroid antibodies. No changes in hypothalamic-pituitary-thyroid axis activity and thyroid antibody titers were observed in vitamin-naïve patients. Vitamin D increased serum levels of 25-hydroxyvitamin D, as well as reduced titers of thyroid antibodies. This effect was more pronounced for thyroid peroxidase than for thyroglobulin antibodies and correlated with their baseline titers. Conclusions: Vitamin D preparations may reduce thyroid autoimmunity in levothyroxine-treated women with Hashimoto's thyroiditis and normal vitamin D status.

  10. Steroid Responsive Xanthomatous Hypophysitis Associated with Autoimmune Thyroiditis: A Case Report

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    Ji Young Joung

    2013-03-01

    Full Text Available We report the case of a 36-year-old woman who presented with headache, fever, and amenorrhea. Laboratory analysis revealed hypopituitarism and autoimmune thyroiditis, while a cerebrospinal fluid study suggested concurrent aseptic meningitis. A magnetic resonance image (MRI scan revealed a 1.0×0.9 cm cystic mass enlarging the sella turcica. Surgical resection via an endoscopic transsphenoidal route was performed. The histological finding of the excised tissue revealed foamy histiocytes with vacuolated cytoplasm, supporting the diagnosis of xanthomatous hypophysitis. Although a residual soft lesion was observed on the MRI image postoperatively, the patient's headache and fever improved. Ten months after surgery, the patient complained of visual impairment and headache, and the residual mass had enlarged into the suprasellar area. High dose (500 mg intravenous methylprednisolone was administered for 3 days. During the methylprednisolone pulse therapy, the patient's visual acuity and headache improved. A follow-up MRI taken after methylprednisolone therapy showed a marked mass reduction. Our case supports an autoimmune pathophysiology for xanthomatous hypophysitis and suggests that high dose glucocorticoid therapy as a treatment option.

  11. Autoimmune thyroid disease as a risk factor for angioedema in patients with chronic idiopathic urticaria: a case-control study

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    Ruy Felippe Brito Gonçalves Missaka

    Full Text Available CONTEXT AND OBJECTIVE: An association between chronic idiopathic urticaria (CIU and autoimmune thyroid disease (ATD has been reported. However, there have not been any reports on whether ATD raises the risk of angioedema, which is a more severe clinical presentation of CIU. Thus, the aim of the present study was to evaluate whether the risk of angioedema is increased in patients with CIU and ATD. DESIGN AND SETTING: Case-control study including 115 patients with CIU at a tertiary public institution. METHODS: The patients were evaluated with regard to occurrence of angioedema and presence of ATD, hypothyroidism or hyperthyroidism. RESULTS: Angioedema was detected in 70 patients (60.9%. There were 22 cases (19.1% of ATD, 19 (16.5% of hypothyroidism and nine (7.8% of hyperthyroidism. The risk among patients with ATD was 16.2 times greater than among those without this thyroid abnormality (confidence interval, CI = 2.07-126.86. The odds ratio for hypothyroidism was 4.6 (CI = 1.00-21.54 and, for hyperthyroidism, 3.3 (CI = 0.38-28.36. CONCLUSIONS: Patients with CIU and ATD presented greater risk of angioedema, which reinforces the idea that a relationship exists between this allergic condition and thyroid autoimmunity. This finding could imply that such patients require specifically directed therapy.

  12. Effect of steroid replacement on thyroid function and thyroid autoimmunity in Addison′ s disease with primary hypothyroidism

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    Jaya Prakash Sahoo

    2016-01-01

    Full Text Available Background: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab titer in Addison's disease with primary hypothyroidism. Materials and Methods: This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical was defined as high thyroid stimulating hormone (TSH with/without low free thyroxine (fT4. TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Results: Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. Conclusions: The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations.

  13. Autoimmune thyroid disorder in patient with chronic hepatitis C before treatment

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    Mehr Ali Rahimi

    2011-07-01

    Full Text Available Background: Creating autoantibodies against thyroid in hepatitis C patients who are being treated with interferon is now recognized for several years. Recently, some studies have claimed that prevalence of autoimmune thyroid disorders in Hepatitis C patients is higher when they are not treated by interferon and/or at the beginning of diagnosis, however the area still remained controversial. In order to analyze autoimmune thyroid disorders in Hepatitis C patients who are not still treated by interferon and compare them with the control group this study has been conducted.Methods: A Case-Control study including 86 chronic hepatitis C patients before commencing treatment by interferon and 86 healthy volunteer individuals were examined. Data was collected using demographic and clinical variables questionnaires from both groups. FT4, TSH, Anti TPO and Anti TG examinations carried out in both group. Results: The findings of this study showed increase Anti TPO in 4 cases in 13 case, increased is Anti TG in 5 case, sub clinical hypothyroid, ism sub clinical hyperthyroid in 3 ism and hyperthyroid ism in one case in the case group were observed. There was no significant difference between the case and the control group. Conclusion: We can conclude that there is no relationship between chronic hepatitis C infection and autoimmune thyroid.

  14. Prevalence of coeliac disease in patients with autoimmune thyroiditis in a Turkish population

    Institute of Scientific and Technical Information of China (English)

    Sefa Guliter; Fahri Yakaryilmaz; Zubeyde Ozkurt; Reyhan Ersoy; Derya Ucardag; Osman Caglayan; Pinar Atasoy

    2007-01-01

    AIM: To investigate the prevalence of coeliac disease in a series of Turkish patients with autoimmune thyroiditis.METHODS: Sera from 136 consecutive patients with newly diagnosed autoimmune thyroiditis and 119 healthy blood donors were tested for IgA tissue transglutaminase antibody with enzyme-linked immunosorbent assay. Endoscopic mucosal biopsy from the second part of duodenum was performed in patients with positive antibody test.RESULTS: Eight patients (5.9%) and one control subject (0.8%) were positive for IgA tissue transglutaminase antibody (OR: 7.38, 95% CI: 0.91-59.85, P = 0.04). Six patients and one control agreed to take biopsies. Histopathological examination revealed changes classified as Marsh ma in one, Marsh n in one, Marsh I in two, and Marsh 0 in two patients with autoimmune throiditis, and Marsh I in one blood donor.CONCLUSION: Turkish patients with autoimmune thyroiditis have an increased risk of coeliac disease and serological screening may be useful for early detection of coeliac disease in these patients. Our findings need to be confirmed in a larger series of patients.

  15. Autoimmune clustering: sweet syndrome, Hashimoto thyroiditis, and psoriasis.

    Science.gov (United States)

    Saeed, Mohammad; Brown, Grace E; Agarwal, Abhishek; Pellowski, Donna; Jacks, Jennifer; Liverett, Hazel K; Vyas, Keyur S

    2011-03-01

    Acute febrile neutrophilic dermatosis (AFND; Sweet syndrome) is characterized by a constellation of symptoms and findings: fever, neutrophilia, and tender erythematous skin lesions that typically show an upper dermal infiltrate of mature neutrophils. Whereas some cases are idiopathic, others have been associated with a variety of disorders. In this report, we describe the occurrence of AFND with chronic lymphocytic thyroiditis (Hashimoto thyroiditis) and preexisting psoriasis. This is the first case report of the association of chronic lymphocytic thyroiditis with AFND from the United States and only the third reported in the world's literature. Because the coexistence of these disorders is rare, an underlying common pathogenic mechanism is a possibility. We postulate this to be CD4(+) T-cell dysfunction.

  16. CMV-hFasL transgenic mice prevent from experimental autoimmune thyroiditis

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhen-lin; LIN Bo; YU Lu-yang; GUO Li-he

    2005-01-01

    Background Previous studies showed that the role of Fas ligand (FasL) is not consistent in the pathogenesis of autoimmune thyroiditis. This study was designed to investigate the effects of FasL on the pathogenesis of experimental autoimmune thyroiditis (EAT) using CMV-human FasL (hFasL) transgenic mice. Methods Transgenic mice ubiquitously expressing hFasL were used as an animal model of EAT by injection of porcine thyroglobulin (pTg). Expression of hFasL was detected by RT-PCR and Western blot. The activity of hFasL transgenic thyrocytes killing Jurket cells was determined. CMV-hFasL transgenic mice and wild type (WT) mice were immunized with pTg and killed 28 days later to evaluate the lymphocytic infiltration of their thyroids. The number of CD4+ and CD8+ lymphocytes from the spleen was detected using FACS. The serum interferon-γ (IFN-γ) concentration was measured by ELISA. Results hFasL expression in the thyroid of CMV-hFasL transgenic mice was confirmed. After co-incubation of Jurket thymocytes with thyroid tissues of CMV-hFasL transgenic mice, the percentage of apoptotic cells in the CMV-hFasL transgenic thyroid group was significantly higher than that of the control WT thyroid group [(23.4±4.3)% vs (6.6±2.5)%, P<0.01]. On day 28 after immunization with pTg, the infiltration index of lymphocytes in thyroids of the CMV-hFasL transgenic mice was significantly lower than that of the WT mice [(1.0±0.5) vs (2.1±0.7), P<0.001]. Moreover, the number of CD4+ and CD8+ lymphocytes of the spleen and serum IFN-γ concentration were significantly decreased in the CMV-hFasL transgenic mice. Conclusions FasL plays an important role in the pathogenesis of autoimmune thyroiditis. Transgenic mice ubiquitously expressing hFasL may strongly inhibit lymphocytic infiltration of the thyroid of EAT and ameliorate the course of this disease.

  17. Selenium status and over-expression of interleukin-15 in celiac disease and autoimmune thyroid diseases

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    Anna Velia Stazi

    2010-12-01

    Full Text Available In celiac disease (CD, for its multifactorial nature, the target organs are not limited to the gut, but include thyroid, liver, skin and reproductive and nervous systems. Between the extraintestinal symptoms associated with CD, autoimmune thyroid diseases (AITDs are more evident, underlining as CD-related autoimmune alterations can be modulated not only by gluten but also by various concurrent endogenous (genetic affinity, over-expression of cytokines and exogenous (environment, nutritional deficiency factors. In their pathogenesis a central role for over-expression of interleukin-15 (IL-15 is shown, by inhibiting apoptosis, leading to the perpetuation of inflammation and tissue destruction. Thyroid is particularly sensitive to selenium deficiency because selenoproteins are significant in biosynthesis and activity of thyroid hormones; besides, some selenoproteins as glutathione peroxidase are involved in inhibiting apoptosis. Thus, selenium malabsorption in CD can be thought as a key factor directly leading to thyroid and intestinal damage. Considering the complexity of this interaction and on the basis of available evidence, the aim of this review is to assess as preventive and therapeutic target the role of IL-15 and selenium in the pathogeneses of both CD and AITD.

  18. Same-sex marriage, autoimmune thyroid gland dysfunction and other autoimmune diseases in Denmark 1989-2008.

    Science.gov (United States)

    Frisch, Morten; Nielsen, Nete Munk; Pedersen, Bo Vestergaard

    2014-01-01

    Autoimmune diseases have been little studied in gay men and lesbians. We followed 4.4 million Danes, including 9,615 same-sex married (SSM) persons, for 47 autoimmune diseases in the National Patient Registry between 1989 and 2008. Poisson regression analyses provided first hospitalization rate ratios (RRs) comparing rates between SSM individuals and persons in other marital status categories. SSM individuals experienced no unusual overall risk of autoimmune diseases. However, the risk of autoimmune thyroid dysfunction was increased, notably Hashimoto's thyroiditis (women(SSM), RR = 2.92; 95% confidence interval (CI) 1.74-4.55) and Graves' disease (men(SSM), RR = 1.88; 95% CI 1.08-3.01). There was also an excess of primary biliary cirrhosis (women(SSM), RR = 4.09; 95% CI 1.01-10.7), and of psoriasis (men(SSM), RR = 2.48; 95% CI 1.77-3.36), rheumatic fever (men(SSM), RR = 7.55; 95% CI 1.87-19.8), myasthenia gravis (men(SSM), RR = 5.51; 95% CI 1.36-14.4), localized scleroderma (men(SSM), RR = 7.16; 95% CI 1.18-22.6) and pemphigoid (men(SSM), RR = 6.56; 95% CI 1.08-20.6), while Dupuytren's contracture was reduced (men(SSM), RR = 0.64; 95% CI 0.39-0.99). The excess of psoriasis was restricted to same-sex married men with HIV/AIDS (men(SSM), RR = 10.5; 95% CI 6.44-15.9), whereas Graves' disease occurred in excess only among same-sex married men without HIV/AIDS (men(SSM), RR = 1.99; 95% CI 1.12-3.22). Lesbians and immunologically competent gay men in same-sex marriage face no unusual overall risk of autoimmune diseases. However, the observed increased risk of thyroid dysfunction in these lesbians and gay men deserves further study.

  19. Diffuse sclerosing variant of thyroid carcinoma presenting as Hashimoto thyroiditis: a case report.

    Science.gov (United States)

    Vukasović, Anamarija; Kuna, Sanja Kusacić; Ostović, Karmen Trutin; Prgomet, Drago; Banek, Tomislav

    2012-11-01

    The aim of report is to present a case of a rare diffuse sclerosing variant of a papillary thyroid carcinoma. A 15-year old girl referred for ultrasound examination because of painless thyroid swelling lasting 10 days before. An ultrasound of the neck showed diffusely changed thyroid parenchyma, without nodes, looking as lymphocytic thyroiditis Hashimoto at first, but with snow-storm appearance, predominantly in the right lobe. Positive thyroid peroxidase antibodies (TPO-AT) also suggested Hashimoto thyroiditis. Repeated US-FNAB (fine needle-aspiration biopsy) of the right lobe revealed diffuse sclerosing variant of papillary thyroid carcinoma and patient underwent total thyreoidectomy. Patohistologic finding confirmed diffuse sclerosing variant of a papillary thyroid carcinoma in the both thyroid lobes and several metastatic lymph nodes. Two months later patient recived radioablative therapy with 3700 MBq (100 mCi) of 1-131 followed by levothyroxine replacement. At the moment, patient is without evidence of local or distant metastases and next regular control is scheduled in 6 months. In conclusion, a diffuse sclerosing variant is rare form of papillary thyroid carcinoma that echographically looks similar to Hashimoto thyroiditis and sometimes could be easily overlooked.

  20. Evaluation of epitopes specificity of antibodies to thyroid peroxidase in autoimmune thyroid disorders

    Directory of Open Access Journals (Sweden)

    A V Subkov

    2011-06-01

    Full Text Available The problem of the human antithyroid peroxidase autoantibodies epitopes heterogeneity diagnosed in case of Graves' disease and Hashimoto's thyroiditis has been researched using monoclonal antibodies to thyroid peroxidase. It was shown, that in the competition for the binding sites of thyroid peroxidase and autoantibodies taken from patients with Graves' disease and Hashimoto's thyroiditis sera participate 8 mAb to epitopes 1, 70, 82, 88, 2, 3, 77 and 79. The maxima of the binding inhibition has been marked for the conformation epitope mAb 3: in case of Graves' disease it amounts to 60.3 ± 12.7%, in case of Hashimoto's thyroiditis – 61.8 ± 32.2%. Moreover the level of the binding inhibition did not depend on the concentration of Ab to thyroid peroxidase in the sera of patient with Graves' as opposed to the serum of patients with Hashimoto's thyroiditis. Autoantibodies in the serum of the patientswith Hashimoto's thyroiditis inhibited the binding of mAb to epitope 77 much more effectively, than in the serum of the patients with: 36.3 ± 17.2 and 54.3 ± 9.6% (p ≤ 0.05.The obtained results represented the specific reaction of the autoantibodies to the certain thyroid peroxidase molecular patterns which corresponds to the literature data. It is possible to assume that the further research of the competitive interactions with other autoantibodies to monoclonal antibodies, not included in this trial, and widening of the different thyroid diseased patients' serum palette can expose new immunodominant thyroid peroxidase molecular patterns, forming antibodies for different diseases, and enable the development of diagnostics and control of the thyroid functions and applied therapy.

  1. Effects of low-carbohydrate diet therapy in overweight subject with autoimmune thyroiditis: possible synergism with ChREBP

    Directory of Open Access Journals (Sweden)

    Esposito T

    2016-09-01

    Full Text Available Teresa Esposito,1,2 Jean Marc Lobaccaro,3 Maria Grazia Esposito,4 Vincenzo Monda,1 Antonietta Messina,1 Giuseppe Paolisso,5 Bruno Varriale,2 Marcellino Monda,1 Giovanni Messina1,6 1Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, 2Laboratory of Molecular Biology and Genetics, Department of Experimental Medicine, Second University of Naples, Naples, Italy; 3UMR, Clermont Université, Centre de Recherche en Nutrition Humaine d’Auvergne, Aubière Cedex, France; 4Complex Surgery Unit, Evangelic Hospital Villa Betania, 5Department of Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell’Invecchiamento, Second University of Naples, Naples, 6Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy Abstract: The thyroid is one of the metabolism regulating glands. Its function is to determine the amount of calories that the body has to burn to maintain normal weight. Thyroiditides are inflammatory processes that mainly result in autoimmune diseases. We have conducted the present study in order to have a clear picture of both autoimmune status and the control of body weight. We have evaluated the amount of either thyroid hormones, or antithyroid, or anti-microsomal, or anti-peroxidase antibodies (Abs in patients with high amounts of Abs. In a diet devoid of carbohydrates (bread, pasta, fruit, and rice, free from goitrogenic food, and based on body mass index, the distribution of body mass and intracellular and extracellular water conducted for 3 weeks gives the following results: patients treated as above showed a significant reduction of antithyroid (-40%, P<0.013, anti-microsomal (-57%, P<0.003, and anti-peroxidase (-44%, P<0,029 Abs. Untreated patients had a significant increase in antithyroid (+9%, P<0.017 and anti-microsomal (+30%, P<0.028 Abs. Even the level of anti-peroxidase Abs increased without reaching statistical significance (+16%, P>0064

  2. Impact of month of birth on the development of autoimmune thyroid disease in the United Kingdom and Europe

    DEFF Research Database (Denmark)

    Hamilton, Alexander; Newby, Paul R; Carr-Smith, Jacqueline D;

    2014-01-01

    CONTEXT: Viral/bacterial infection is proposed as a trigger for the autoimmune thyroid diseases (AITD): Graves' disease (GD) and Hashimoto's thyroiditis (HT). Previous studies in European Caucasian AITD subjects found higher birth rates in the autumn/winter, suggesting those born in the autumn/wi...

  3. Maternal thyroid autoimmunity during pregnancy and the risk of attention deficit/hyperactivity problems in children: The generation r study

    NARCIS (Netherlands)

    A. Ghassabian (Akhgar); J.J. Bongers-Schokking (Jacoba J.); Y.B. de Rijke (Yolanda); N.H. van Mil (Nina); V.W.V. Jaddoe (Vincent); S.M.P.F. de Muinck Keizer-Schrama (Sabine); H. Hooijkaas (Herbert); A. Hofman (Albert); W. Visser (Willy); G.C. Roman (Gustavo ); F.C. Verhulst (Frank); H.W. Tiemeier (Henning)

    2012-01-01

    textabstractBackground: Maternal thyroid status and autoimmunity during pregnancy have been associated with impaired development of the offspring in animal and human studies. Our objective was to examine whether elevated titers of maternal thyroid peroxidase antibodies (TPOAbs) in early pregnancy in

  4. Thyrotropin - Binding Inhibiting Immunoglobulin (TBII) in Patients with Autoimmune Thyroid Diseases

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    Jang, Dae Sung; Ahn, Byeong Cheol; Sohn, Sang Kyun; Lee, Jae Tae; Lee, Kyu Bo [Kyungpook National University School of Medicine, Taegu (Korea, Republic of)

    1996-03-15

    In order to evaluate the significance of thyrotropin-binding inhibiting immunoglobulin (TBII) in the patients with autoimmune thyroid diseases, the authors investigated 402 cases of Graves' disease and 230 cases of Hashimoto's thyroiditis comparing 30 cases of normal healthy adult at Kyung Pook University Hospital from February 1993 to August 1994. The TBII was tested by radioimmunoassay and assessed on the dynamic change with the disease course, thyroid functional parameters, and other thyroid autoantibodies; antithyroglobulin antibody(ATAb) and antimicrosomal antibody(AMAb) including thyroglobulin. The serum level of TBII was 40.82 +- 21.651(mean +- SD)% in hyperthyroid Graves' disease and 8.89 +- 14.522% in Hashimoto's thyroiditis and both were significant different from normal control of which was 3.21 +- 2.571%. The frequency of abnormally increased TBII level was 92.2% in hyperthyroid Craves' disease, 46.7% in euthyroid Graves' disease or remission state of hyperthyroidism, and 23.9% in Hashimoto's thyroiditis. The serum levels of increased TBII in Graves' disease were positively correlated with RAIU, serum T3, T4, and FT4, but negatively correlated with serum TSH(each p<0.001). The TBII in Graves' disease had significant positive correlation with serum thyroglobulin and AMAb, but no significant correlation with ATAb. In the Hashimoto's thyroiditis, the serum levels of TBII were positively correlated with RAIU, serum T3, TSH and AMAb, but not significantly correlated with serum T4, FT4, thyroglobulin and ATAb. Therefore serum level of TBII seemed to be a useful mean of assessing the degree of hyperthyroidism in Graves' disease and correlated well with thyroidal stimulation. The serum level of TBII in Hashimoto's thyroiditis is meaningful for the degree of both functional abnormality reflecting either hyperfunction or hypofunction and the immunologic abnormality.

  5. Long-Term Follow-Up of a Child with Autoimmune Thyroiditis and Recurrent Hyperthyroidism in the Absence of TSH Receptor Antibodies

    Directory of Open Access Journals (Sweden)

    Christopher Dunne

    2014-01-01

    Full Text Available Hashitoxicosis is an initial, transient, hyperthyroid phase that rarely affects patients with Hashimoto thyroiditis. We present here an unusual case of a child with Hashimoto thyroiditis and recurrent hyperthyroidism. A 4 yr 6/12 old male was diagnosed by us with autoimmune subclinical hypothyroidism (normal free T4, slightly elevated TSH, and elevated TG antibody titer. Two years and 6/12 later he experienced increased appetite and poor weight gain; a laboratory evaluation revealed suppressed TSH, elevated free T4, and normal TSI titer. In addition, an I123 thyroid uptake was borderline-low. A month later, the free T4 had normalized. After remaining asymptomatic for 3 years, the patient presented again with increased appetite, and he was found with low TSH and high free T4. Within the following 3 months, his free T4 and TSH normalized. At his most recent evaluation, his TSH was normal and the free T4 was borderline-high; the TG antibody titer was still elevated and the TSI titer was negative. To our knowledge, this is the first patient reported with Hashimoto thyroiditis and recurrent hyperthyroidism. This case exemplifies the variability of the manifestations and natural history of Hashimoto thyroiditis and supports the need for a long-term evaluation of patients with autoimmune thyroid disease.

  6. PREVALENCE OF AUTOANTIBODIES TO THYROID PEROXIDASE AND AUTOIMMUNE THYROID DISEASE IN GIRLS WITH TURNER’S SYNDROME

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    H. Moayeri Z. Oloomi

    2006-07-01

    Full Text Available Patients with Turner’s syndrome (TS are at an increased risk of developing autoimmune thyroid disease (ATD. The aim of this study was to determine the frequency of anti-thyroid peroxidase (anti-Tpo antibodies and ATD in children and adolescent girls with TS. It also assessed the influence of karyotype on the development of thyroid disease. Sixty eight patients with TS were compared with 68 age matched healthy unrelated girls in this study. They were screened for anti-Tpo antibodies, free T4 and TSH levels. Sign and symptoms of hypothyroidism and hyperthyroidism and the presence of goiter were also investigated. Anti-Tpo antibodies were found in 18 (26.4% TS patients and 1 (1.4% patient in the control group (P < 0.001, evenly distributed between the karyotypes 45X, 46X, isoXq and mosaicism. Out of 68 TS patients, 8 (11.7% had visible goiter. Subclinical hypothyroidism and hypothyroidism both occurred in 2 patients (5.9%. These patients were characterized by higher levels of anti-Tpo antibodies. Visible goiter was found in 3 (4.4% subjects of the control group, but all of them were euthyroid. We found that younger patients were more likely to be anti-Tpo negative (P < 0.001. Our data demonstrated a high frequency of ATD in a representative sample of Iranian girls with TS which is in accordance with previous observations. Regular follow up assessment of thyroid autoantibodies and thyroid function in patients with TS is recommended for timely diagnosis of thyroid dysfunction and treatment.

  7. Hashimoto thyroiditis with an unusual presentation of cardiac tamponade in Noonan syndrome.

    Science.gov (United States)

    Lee, Mi Ji; Kim, Byung Young; Ma, Jae Sook; Choi, Young Earl; Kim, Young Ok; Cho, Hwa Jin; Kim, Chan Jong

    2016-11-01

    Noonan syndrome is an autosomal dominant, multisystem disorder. Autoimmune thyroiditis with hypothyroidism is an infrequent feature in patients with Noonan syndrome. A 16-year-old boy was admitted because of chest discomfort and dyspnea; an echocardiogram revealed pericardial effusion. Additional investigations led to a diagnosis of severe hypothyroidism due to Hashimoto thyroiditis. The patient was treated with L-thyroxine at 0.15 mg daily. However, during admission, he developed symptoms of cardiac tamponade. Closed pericardiostomy was performed, after which the patient's chest discomfort improved, and his vital signs stabilized. Herein, we report a case of an adolescent with Noonan syndrome, who was diagnosed with Hashimoto thyroiditis with an unusual presentation of cardiac tamponade.

  8. Unusual pediatric co-morbility: autoimmune thyroiditis and cortico-resistant nephrotic syndrome in a 6-month-old Italian patient

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    Urbano Flavia

    2012-10-01

    Full Text Available Abstract We report on a case of autoimmune thyroiditis in a 6-month-old patient with cortico-resistant nephrotic syndrome. Normal serum levels of thyroid hormons and thyroid-stimulating hormone were detected with high titers of circulant antithyroid antibodies and a dysomogeneous ultrasound appearance of the gland, typical of autoimmune thyroiditis. The research of maternal thyroid antibodies was negative. This is the first case of autoimmune thyroiditis found in such a young patient with pre-existing nephrotic syndrome ever described in literature. This association is random because nephrotic syndrome does not have an autoimmune pathogenesis and the genes involved in autoimmune thyroiditis are not related to those of nephrotic syndrome.

  9. The Thyro-Gastric syndrome: from thyroid autoimmunity to neuroendocrine gastric tumors

    OpenAIRE

    2011-01-01

    THE THYRO-GASTRIC SYNDROME: FROM THYROID AUTOIMMUNITY TO NEUROENDOCRINE GASTRIC TUMORS. In 1849, Prof Addison described a fatal case of anemia, or anemia perniciosa. Dr Biermer expanded this original description in 1872. Nowadays, this pathological condition associating a megaloglastic anemia associated with a metabolic polyneuropathy is recognized as Biermer disease. Biermer anemia or anemia perniciosa and its associated polyneuropathy are the consequence of vitamine B12 malabsorpti...

  10. Thyroid Autoimmunity is Associated with Decreased Cytotoxicity T Cells in Women with Repeated Implantation Failure

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    Chunyu Huang

    2015-08-01

    Full Text Available Thyroid autoimmunity (TAI, which is defined as the presence of autoantibodies against thyroid peroxidase (TPO and/or thyroglobulin (TG, is related to repeated implantation failure (RIF. It is reported that TAI was involved in reproductive failure not only through leading thyroid function abnormality, but it can also be accompanied with immune imbalance. Therefore, this study was designed to investigate the association of thyroid function, immune status and TAI in women with RIF. Blood samples were drawn from 72 women with RIF to evaluate the prevalence of TAI, the thyroid function, the absolute numbers and percentages of lymphocytes. The prevalence of thyroid function abnormality in RIF women with TAI was not significantly different from that in RIF women without TAI (c2 = 0.484, p > 0.05. The absolute number and percentage of T cells, T helper (Th cells, B cells and natural killer (NK cells were not significantly different in RIF women with TAI compared to those without TAI (all p > 0.05. The percentage of T cytotoxicity (Tc cells was significantly decreased in RIF women with TAI compared to those without TAI (p < 0.05. Meanwhile, Th/Tc ratio was significantly increased (p < 0.05. These results indicated that the decreased Tc percentage and increased Th/Tc ratio may be another influential factor of adverse pregnancy outcomes in RIF women with TAI.

  11. Gene therapy of experimental autoimmune thyroiditis mice by in vivo administration of plasmid DNA coding for human interleukin-10

    Institute of Scientific and Technical Information of China (English)

    ZHANGZhen-Lin; LINBo; YULu-Yang; SHENShui-Xian; ZHULi-Hua; WANGWui-Ping; GUOLi-He

    2003-01-01

    AIM: To investigate the effect of interleukin-10 (IL-10) gene on experimental autoimmune thyroiditis mice.METHODS: Mice were immunized to induce autoimmune thyroiditis with porcine thyroglobulin (pTg), and thyroids of mice were injected with IL-10 DNA. On d 28 after immunization with pTg, mRNA expression of IL-10 inthyroid glands was detected and thyroid specimens were histopathological studied. RESULTS: The mRNA expression of IL-10 was detected in thyroid glands on d 7 and 14 after injection of IL-10 plasmid DNA or on COS-7 cells48 h after IL-10 plasmid DNA transfection. In addition, hlL-10 levels in culture media significantly increased 48 hand 72 h after IL-10 plasmid DNA transfection. Infiltration index of lymphocytes (1.1±0.4) in thyroids ofIL-10-treated mice was significantly lower than that of pcDNA3-null-treated mice (2.2±0.5) (P<0.01). Comparedwith pcDNA3-null control mice, IL-10-treated mice had lower levels of serum IFN-γ(P<0.01). CONCLUSION:The direct injection of DNA expression vectors encoding IL-10 into thyroid significantly inhibited development oflymphocytic infiltration of thyroid of autoimmune th,yroiditis mice, and alleviated the progression of this disease.

  12. STUDY ON THE HETEROGENEITY OF TSH RECEPTOR ANTIBODIFSIN THE PATHOGENESIS OF AUTOIMMUNE THYROID DISEASE

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To investigate the heterogeneity of TSH receptor antibodies of patients with autoimmune thyroid disease (AITD). Methods Six patients with heterogeneous TSH receptor antibodies were selected. The EBV-transformed B cell clones producing monoclonal anti-thyrotropin receptor antibodies were established from those selected patients. Results 125l-TSHbinding inhibiting immunoglobulin (TBII) values of the 6 patients ranged from 51% to 89%. Thyroid stimulating an tibody (TSAb) existed in patients No. 1,2,4,5 and 6 while only patients No. 1,2 and 3 had thyroid stimulation-blocking an tibody (TSBAb). After EBV-transformation of the peripheral B lymphocytes from those patients, we isolated and characterized 5 B cell clones producing the TBII from patient No. 3 and 4 B cell clones producing TSAb from patient No. 6. Conclusion Autoantibodies against the TSH receptor are polyclonal and consist of heterogeneous populations with both stimulatory and in hibi tory effec ts.

  13. Thyroid Cancer Presenting with Concomitant Metastatic Breast Cancer in the Thyroid

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    Chung-Chen Wang

    2014-12-01

    Full Text Available The thyroid is an unusual site to find cancer metastasis. When it does occur, such cancer spread is often manifested in multiple metastases and generally suggests a poor prognosis. We presented here a 49-year-old woman recently diagnosed with thyroid cancer, who had been treated for stage IIA breast cancer 8 years ago. After radical right thyroidectomy and left subtotal thyroidectomy, her pathological report showed papillary thyroid carcinoma, right thyroid, with concomitant metastatic breast carcinoma. This is the first case of which we are aware involving coexisting thyroid cancer and metastatic breast cancer in the ipsilateral lobe. Moreover, the circumstances of this case show a very unique clinical course compared with previous studies. Given the unusual circumstances of our case, we further discuss the relationship between thyroid cancer and breast cancer.

  14. Ocular surface and salivary gland involvement in patients with autoimmune thyroid disease

    Directory of Open Access Journals (Sweden)

    Flavia Pelinsari Lana

    2015-02-01

    Full Text Available Purpose: Many reports have indicated an association between thyroid dieases and primary Sjögren’s syndrome (pSS. The aim of our study was to evaluate the outcomes of the tests used for dry eye diagnosis and salivary gland involvement in patients with autoimmune thyroiditis. Methods: Forty-two patients (group 1 with autoimmune thyroid disease and 30 controls (group 2 were selected. Tear film break up time, Schirmer I test, Schirmer II test, ocular staining with 1% rose Bengal and salivary gland cintilography were performed in both groups. Results: Regarding the ocular surface damage observed by Rose Bengal test there was no difference between groups (p=0.77. For tear film break up time the groups did not differ statistically (p=0.46. There was no statistical difference between groups 1 and control in scintigraphy of the salivary gland (p=0.99. A statistical difference between the patients with thyroid disease and the control group was seem only in the Schirmer II test (p=0.0009. Conclusions: No patients fulfilled all criteria for Sjögren’s syndrome. It is possible that it could be underestimated.

  15. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis

    Science.gov (United States)

    Basciani, Sabrina

    2017-01-01

    Clinical evidences have highlighted the efficacy of myo-inositol and selenium in the treatment of autoimmune thyroiditis. Aim of this study was to further analyze the role of myo-inositol plus selenium (Myo-Ins-Se) in restoring a normal thyroid function of Hashimoto's patients with subclinical hypothyroidism. Eighty-six patients with Hashimoto's thyroiditis having thyroid-stimulating hormone (TSH) levels between 3 and 6 mIU/L, elevated serum antithyroid peroxidase (TPOAb) and/or antithyroglobulin (TgAb), and normal free thyroxine (fT4) and free triiodothyronine (fT3) levels were enrolled in the study: one hyperthyroid subject with TSH about 0.14 μU/ml was included in this trial as a single case. Patients were assigned to receive Myo-Ins-Se. TSH, TPOAb, and TgAb levels were significantly decreased in patients treated with combined Myo-Ins-Se after 6 months of treatment. In addition, a significant fT3 and fT4 increase, along with an amelioration of their quality of life, was observed. Remarkably, TSH values of the hyperthyroid patient increased from 0.14 μU/ml up to 1.02 μU/ml, showing a complete restoration of TSH values at a normal range. In conclusion, the administration of Myo-Ins-Se is significantly effective in decreasing TSH, TPOAb, and TgAb levels, as well as enhancing thyroid hormones and personal wellbeing, therefore restoring euthyroidism in patients diagnosed with autoimmune thyroiditis. PMID:28293260

  16. Type of fish consumed and thyroid autoimmunity in pregnancy and postpartum.

    Science.gov (United States)

    Benvenga, Salvatore; Vigo, Maria Teresa; Metro, Daniela; Granese, Roberta; Vita, Roberto; Le Donne, Maria

    2016-04-01

    Fish consumption or supplementation with omega-3 fatty acids was reported to cure and/or prevent autoimmune and nonautoimmune disorders. Serum positivity for thyroid autoantibodies is a predictive marker of postpartum thyroiditis and postpartum depression. We hypothesized that stable consumption of the omega-3-rich oily fish was associated with a more favorable profile of serum thyroid antibodies throughout pregnancy and early postpartum compared with stable consumption of swordfish, a predator that concentrates pollutants. We prospectively measured serum thyroglobulin antibodies and thyroperoxidase antibodies in pregnancy (first, second trimesters) and postpartum (day 4), in 236 thyroid disease-free, nonsmoker Caucasian women with stable dietary habits. We did not measure thyroid autoantibodies prior to pregnancy. Women were divided into groups A (n = 48; swordfish), B (n = 52; oily fish), C (n = 68; swordfish + other fish, not necessarily oily fish), and D (n = 68; fish other than swordfish and oily fish). Major endpoints were positivity rates and serum concentrations of the two autoantibodies. We resorted to previous studies for the estimated content of fatty acids and microelements in the consumed fish. Positivity rates and serum concentrations of both antibodies were the greatest in group A and the lowest in group B (P fish consumption and serum concentrations of either antibody was direct in group A but inverse in group B. The estimated content of omega-3 fatty acids in fish consumed by group B was the greatest (P fish as a favorable alternative. Because thyroid autoantibodies are markers of autoimmune-related postpartum problems, our data suggest a dietary prophylaxis of such problems.

  17. Self-antigen presentation by dendritic cells in autoimmunity

    Directory of Open Access Journals (Sweden)

    Ann-Katrin eHopp

    2014-02-01

    Full Text Available The operation of both central and peripheral tolerance ensures the prevention of autoimmune diseases. The maintenance of peripheral tolerance requires self-antigen presentation by professional antigen presenting cells (APCs. Dendritic cells (DCs are considered as major APCs involved in this process. The current review discusses the role of DCs in autoimmune diseases, the various factors involved in the induction and maintenance of tolerogenic DC phenotype and pinpoints their therapeutic capacity as well as potential novel targets for future clinical studies.

  18. Relationship between Clinical and Immunological Features of Thyroid Autoimmunity and Ophthalmopathy during Pregnancy

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    Jack R. Wall

    2015-01-01

    Full Text Available Problem. Clinical features of Graves’ hyperthyroidism (GH generally improve during pregnancy and rebound in the postpartum period. It is unclear whether the ophthalmopathy that is associated with GH and, less often, Hashimoto’s thyroiditis (HT changes in parallel with the thyroid associated antibody reactions and clinical features or runs a different course. Method of Study. We retrospectively studied 19 patients with autoimmune thyroid disease over 22 pregnancies: 9 pregnancies with GH and 13 with HT. Ophthalmopathy was defined by NOSPECS class. Results. Thyroid peroxidase (TPO and thyroglobulin (Tg antibody titres decreased during pregnancy and rose in the postpartum period. During pregnancy, 5 patients with GH and 4 patients with HT developed mild ophthalmopathy and two patients with GH and HT developed new upper eyelid retraction (UER. In the postpartum period, eye scores improved in 3 patients with GH and 3 with HT, remained stable in two and 5 patients, respectively, and worsened in 2 patients with GH and one with HT. Conclusions. In patients with mild to moderate eye signs associated with GH and HT, the orbital and thyroid reactions ran different courses during pregnancy. Since no patient had severe ophthalmopathy, we cannot draw definitive conclusions from this preliminary study.

  19. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity

    DEFF Research Database (Denmark)

    Feldthusen, Anne-Dorthe; Pedersen, Palle L; Larsen, Jacob

    2015-01-01

    INTRODUCTION: The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb), and mild (subclinical) hypothyroidism in women from The Danish General Suburban Population Study (GESUS) on the number of children born, the number of pregnancies, and the number...... of spontaneous abortions. METHODS: Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. RESULTS: 6.7% had mild (subclinical) hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism...... with spontaneous abortions. Mild (subclinical) hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous...

  20. Papillary thyroid microcarcinoma presenting as skull base metastasis

    Institute of Scientific and Technical Information of China (English)

    YAN Bo; LIU Dian-gang; L(U) Hai-li; ZHANG Qiu-hang

    2010-01-01

    @@ Papillary thyroid carcinoma (PTC) is the most common type of well-differentiated thyroid cancer and is considered to be a relatively indolent tumor in which distant metastasis and death are rare.1 The metastasis of PTC is usually to regional lymph nodes, especially the cervical and mediastinal nodes. Metastases to the brain are rare, and constitute 0.1%-5.0% of distant metastases of papillary carcinoma.2 Skull metastasis is uncommon,and is found in 2.5%-5.8% of cases of thyroid cancer.3 Skull base metastasis of PTC is extremely rare, with only eight reported cases in the literature involving the clivus,cavernous sinus, sella turcica, and the petrous apex and ridge.4 A metastatic lesion can arise from histologically benign and silent thyroid neoplasms,5 and differential diagnosis between ectopic and metastatic thyroid cancer can be difficult,6 therefore, the management of thyroid cancer is controversial after removal of metastatic disease.Here we reported a case of papillary thyroid microcarcinoma (PTMC) that was manifested as a solitary clivus metastasis and discussed the diagnostic and therapeutic management strategies. The 73-year-old patient presented with visual impairment in the right eye,and epistaxis. The patient subsequently underwent complete total thyroidectomy after a diagnosis of papillary microcarcinoma. This finding emphasizes that clinically significant metastases can arise from thyroid papillary microcarcinoma. Total thyroidectomy and careful review of the histology are necessary to prevent delay in proper diagnosis.

  1. {sup 99m}Tc-sestamibi thyroid uptake in euthyroid individuals and in patients with autoimmune thyroid disease

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Allan O. [Campinas State University, Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas (Brazil); Avenida Independencia, Piracicaba, Sao Paulo (Brazil); Zantut-Wittmann, D.E.; Tambascia, M.A. [Campinas State University, Division of Endocrinology, Department of Internal Medicine, School of Medical Sciences, Campinas (Brazil); Nogueira, R.O.; Etchebehere, E.C.S.C.; Lima, M.C.L.; Camargo, E.E.; Ramos, C.D. [Campinas State University, Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas (Brazil)

    2005-06-01

    We investigated the biokinetics of {sup 99m}Tc-sestamibi in the thyroid of euthyroid volunteers (EVs) and in patients with autoimmune thyroid diseases and determined the best time interval between {sup 99m}Tc-sestamibi injection and calculation of uptake. Forty EVs, 30 patients with Graves' disease (GD), 15 patients with atrophic Hashimoto's thyroiditis (AHT) and 15 patients with hypertrophic Hashimoto's thyroiditis (HHT) underwent {sup 99m}Tc-sestamibi thyroid scintigraphy. Dynamic images were acquired for 20 min, and static images were obtained 20 min, 60 min and 120 min post injection. Five-, 20-, 60- and 120-min uptake, time to maximal uptake (T{sub max}) and T{sub 1/2} of tracer clearance were calculated. Thyroid hormones and antibodies were measured. {sup 99m}Tc-pertechnetate uptake was investigated in GD patients. T{sub max} was approximately 5 min in all four groups. The mean T{sub 1/2} value for EVs was similar to the GD value and lower than the HHT and AHT values. The mean ({+-}SD) 5-min uptake was 0.13% ({+-}0.05%) for EVs. The 5-min uptake in GD was higher than that in EVs(P<0.001) and correlated with free thyroxine (r=0.54) and with {sup 99m}Tc-pertechnetate uptake (r=0.68). Uptake in HHT was higher than that in AHT (P=0.0003) and EVs (P=0.002). Uptake in AHT was lower than uptake in EVs (P=0.0001). Five minutes is the optimal time interval between {sup 99m}Tc-sestamibi injection and calculation of thyroid uptake. Five-minute uptake differentiates euthyroid individuals from GD patients. There is a high correlation between {sup 99m}Tc-sestamibi and {sup 99m}Tc-pertechnetate uptake in GD. The reduced {sup 99m}Tc-sestamibi uptake in AHT patients is probably due to glandular destruction and fibrosis. Inflammatory infiltrate and high mitochondrial density in thyrocytes possibly explain the increased uptake in GD and HHT. (orig.)

  2. Hashimoto's thyroiditis in childhood: presentation modes and evolution over time

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    De Luca Filippo

    2013-01-01

    Full Text Available Abstract Aim of this survey is to report the most recent views about Hashimoto’s thyroiditis (HT natural history according to the different presentations. In children presenting with either euthyroidism or subclinical hypothyroidism HT spontaneous course is frequently characterized by a trend towards deterioration of thyroid function, whereas in those presenting with overt hyperthyroidism a definitive resolution of hyperthyroid phase is to be expected. Another possible even though unusual outcome of HT is the conversion to Graves’ disease.

  3. Control of Her-2 tumor immunity and thyroid autoimmunity by MHC and regulatory T cells.

    Science.gov (United States)

    Jacob, Jennifer B; Kong, Yi-chi M; Meroueh, Chady; Snower, Daniel P; David, Chella S; Ho, Ye-Shih; Wei, Wei-Zen

    2007-07-15

    Immune reactivity to self-antigens in both cancer and autoimmune diseases can be enhanced by systemic immune modulation, posing a challenge in cancer immunotherapy. To distinguish the genetic and immune regulation of tumor immunity versus autoimmunity, immune responses to human ErbB-2 (Her-2) and mouse thyroglobulin (mTg) were tested in transgenic mice expressing Her-2 that is overexpressed in several cancers, and HLA-DRB1*0301 (DR3) that is associated with susceptibility to several human autoimmune diseases, as well as experimental autoimmune thyroiditis (EAT). To induce Her-2 response, mice were electrovaccinated with pE2TM and pGM-CSF encoding the extracellular and transmembrane domains of Her-2 and the murine granulocyte macrophage colony-stimulating factor, respectively. To induce EAT, mice received mTg i.v. with or without lipopolysaccharide. Depletion of regulatory T cells (Treg) with anti-CD25 monoclonal antibody enhanced immune reactivity to Her-2 as well as mTg, showing control of both Her-2 and mTg responses by Treg. When immunized with, Her-2xDR3 and B6xDR3 mice expressing H2(b)xDR3 haplotype developed more profound mTg response and thyroid pathology than Her-2 or B6 mice that expressed the EAT-resistant H2(b) haplotype. In Her-2xDR3 mice, the response to mTg was further amplified when mice were also immunized with pE2TM and pGM-CSF. On the contrary, Her-2 reactivity was comparable whether mice expressed DR3 or not. Therefore, induction of Her-2 immunity was independent of DR3 but development of EAT was dictated by this allele, whereas Tregs control the responses to both self-antigens. These results warrant close monitoring of autoimmunity during cancer immunotherapy, particularly in patients with susceptible MHC class II alleles.

  4. Helicobacter pylori infection might be responsible for the interconnection between type 1 diabetes and autoimmune thyroiditis

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    El-Eshmawy Mervat M

    2011-10-01

    Full Text Available Abstract Background Higher serological prevalence rates of helicobacter pylori (H. pylori infection have been reported in patients with type 1 diabetes (T1DM and autoimmune thyroiditis (AT. Patients with T1DM are at increased risk for developing other autoimmune diseases, most commonly AT. It is unknown whether H. pylori infection could explain the high prevalence of thyroid autoantibodies and AT in T1DM. The aim of the current study was to evaluate anti-thyroid peroxidase (anti-TPO and anti-thyroglobulin (anti-Tg autoantibodies in correlation with anti-H. pylori IgG and IgA in young patients with T1DM. Methods Anti-H. Pylori IgG, IgA, anti-TPO and anti-Tg antibodies titers were measured in 162 euthyroid patients with T1DM and 80 healthy controls matched for age, sex and socioeconomic status. Results Seroprevalence of H. pylori was significantly higher in patients with T1DM than in healthy controls; 79% vs. 51.2%, p Conclusion our results support the idea of a connection between H. pylori infection and the occurrence of anti-TPO, anti-Tg autoantibodies and AT in young patients with T1DM. So, H. pylori infection could be considered as an environmental trigger for development of AT in T1DM. Young patients with T1DM should be screened for H. pylori infection.

  5. B cell depletion inhibits spontaneous autoimmune thyroiditis in NOD.H-2h4 mice.

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    Yu, Shiguang; Dunn, Robert; Kehry, Marilyn R; Braley-Mullen, Helen

    2008-06-01

    B cells are important for the development of most autoimmune diseases. B cell depletion immunotherapy has emerged as an effective treatment for several human autoimmune diseases, although it is unclear whether B cells are necessary for disease induction, autoantibody production, or disease progression. To address the role of B cells in a murine model of spontaneous autoimmune thyroiditis (SAT), B cells were depleted from adult NOD.H-2h4 mice using anti-mouse CD20 mAb. Anti-CD20 depleted most B cells in peripheral blood and cervical lymph nodes and 50-80% of splenic B cells. Flow cytometry analysis showed that marginal zone B cells in the spleen were relatively resistant to depletion by anti-CD20, whereas most follicular and transitional (T2) B cells were depleted after anti-CD20 treatment. When anti-CD20 was administered before development of SAT, development of SAT and anti-mouse thyroglobulin autoantibody responses were reduced. Anti-CD20 also reduced SAT severity and inhibited further increases in anti-mouse thyroglobulin autoantibodies when administered to mice that already had autoantibodies and thyroid inflammation. The results suggest that B cells are necessary for initiation as well as progression or maintenance of SAT in NOD.H-2h4 mice.

  6. Metastatic thyroid carcinoma presenting as distal spinal cord compression.

    Science.gov (United States)

    Goldstein, S I; Kaufman, D; Abati, A D

    1988-01-01

    The prognosis of metastatic thyroid carcinoma is dependent on the age of the patient, the histologic characteristics of the neoplasm, and the site of metastasis. A more favorable prognosis is found in patients less than 40 years old with follicular carcinoma and without any bony metastases. Metastatic thyroid carcinoma presenting as distal spinal cord compression is extremely rare. We report one such case and review the literature. As reported in the literature, the combination of decompressive laminectomy followed by total thyroidectomy and radioactive iodine therapy has proved to be effective in the treatment of patients with thyroid carcinoma metastatic to the distal vertebral bodies.

  7. Cutaneous metastasis as the presenting sign of papillary thyroid carcinoma.

    Science.gov (United States)

    Somoza, Arthur David; Bui, Hai; Samaan, Saad; Dhanda-Patil, Reena; Mutasim, Diya F

    2013-02-01

    Cutaneous metastasis of visceral tumors accounts for 2% of skin tumors. We report the case of a 71-year-old male with a smoking history who presented to dermatology department with a violaceous nodule of the right sideburn skin. The lesion was interpreted as an adenocarcinoma that was completely excised and was suspicious for a metastasis. There was a recommendation for additional work-up. At a different institution, a positron emission tomography scan showed a left hilar mass and uptake in the right thyroid. He was then referred to our hospital for tissue diagnosis. Mediastinoscopy with biopsy of the left hilar mass showed metastatic follicular thyroid carcinoma. Subsequently, a thyroid fine needle aspirate showed suspicion for malignancy with similar morphology. Thyroidectomy and central neck dissection showed right thyroid papillary carcinoma extending to one margin and involving the lymph nodes. The left hilar metastasis mass resection showed similar lymph node findings. A re-review of the sideburn excision revealed similar histopathology to the thyroid and mediastinal resection. This case illustrates the opportunity of considering metastatic thyroid carcinoma to skin even in cases which lack the classic cytologic and architectural features of papillary thyroid carcinoma follicular variant.

  8. Lack of association between thyroid autoantibodies and parity in a population study argues against microchimerism as a trigger of thyroid autoimmunity

    DEFF Research Database (Denmark)

    Pedersen, Inge Bülow; Laurberg, Peter; Knudsen, Nils;

    2006-01-01

    Background: Thyroid autoimmunity is more common in females than in males. One possible explanation for this female preponderance may be the effect of oestrogens on the immune system. It has also been suggested that foetal microchimerism involving transfer of foetal cells into maternal tissue during...... circulating thyroid antibodies and previous pregnancy, number of pregnancies, parity and previous abortion. There was no association between thyroid autoantibodies and use of OCs. Women aged 60-65 years receiving HRT now or previously had a lower prevalence of Tg-Ab (univariate. P = 0.01; multivariate, P = 0...

  9. Quantitative thyroid scintigraphy for the differentiation of Graves' disease and hyperthyroid autoimmune thyroiditis

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    Sahlmann, C.O.; Siefker, U.; Lehmann, K.; Harms, E.; Conrad, M.; Meller, J. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin

    2004-08-01

    The purpose of this study is the evaluation of the TCTUs in the differentiation between AIT and GD in patients with hyperthyroidism. Methods: We determined the TCTUs in 59 patients with untreated hyperthyroid GD and in 51 patients with AIT who had subclinical or manifest hyperthyroidism without medication. Patients with GD were characterized by the presence of hyperthyroidism, decreased echogenicity of the thyroid, elevation of TSH-receptor autoantibodies (TRAb). AIT was defined by a decreased echogenicity of the thyroid, absence of elevated TSH-receptor autoantibodies (TRAb), autoantibodies against the thyroid peroxidase (anti-TPO) and spontaneous remission or development of subclinical hypothyroidism within 3 months. Results: Thyroid volumes of patients with AIT were significantly lower than those of patients with GD (p<0.05). TRAb levels were significantly higher in GD-patients (median: 19.5 U/ml; range: 15.3-35 U/ml) than in AIT-patients (median: 1.3 U/ml; range: 0-4.1 U/ml). 73% (38/59) of patients with GD had elevated anti-TPO levels. In these patients anti-TPO levels (median: 768 U/l; range: 83-6397 U/l) were not significantly different from anti-TPO levels of patients with AIT (median: 834 U/l; range: 107-8675 U/l; p=0.17). TCTUs values of patients with AIT were significantly lower (p<0.05; median: 0.9%; range: 0.1-3.2%) than those of patients with GD (median: 5.7%; range: 1.9-28.3%). Conclusion: In our patients quantitative thyroid scintigraphy with {sup 99m}TcO{sub 4}{sup -} offered rapid and reliable differentiation between hyperthyroid GD and AIT. (orig.)

  10. Autoimmune encephalopathy associated with thyroid autoantibodies as the cause of reversible cognitive impairment

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    Robert Dobbin Chow

    2012-04-01

    Full Text Available We herewith describe a patient with acute confusion, expressive aphasia and generalized seizures. A through workup excluded most causes of encephalopathy. He was, however, found to have TSH = 18.6 MIU/ml, T3reverse = 0.44nmol/L, T4 = 0.8ng/dl and Anti-Thyroid-Peroxidase AB titer >1000 IU/ml. Based on the above findings the patient was diagnosed with Hashimoto's encephalopathy and his mental status showed dramatic improvement (MMS 30/30 with high dose prednisone. Hashimoto's encephalopathy is rare disorder of presumed autoimmune origin characterized by cognitive decline, seizures, neuro-psychiatric symptoms, high titers of Anti-Thyroid-Peroxidase AB, and a positive response to steroids.

  11. Dual-Directional Immunomodulatory Effects of Corbrin Capsule on Autoimmune Thyroid Diseases

    Science.gov (United States)

    He, Tianyi; Zhao, Ruxing; Lu, Yiran; Li, Wenjuan; Hou, Xinguo; Sun, Yu

    2016-01-01

    Purpose. To investigate the effects of Corbrin Capsule (CS-C-Q80), a drug derived from Cordyceps sinensis (Berk.) Sacc., on autoimmune thyroid diseases (AITD). Methods. 44 Patients with Graves's disease (GD) and 56 patients with Hashimoto's thyroiditis (HT) were randomly assigned to treatment group (GD-Tx and HT-Tx) or control group (GD-Ct and HT-Ct). The control groups were given methimazole or levothyroxine only while the treatment groups were given Corbrin Capsule (2.0 g tid) besides the same conventional prescriptions as control groups. Thyroid hormones, thyroid antibodies, and T lymphocyte subsets were quantified at baseline and 24 weeks posttreatment. Results. Significant drop of serum anti-TPO-Ab levels was observed in both GD-Tx and HT-Tx groups. Before treatment, GD patients had higher helper T cells compared to cytotoxic T cells, while HT patients suffered from a nearly inverted proportion of helper T/cytotoxic T cells. There was a significant drop of the helper T/cytotoxic T cells ratio in GD-Tx to the median of the normal ranges after Corbrin treatment for 24 weeks, while that in HT-Tx was elevated. Conclusion. Corbrin Capsule could restore the balance between helper T and cytotoxic T cells in both GD and HT patients with dual-directional immunomodulatory effects. And it could significantly reduce the autoantibody levels in both GD and HT. PMID:27721890

  12. Dual-Directional Immunomodulatory Effects of Corbrin Capsule on Autoimmune Thyroid Diseases

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    Tianyi He

    2016-01-01

    Full Text Available Purpose. To investigate the effects of Corbrin Capsule (CS-C-Q80, a drug derived from Cordyceps sinensis (Berk. Sacc., on autoimmune thyroid diseases (AITD. Methods. 44 Patients with Graves’s disease (GD and 56 patients with Hashimoto’s thyroiditis (HT were randomly assigned to treatment group (GD-Tx and HT-Tx or control group (GD-Ct and HT-Ct. The control groups were given methimazole or levothyroxine only while the treatment groups were given Corbrin Capsule (2.0 g tid besides the same conventional prescriptions as control groups. Thyroid hormones, thyroid antibodies, and T lymphocyte subsets were quantified at baseline and 24 weeks posttreatment. Results. Significant drop of serum anti-TPO-Ab levels was observed in both GD-Tx and HT-Tx groups. Before treatment, GD patients had higher helper T cells compared to cytotoxic T cells, while HT patients suffered from a nearly inverted proportion of helper T/cytotoxic T cells. There was a significant drop of the helper T/cytotoxic T cells ratio in GD-Tx to the median of the normal ranges after Corbrin treatment for 24 weeks, while that in HT-Tx was elevated. Conclusion. Corbrin Capsule could restore the balance between helper T and cytotoxic T cells in both GD and HT patients with dual-directional immunomodulatory effects. And it could significantly reduce the autoantibody levels in both GD and HT.

  13. The Effect of Ezetimibe/Statin Combination and High-Dose Statin Therapy on Thyroid Autoimmunity in Women with Hashimoto's Thyroiditis and Cardiovascular Disease: A Pilot Study.

    Science.gov (United States)

    Krysiak, R; Szkróbka, W; Okopień, B

    2016-10-01

    Background: Intensive statin therapy was found to reduce thyroid autoimmunity in women with Hashimoto's thyroiditis. No similar data are available for other hypolipidemic agents. Methods: The participants of the study were 16 women with Hashimoto's thyroiditis and coronary artery disease. On the basis of statin tolerance, they were divided into 2 groups. 8 patients who did not tolerate high-dose statin therapy were treated with a statin, the dose of which was reduced by half, together with ezetimibe. The remaining 8 patients tolerating the treatment continued high-dose statin therapy. Plasma lipids, serum levels of thyrotropin, free thyroxine and free triiodothyronine, as well as titers of thyroid peroxidase and thyroglobulin antibodies were measured at the beginning of the study and 6 months later. Results: Replacing high-dose statin therapy with ezetimibe/statin combination therapy increased serum titers of thyroid peroxidase as well as led to an insignificant increase in serum titers of thyroglobulin antibodies. At the end of the study, thyroid peroxidase and thyroglobulin antibody titers were higher in patients receiving the combination therapy than in those treated only with high-dose statin. Conclusions: Our study shows that high-dose statin therapy produces a stronger effect on thyroid autoimmunity than ezetimibe/statin combination therapy.

  14. Analysis of Associations of Human BAFF Gene Polymorphisms with Autoimmune Thyroid Diseases.

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    Jiunn-Diann Lin

    Full Text Available The B-lymphocyte-activating factor (BAFF is associated with B-cell functions, and gene polymorphisms of the BAFF have been linked to autoimmune diseases (AIDs. In this study, we explored possible associations of two BAFF single-nucleotide polymorphisms (SNPs, rs1041569 and rs2893321, with autoimmune thyroid diseases (AITDs in an ethnic Chinese population.In total, 319 Graves' disease (GD, 83 Hashimoto's thyroiditis (HT patients, and 369 healthy controls were enrolled. Polymerase chain reaction-restriction fragment length polymorphism and direct sequencing were used to genotype rs2893321 and rs1041569.There was a significant difference in frequencies of the G allele and AG+GG genotype of rs2893321 between the GD and control groups (p = 0.013, odds ratio (OR = 0.76, and p = 0.017, OR = 0.68, respectively and between the AITD and control groups (p = 0.009, OR = 0.76, and, p = 0.014, OR = 0.69, respectively. The AA genotype of rs2893321 was associated with low titers of the thyroid-stimulating hormone receptor antibody (TSHRAb (p = 0.015 in males but not in females. The AA genotype of rs2893321 was associated with the presence of two different types of thyroid autoantibody (TAb (TSHRAb and Hashimoto's autoantibody (anti-thyroglobulin or anti-microsomal antibody in females and with that of one type in males.rs2893321 may be a susceptible genetic variant for the development of GD and AITDs. Associations of rs2893321 with susceptibility to GD and AITDs and the correlation between rs2893321 and TAb exhibit a dimorphic pattern. Additional studies with larger sample sizes are required to confirm our findings.

  15. Thyroid function and autoimmunity in Danish pregnant women after an iodine fortification program and associations with obstetric outcomes

    DEFF Research Database (Denmark)

    Bliddal, Sofie; Boas, Malene; Hilsted, Linda

    2015-01-01

    OBJECTIVE: Aberrations in maternal thyroid function and autoimmunity during pregnancy have been associated with negative obstetric outcome. In Denmark, a national iodine fortification program was implemented in the year 2000 with the aim to alleviate the mild-moderate iodine deficiency. Following...... the iodine implementation, there has been an increase in thyroid autoimmunity in the background population. This study investigates the thyroid status of pregnant Danish women following the iodine fortification program, and a possible association with preterm delivery. DESIGN: Historical cohort study of 1278...... randomly selected pregnant Danish women attending the national Down's syndrome screening program. METHODS: The main outcome measures were thyroid status according to laboratory- and gestational-age-specific reference intervals, and association with risk of abnormal obstetric outcome. Antibody...

  16. Virtual touch tissue quantification (VTQ) in the diagnosis of thyroid nodules with coexistent chronic autoimmune Hashimoto's thyroiditis: A preliminary study

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    Han, Ruijun, E-mail: jine_nina@hotmail.com [Department of Ultrasound, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.1630 Dongfang Road, Shanghai 200127 (China); Li, Fenghua, E-mail: prfenghuali@126.com [Department of Ultrasound, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.1630 Dongfang Road, Shanghai 200127 (China); Wang, Yan [Department of Ultrasound, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.1630 Dongfang Road, Shanghai 200127 (China); Ying, Zhiqiang, E-mail: yingzhiqiang@126.com [Departmen of Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.1630 Dongfang Road, Shanghai 200127 (China); Zhang, Yun, E-mail: profzhangyun@126.com [Departmen of Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.1630 Dongfang Road, Shanghai 200127 (China)

    2015-02-15

    Highlights: • Virtual Touch Tissue Quantification could provide quantitative measurements to estimate tissue stiffness noninvasively. • Severity of Hashimoto's thyroiditis could affect stiffness of extra-nodular thyroid tissue significantly. • Shear wave velocity of malignant nodules significantly higher than that of benign nodules. • Acoustic Radiation Force Impulse imaging is useful in differential diagnosis between malignant/benign thyroid nodules with HT. - Abstract: Objectives: This study aimed at detecting whether Virtual Touch Tissue Quantification (VTQ) could be applied to differentiate between benign and malignant thyroid nodules with chronic autoimmune Hashimoto's thyroiditis (HT). Methods: Convenient ultrasound and Virtual Touch Tissue Quantification were performed in 118 patients with 140 thyroid nodules with histology results. The HT group consisted of 46 patients with 58 nodules. The non-HT group consisted of 72 patients with 82 nodules. Results: The stiffness of extra-nodular thyroid tissue could be significantly affected by the severity of chronic autoimmune thyroiditis. The shear wave velocity of thyroid benign nodules and malignant nodules did not significantly differ in the HT group as compared with the non-HT group (benign nodules: 2.13 ± 0.32 m/s vs 1.98 ± 0.48 m/s, P = 0.122; malignant nodules: 3.32 ± 0.77 m/s vs 3.30 ± 0.74 m/s, P = 0.894). In two groups, the shear wave velocity of malignant nodules is significantly higher than that of benign nodules (HT group: 3.32 ± 0.77 m/s vs 2.13 ± 0.32 m/s; non-HT group: 3.30 ± 0.74 m/s vs 1.98 ± 0.48 m/s, P < 0.001). The best cutoff point for shear wave velocity between malignant and benign thyroid nodules was 2.75 m/s. Conclusions: Virtual Touch Tissue Quantification technology could be performed in the differential diagnosis between malignant thyroid nodules and benign thyroid nodules independently from the coexistence of chronic autoimmune thyroiditis.

  17. An unusual presentation of carcinoma lower oesophagus with thyroid metastasis

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    Sreenivasa Rao B

    2015-04-01

    Full Text Available Carcinoma lower oesophagus metastasizing to thyroid occurs rarely. We report the case of a 56-year-old male who was referred for evaluation of dysphagia in whom such an occurrence has been documeneted. Clinically patient had palpable cervical lymphadenopathy. There was no thyroid swelling. Upper gastro-intestinal endoscopic biopsy revealed squamous cell carcinoma of lower third oesophagus. Fine needle aspiration cytology (FNAC from the right cervical lymph node also revealed squamous cell carcinomatous deposits. Patient was then evaluated by integrated whole-body positron emission tomography-computed tomography using 18F fluorodeoxyglucose which revealed metabolic activity in thyroid gland. Ultrasound guided FNAC from thyroid shown metastatic squamous cell carcinomatous deposits which was further confirmed by imunocytochemistry. We present this case because of its exceedingly rare occurrence and poor prognosis.

  18. The effect of Vitamin D treatment on thyroid function and the levels of thyroid autoantibodies, TNF-α, IL-6, IL-1β in patients with autoimmune thyroiditis

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    Fettah Acıbucu

    2016-12-01

    Full Text Available Objective: To investigate the relationship between autoimmune thyroid disease and vitamin D treatment. Method: Fifty four (54 patients with both vitamin D deficiency and newly diagnosed euthyroid Hashimoto’s thyroiditis (HT were recruited for this study. The patients were given intramuscular administration of cholecalciferol at a dose of 300,000 IU/month for 3 months. At the time of diagnoses and after the treatment of vitamin D, free T3 (FT3, free T4 (FT4, thyroid stimulating hormone (TSH, antithyroid peroxidase (anti-TPO, antithyroglobulin (anti-TG, 25 (OH D3, parathormone (PTH, calcium (Ca, phosphorus (P and alkaline phosphatase (ALP levels were measured in all patients; TNF-a, IL-6 and IL-1ß levels were measured in only 43 patients. Results: A statistically significant difference (p˂0.05 was observed between the pre and post treatment FT4, TSH, antiTPO, antiTG, PTH and ALP levels. After the treatment of vitamin D, a statistically significant increase was found in 25 (OH D3 and FT4 levels, and a significant decrease was found in TSH, antiTPO, antiTG, PTH and ALP levels, whereas no significant difference was noted in FT3, Ca, P, TNF- a, IL-6 and IL-1ß levels. Further, levels of vitamin D were not correlated with FT3, FT4, TSH, antiTPO, antiTG, TNF-a, IL-6 and IL-1ß levels (p˃0.05. Conclusions: For patients with both vitamin D deficiency and newly diagnosed HT, treatment of vitamin D had a positive effect on the thyroid antigenicity and thyroid function.

  19. TNFSF4 Gene Variations Are Related to Early-Onset Autoimmune Thyroid Diseases and Hypothyroidism of Hashimoto's Thyroiditis.

    Science.gov (United States)

    Song, Rong-Hua; Wang, Qiong; Yao, Qiu-Ming; Shao, Xiao-Qing; Li, Ling; Wang, Wen; An, Xiao-Fei; Li, Qian; Zhang, Jin-An

    2016-08-20

    The aim of the current study was to examine whether the polymorphism loci of the tumor necrosis factor superfamily member 4 (TNFSF4) gene increase the risk of susceptibility to autoimmune thyroid diseases (AITDs) in the Han Chinese population, and a case-control study was performed in a set of 1,048 AITDs patients and 909 normal healthy controls in the study. A total of four tagging single nucleotide polymorphisms (SNPs) in the TNFSF4 region, including rs7514229, rs1234313, rs16845607 and rs3850641, were genotyped using the method of ligase detection reaction. An association between GG genotype of rs3850641 in TNFSF4 gene and AITDs was found (p = 0.046). Additionally, the clinical sub-phenotype analysis revealed a significant association between GG genotype in rs7514229 and AITDs patients who were ≤18 years of age. Furthermore, rs3850641 variant allele G was in strong association with hypothyroidism in Hashimoto's thyroiditis (HT) (p = 0.018). The polymorphisms of the TNFSF4 gene may contribute to the susceptibility to AITDs pathogenesis.

  20. Follicular thyroid carcinoma presenting as bilateral cheek masses.

    Science.gov (United States)

    Kim, Dong-Wook; Hah, J Hun; An, Soo-Youn; Chang, Hak; Kim, Kwang Hyun

    2013-03-01

    Mandibular metastasis of thyroid carcinoma is extremely rare. We present the case of a 46-year-old woman who had bilateral huge cheek masses that had grown rapidly over several years. Intra-oral mucosal tissue biopsy and imaging work-up including computed tomography scan and magnetic resonance imaging were performed and the initial diagnosis was presumed to be central giant cell granuloma. Incidentally detected thyroid lesions were studied with ultra-sonography guided fine needle aspiration and diagnosed as simple benign nodules. Due to continuous oral bleeding and the locally destructive feature of the lesions, we decided to excise the mass surgically. To avoid functional deficit, a stepwise approach was performed: Firstly, the larger left mass was excised and the mandible was reconstructed with a fibular free flap. The final pathologic diagnosis was follicular thyroid cancer. Postoperative I-131 thyroid scan and whole body positron-emissions-tomography were performed. Right side mass was revealed as a thyroid malignancy. Multiple bony metastases were detected. Since further radioactive iodine therapy was required, additional total thyroidectomy and right side mandibulectomy with fibular free flap reconstruction was performed. The patient also underwent high dose radioactive iodine therapy and palliative extra-beam radiotherapy for the metastatic lumbar lesion. Follicular thyroid carcinoma should be considered as a differential diagnosis for mandibular mass lesions.

  1. Effect of transgenic overexpression of FLIP on lymphocytes on development and resolution of experimental autoimmune thyroiditis.

    Science.gov (United States)

    Fang, Yujiang; Sharp, Gordon C; Braley-Mullen, Helen

    2011-09-01

    In our previous studies, resolution of granulomatous experimental autoimmune thyroiditis (G-EAT) was promoted when thyroid epithelial cells were protected from Fas-mediated apoptosis due to transgenic overexpression of FLIP. We hypothesized that if FLIP were overexpressed on lymphocytes, CD4(+) effector cells would be protected from Fas-mediated apoptosis, and resolution would be delayed. To test this hypothesis, we generated transgenic (Tg) mice overexpressing FLIP under the CD2 promoter. Transgenic FLIP was expressed on CD4(+) and CD8(+) T cells and B cells. Transgenic overexpression of FLIP protected cultured splenocytes from Fas-mediated, but not irradiation-induced, apoptosis in vitro. Unexpectedly, Tg(+) donor cells transferred minimal G-EAT, which was partially overcome by depleting donor CD8(+) T cells. When Tg(+) and Tg(-) donors transferred equivalent disease, G-EAT resolution was delayed in FLIP transgenic mice. However, CD2-FLIP Tg(+) donors often transferred less severe G-EAT, even after depletion of CD8(+) T cells. This influenced the rate of G-EAT resolution, resulting in little difference in G-EAT resolution between groups. Tg(+) mice always had reduced anti-mouse thyroglobulin autoantibody responses, compared with Tg(-) littermates, presumably because of FLIP overexpression on B cells. These results suggest that effects of transgenic FLIP on a particular autoimmune disease vary, depending on what cells express the transgene and whether those cells are effector cells or if they function to modulate disease.

  2. Glutamate decreases the secretion of IL-10 by peripheral blood lymphocytes in persons with autoimmune thyroiditis.

    Science.gov (United States)

    Kvaratskhelia, E; Dabrundashvili, N; Gagua, M; Maisuradze, E; Mikeladze, D

    2008-11-01

    Human T lymphocytes expose ionotropic and metabotropic glutamate receptors, which control immune responses, cell activation, maturation, and death. Several cytokines release during inflammation which identification may have important physiological and clinical implications. Main biological function of IL-10 is limitation and termination of inflammatory responses and the regulation of differentiation and proliferation of several immune cells. Various inflammatory molecules regulated the secretion of IL-8 and IL-10, but the action of glutamate on the biosynthesis of cytokines is unknown. We have found that in peripheral blood lymphocytes glutamate at the concentrations within normal plasma levels (1 x 10(-5) M), as well as at lower concentration (0.3 x 10(-6) M) changes the secretion of immunosuppressive cytokine IL-10, whereas synthesis of proinflammatory chemokine, IL-8 did not changed significantly. Moreover, our results have shown that peripheral blood lymphocytes from patients with autoimmune thyroiditis release less IL-10 at both concentration of glutamate than peripheral blood lymphocytes from healthy persons. These data suggest that glutamate decrease the secretion of IL-10 by peripheral blood lymphocytes, especially in patients with autoimmune thyroiditis that may be responsible for prolongation of inflammation.

  3. Association between STAT4 Gene Polymorphisms and Autoimmune Thyroid Diseases in a Chinese Population

    Directory of Open Access Journals (Sweden)

    Ni Yan

    2014-07-01

    Full Text Available The STAT4 gene encodes a transcriptional factor that transmits signals induced by several key cytokines which play important roles in the development of autoimmune diseases. The aim of this study was to explore the association of STAT4 polymorphism with Graves’ disease (GD and Hashimoto’s thyroiditis (HT. A total of 1048 autoimmune thyroid diseases (AITDs patients (693 with GD and 355 with HT and 909 age- and gender-matched controls were examined. STAT4 polymorphisms (rs7574865/rs10181656/ rs7572482 were genotyped by multiplex polymerase chain reaction (PCR and ligase detection reaction (LDR. The results indicated that the frequencies of rs7574865 genotypes in patients with GD differed significantly from the controls (p = 0.028, the T allele frequency of GD patients was also significantly higher than the controls (p = 0.020. The genotypes of rs10181656 differed significantly in GD patients from controls (p = 0.012; G allele frequencies were significantly higher in AITD patients than the controls (p = 0.014 and 0.031, respectively. The frequencies of haplotype GC with GD and HT patients were significantly lower than their controls (p = 0.015 and 0.030, respectively. In contrast, the frequencies of haplotype TG with GD and HT patients were significantly higher than their controls (p = 0.016 and 0.048, respectively. These findings strongly suggest that STAT4 rs7574865/rs10181656 polymorphisms increase the risk of AITD in a Chinese population.

  4. Interferon induced thyroiditis.

    Science.gov (United States)

    Tomer, Yaron; Menconi, Francesca

    2009-12-01

    Interferon-alpha (IFNalpha) is used for the treatment of various disorders, most notable chronic hepatitis C virus (HCV) infection. One of the commonest side effects of IFNalpha therapy is thyroiditis, with up to 40% of HCV patients on IFNalpha developing clinical or subclinical disease. In some cases interferon induced thyroiditis (IIT) may result in severe symptomatology necessitating discontinuation of therapy. IIT can manifest as clinical autoimmune thyroiditis, presenting with symptoms of classical Hashimoto's thyroiditis or Graves' disease, or as non-autoimmune thyroiditis. Non-autoimmune thyroiditis can manifest as destructive thyroiditis, with early thyrotoxicosis and later hypothyroidism, or as non-autoimmune hypothyroidism. While the epidemiology and clinical presentation of IIT have been well characterized the mechanisms causing IIT are still poorly understood. It is likely that the hepatitis C virus (HCV) itself plays a role in the disease, as the association between HCV infection and thyroiditis is well established. It is believed that IFNalpha induces thyroiditis by both immune stimulatory effects and by direct effects on the thyroid. Early detection and therapy of this condition are important in order to avoid complications of thyroid disease such as cardiac arrhythmias.

  5. Coumestrol inhibits autoantibody production through modulating Th1 response in experimental autoimmune thyroiditis

    Science.gov (United States)

    Zhao, Xuemin; Jin, Qian; Fan, Chenling; Li, Jing; Shan, Zhongyan; Teng, Weiping

    2016-01-01

    Coumestrol is a common phytoestrogen found in plants and Chinese medicinal herbs. Its influences on experimental autoimmune thyroiditis (EAT) were investigated in this study. Female adult CBA/J mice were fed with drinking water containing 1% Tween80 only (Control group), 0.8 mg/l (L group) and 8 mg/l coumestrol (H group) from 6 to 15 weeks of age, respectively. Their serum coumestrol concentrations were determined by high performance liquid chromatography, which were undetectable, 43.70 ± 21.74 ng/ml and 135.07 ± 70.40 ng/ml, respectively. In addition, the mice (n = 14–16/group) were immunized twice with thyroglobulin (Tg) and Freund's adjuvant to induce EAT during the meantime. Although no overt changes in the extent of intrathyroidal mononuclear cell infiltration were shown in the two coumestrol-treated groups as compared with the controls, serum anti-Tg IgG2a, IgG3 and IgG1 titers, ratio of IgG2a to IgG1 and the percentage of T helper (Th)1 cells in the splenocytes were significantly reduced in the L group. Another consistent change was the significantly decreased expression of splenic IFN-γ mRNA after low dose of coumestrol exposure. Uterine weight was also markedly reduced in the mice of L group. These findings suggest that coumestrol treatment may have some beneficial actions against thyroid-specific autoantibody production in the development of autoimmune thyroiditis through suppression of Th1 response due to its anti-estrogenic activity. PMID:27384679

  6. 25 Hydroxyvitamin D Deficiency and Its Relationship to Autoimmune Thyroid Disease in the Elderly

    Directory of Open Access Journals (Sweden)

    Giovanna Muscogiuri

    2016-08-01

    Full Text Available Background: Low 25(OH vitamin D levels have been associated with several autoimmune diseases and recently with autoimmune thyroiditis (AT. The aim of the study was to investigate the association of AT with low 25(OH vitamin D levels in the elderly. Methods: One hundred sixty-eight elderly subjects (mean age: 81.6 ± 9.4 years were enrolled. Serum levels of 25(OH vitamin D, anti-thyroid peroxidase (TPO-Ab, anti-thyroglobulin (TG-Ab antibodies, free triiodothyronine (FT3, free thyroxine (FT4 and thyroid stimulating hormone (TSH were measured. Results: The prevalence of AT was significantly higher in subjects with vitamin D deficiency (25(OH vitamin D < 20 ng/mL when compared with subjects with normal 25(OH vitamin D (25(OH vitamin D ≥ 20 ng/mL levels (28% vs. 8%, respectively, p = 0.002. Patients with AT and vitamin D deficiency had a comparable hormonal profile compared to patients with AT and vitamin D sufficiency in terms of TSH (p = 0.39, FT3 (p = 0.30, FT4 (p = 0.31, TG-Ab (0.44 and TPO-Ab (0.35. Interestingly, a significant correlation between 25(OH vitamin D and TPO-Ab (r = −0.27, p = 0.03 and FT3 (r = 0.35, p = 0.006 has been found in subjects with AT while no correlation was found between 25(OH vitamin D levels and TG-Ab (r = −0.15, p = 0.25, TSH (r = −0.014, p = 0.09 and FT4 (r = 0.13, p = 0.32. Conclusions: These findings suggest that vitamin D deficiency was significantly associated with AT in the elderly. Therefore, the screening for AT should be suggested in subjects with vitamin D deficiency.

  7. 25 Hydroxyvitamin D Deficiency and Its Relationship to Autoimmune Thyroid Disease in the Elderly

    Science.gov (United States)

    Muscogiuri, Giovanna; Mari, Daniela; Prolo, Silvia; Fatti, Letizia M.; Cantone, Maria Celeste; Garagnani, Paolo; Arosio, Beatrice; Di Somma, Carolina; Vitale, Giovanni

    2016-01-01

    Background: Low 25(OH) vitamin D levels have been associated with several autoimmune diseases and recently with autoimmune thyroiditis (AT). The aim of the study was to investigate the association of AT with low 25(OH) vitamin D levels in the elderly. Methods: One hundred sixty-eight elderly subjects (mean age: 81.6 ± 9.4 years) were enrolled. Serum levels of 25(OH) vitamin D, anti-thyroid peroxidase (TPO-Ab), anti-thyroglobulin (TG-Ab) antibodies, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were measured. Results: The prevalence of AT was significantly higher in subjects with vitamin D deficiency (25(OH) vitamin D < 20 ng/mL) when compared with subjects with normal 25(OH) vitamin D (25(OH) vitamin D ≥ 20 ng/mL) levels (28% vs. 8%, respectively, p = 0.002). Patients with AT and vitamin D deficiency had a comparable hormonal profile compared to patients with AT and vitamin D sufficiency in terms of TSH (p = 0.39), FT3 (p = 0.30), FT4 (p = 0.31), TG-Ab (0.44) and TPO-Ab (0.35). Interestingly, a significant correlation between 25(OH) vitamin D and TPO-Ab (r = −0.27, p = 0.03) and FT3 (r = 0.35, p = 0.006) has been found in subjects with AT while no correlation was found between 25(OH) vitamin D levels and TG-Ab (r = −0.15, p = 0.25), TSH (r = −0.014, p = 0.09) and FT4 (r = 0.13, p = 0.32). Conclusions: These findings suggest that vitamin D deficiency was significantly associated with AT in the elderly. Therefore, the screening for AT should be suggested in subjects with vitamin D deficiency. PMID:27571093

  8. There Is No Elevation of Immunoglobulin E Levels in Albanian Patients with Autoimmune Thyroid Diseases

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    Hatixhe Latifi-Pupovci

    2014-01-01

    Full Text Available Background. Studies in several ethnic groups reported high incidence of elevated levels of immunoglobulin E (IgE in patients with autoimmune thyroid diseases (ATD, especially in patients with Graves’ disease. Objective. To study association between serum levels of IgE and thyroid stimulating hormone receptor antibodies (TRAb in Albanian patients with ATD. Material and Methods. Study was performed in 40 patients with Graves’ disease, 15 patients with Hashimoto’s thyroiditis, and 14 subjects in the control group. The IgE levels were measured by immunoradiometric assay, whereas the TRAb levels were measured by radioreceptor assay. Results. In all groups of subjects the IgE levels were within reference values (<200 kIU/L. Significant difference in mean concentration of IgE was found between two groups of Graves’ disease patients, and those with normal and elevated TRAb levels (22.57 versus 45.03, P<0.05. Positive correlation was found between TRAb and IgE only in Graves’ disease patients (r=0.43, P=0.006. Conclusion. In Albanian patients with ATD there is no elevation of IgE levels. This could be the result of low prevalence of allergic diseases in Albanian population determined by genetic and environmental factors.

  9. Clustering of autoimmune thyroid diseases in children and adolescents: a study of 66 families.

    Science.gov (United States)

    Segni, M; Wood, J; Pucarelli, I; Toscano, V; Toscano, R; Pasquino, A M

    2001-01-01

    Autoimmune thyroid diseases (AITD) are known to be clustered in families, but to what extent this occurs in childhood and adolescence is not well defined. In order to establish the prevalence of AITD in the siblings of affected children and adolescents, we examined 73 siblings from 66 families selected on the basis of a pediatric index patient. Sixty-six families, including a total of 146 offspring, were selected on the basis of diagnosis of chronic lymphocytic thyroiditis (CLT) (n = 55) or Graves' disease (GD) (n = 11). Among the 73 siblings examined, 20 new cases of CLT (27%) were detected. L-Thyroxine therapy was required in 4/20. History of AITD was recorded in 24/66 mothers (36%), and in two fathers. Overall in these families, considering both the index patients and the new patients, 86/141 (61%) children and adolescents were affected with AITD, with a female/male ratio of 3.3:1. Our study confirms that AITD clusters in families with a high prevalence in the siblings of affected children and adolescents. These children should be followed in order to avoid undiagnosed hypothyroidism. Prospective studies are warranted to identify predictive factors for overt thyroid disease.

  10. Activation of Helicobacter pylori causes either autoimmune thyroid diseases or carcinogenesis in the digestive tract.

    Science.gov (United States)

    Astl, J; Šterzl, I

    2015-01-01

    Helicobacter pylori has been implicated in stimulation of immune system, development of autoimmune endocrinopathies as autoimmune thyroiditis (AT) and on other hand induction of immunosupresion activates gastric and extra-gastric diseases such as gastric ulcer or cancer. It causes persistent lifelong infection despite local and systemic immune response. Our results indicate that Helicobacter pylori might cause inhibition of the specific cellular immune response in Helicobacter pylori-infected patients with or without autoimmune diseases such as AT. We cannot also declare the carcinogenic effect in oropharynx. However the association of any infection agents and cancerogenesis exists. The adherence of Helicobacter pylori expression and enlargement of benign lymphatic tissue and the high incidence of the DNA of Helicobacter pylori in laryngopharyngeal and oropharyngeal cancer is reality. LTT appears to be a good tool for detection of immune memory cellular response in patients with Helicobacter pylori infection and AT. All these complications of Helicobacter pylori infection can be abrogated by successful eradication of Helicobacter pylori.

  11. Hashimoto’s Thyroiditis and Kikuchi’s Disease: Presentation of a Case and Review of the Literature

    OpenAIRE

    Athanasios Saratziotis; Konstantinos Karakousis; Kelly Tzika; Oikonomou, Katerina G.; Vlachostergios, Panagiotis J.

    2012-01-01

    We report the case of a 19-year-old woman with a history of Hashimoto's thyroiditis who presented with tender right anterior cervical lymphadenopathy and fever. Workup for infectious, autoimmune, and malignant causes was unremarkable. Surgical removal of cervical lymph nodes after detailed magnetic resonance (MR) imaging disclosed necrotizing lymphadenitis, also known as Kikuchi's disease (KD). The patient was treated with a short-term course of steroids, due to the onset of pancytopenia and ...

  12. Ectopic Thyroid in the Adrenal Presenting as an Adrenal Incidentaloma

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    Banu Aktaş Yılmaz

    2016-12-01

    Full Text Available Adrenal incidentalomas are clinical dilemmas for the clinicians. The work up, to differentiate between malignant and benign lesions, and hyperfunctioning and nonfunctioning lesions is mandatory before the consideration of surgical resection. Ectopic thyroid tissue located in the adrenal gland (ETTAG is a very rare condition. We report a case of ETTAG presenting with adrenal incidentaloma. A 57-year-old woman was admitted with incidental right adrenal mass. Hormone evaluation showed no hormonal activity. Magnetic resonance imaging revealed a 20x17 mm lobulated solid mass, which contained millimetric hypointense nodular areas consistent with calcifications. Loss of signal intensity on out-of-phase could not be evaluated because of the calcifications. Right adrenalectomy was performed to establish the histopathological diagnosis and to rule out malignancy. Histopathological diagnosis revealed ETTAG. Her medical history was positive for multinodular goiter and bilateral subtotal thyroidectomy 32 years ago. Thyroid ultrasonography showed residual thyroid tissue in both the right and left lobes, and colloid thyroid nodules. Fine needle aspiration biopsy from the nodules revealed benign nodules. The patient has been followed up for six years, and no change in thyroid nodule sizes and no evidence of metastatic foci have been detected. ETTAG would be considered in the differential diagnosis of adrenal mass showing no hormonal activity, especially when magnetic resonance images are not consistent with adrenal adenoma. Long follow-up duration of this case suggests that it was a benign condition.

  13. Thyroid Diseases Tests

    Science.gov (United States)

    ... Thyroid antibodies – to help differentiate different types of thyroiditis and identify autoimmune thyroid conditions Thyroid peroxidase (TPO) ... can be detected in Graves disease or Hashimoto thyroiditis . It may be especially helpful in early Hashimoto ...

  14. Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Hypothyroidism in patients with Graves\\' disease is usually the result of ablative treatment. We describe a 58 year old man with Graves\\' ophthalmopathy and pre-tibial myxoedema, who presented with spontaneous primary hypothyroidism. Circulating TSH receptor antibody activity was increased, while thyroid microsomal antibody was detectable in titres greater than one in one hundred thousand. It is likely that the TSH receptor antibody of Graves\\' disease was ineffective in stimulating hyperthyroidism because of concomitant thyroid destruction due to Hashimoto\\'s disease. Alternatively, primary hypothyroidism could have resulted from the effects of a circulating TSH receptor blocking antibody.

  15. Postpartum Thyroiditis

    Science.gov (United States)

    ... to be an autoimmune disease very similar to Hashimoto’s thyroiditis. In fact, these two disorders cannot be ... from one another on pathology specimens. As in Hashimoto’s thyroiditis, postpartum thyroiditis is associated with the development ...

  16. Thyroid Antibodies

    Science.gov (United States)

    ... e.g., at regular intervals after thyroid cancer treatment) Thyroid stimulating hormone receptor antibody, Thyroid Stimulating Immunoglobulin TRAb, TSHR Ab, TSI Graves disease When a person has symptoms of hyperthyroidism If a pregnant woman has a known autoimmune ...

  17. Autoimmune hepatitis

    Science.gov (United States)

    ... PA: Elsevier Saunders; 2010:chap 88. Read More Autoimmune disorders Chronic thyroiditis (Hashimoto disease) Cirrhosis Glomerulonephritis Hemolytic anemia Liver cancer - hepatocellular carcinoma Mesenteric venous thrombosis Type ...

  18. Autoimmune Hepatitis as an Initial Presentation of SLE

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    Hassas Yeganeh

    2016-05-01

    Full Text Available An 11-year-old female patient with autoimmune hepatitis (AIH was referred to our rheumatology clinic due to her current musculoskeletal manifestations. The patient had been diagnosed with AIH 3 months previously, based on jaundice and impaired liver function tests, and she had been treated with low-dose prednisolone and azathioprine. She presented with malaise, arthritis, a malar rash on the face, and oral ulcers. Laboratory tests revealed a positive ANA/anti-dsDNA test. Liver biopsy showed chronic hepatitis with severe inflammatory activity, in favor of a diagnosis of definite AIH. She fulfilled the international criteria for both SLE and AIH. The clinical symptoms and laboratory findings of SLE improved with ongoing treatment with corticosteroids and azathioprine, accompanied with hydroxychloroquine sulfate. The present case indicates that AIH can be the first manifestation of SLE in children.

  19. Simultaneous measurement of serum chemokines in autoimmune thyroid diseases: possible role of IP-10 in the inflammatory response.

    Science.gov (United States)

    Hiratsuka, Izumi; Itoh, Mitsuyasu; Yamada, Hiroya; Yamamoto, Keiko; Tomatsu, Eisuke; Makino, Masaki; Hashimoto, Shuji; Suzuki, Atsushi

    2015-01-01

    Autoimmune thyroid diseases (AITDs), including Graves' diseases (GD) and Hashimoto's thyroiditis (HT), are the most common autoimmune diseases, and are mainly mediated by T cells that produce cytokines and chemokines in abnormal amounts. Few reports have described the circulating chemokines active in AITDs. Recently, we used a new multiplex immunobead assay to simultaneously measure cytokines and chemokines in small volume serum samples from patients with AITDs. We measured 23 selected serum chemokines in patients with GD (n=45) or HT (n=26), and healthy controls (n=9). GD patients were further classified as either untreated, intractable, or in remission, while HT patients were classified as either hypothyroid or euthyroid. Of the 23 serum chemokines assayed, only the serum level of IP-10 (CXCL10/interferon-γ-inducible protein 10) was elevated, depending on disease activity, in GD or HT compared with healthy controls. However, the serum level of IP-10 was also increased in both untreated GD patients and hypothyroid HT patients, suggesting that levels of this cytokine may not be affected by disease specificity. In conclusion, autoimmune inflammation in patients with AITD is closely related to the level of the serum chemokine, IP-10. Therefore, IP-10 might be a good biomarker for tissue inflammation in the thyroid, but not a useful biomarker for predicting disease specific activity, the progression of AITDs, or responsiveness to treatment because of its independence from thyroid function or disease specificity.

  20. Imbalance of Th17/Treg in Different Subtypes of Autoimmune Thyroid Diseases

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    Cui Li

    2016-11-01

    Full Text Available Aims: To clarify the imbalance of Th17/Treg in different subtypes of autoimmune thyroid diseases (AITDs including Graves' disease(GD, Hashimoto's thyroiditis(HT and Graves' ophthalmopathy (GO. Methods: 47 patients with AITD (including 16 GD, 15 HT, and 16 GO and 12 healthy controls were enrolled in this study. The percentages of Th17 and Treg cells, the ratio of Th17/Treg, as well as their related transcription factors RORγt and Foxp3 mRNA in peripheral blood mononuclear cells (PBMCs were measured by flow cytometry and real-time quantitative PCR Results: Compared with those in control group, the percentage of CD4+IL-17+T cell(Th17 and the mRNA expression of its transcription factor RORγt were higher in PBMCs of AITDs (P+Foxp3+T (Treg cells and its transcription factor Foxp3 mRNA were significantly decreased in PBMCs of GD (PConclusion: Increased Th17 lymphocytes may play a more important role in the pathogenesis of HT and GO while decreased Treg may be greatly involved in GD.

  1. Prevalence and clinical significance of nonorgan specific antibodies in patients with autoimmune thyroiditis as predictor markers for rheumatic diseases

    Science.gov (United States)

    Elnady, Basant M.; Kamal, Naglaa M.; Shaker, Raneyah H.M.; Soliman, Amal F.; Hasan, Waleed A.; Alghamdi, Hamed A.; Algethami, Mohammed M.; Jajah, Mohamed Bilal

    2016-01-01

    Abstract Autoimmune diseases are considered the 3rd leading cause of morbidity and mortality in the industrialized countries. Autoimmune thyroid diseases (ATDs) are associated with high prevalence of nonorgan-specific autoantibodies, such as antinuclear antibodies (ANA), antidouble-stranded deoxyribonucleic acid (anti-dsDNA), antiextractable-nuclear antigens (anti-ENAs), rheumatoid factor (RF), and anticyclic-citrullinated peptides (anti-CCP) whose clinical significance is unknown. We aimed to assess the prevalence of various nonorgan-specific autoantibodies in patients with ATD, and to investigate the possible association between these autoantibodies and occurrence of rheumatic diseases and, if these autoantibodies could be considered as predictor markers for autoimmune rheumatic diseases in the future. This study had 2 phases: phase 1; in which 61 ATD patients free from rheumatic manifestations were assessed for the presence of these nonorgan-specific autoantibodies against healthy 61 control group, followed by 2nd phase longitudinal clinical follow-up in which cases are monitored systematically to establish occurrence and progression of any rheumatic disease in association to these autoantibodies with its influences and prognosis. Regarding ATD patients, ANA, anti-dsDNA, Anti-ENA, and RF were present in a percentage of (50.8%), (18%), (21.3%), and (34.4%), respectively, with statistically significance difference (P < 0.5) rather than controls. Nearly one third of the studied group (32.8%) developed the rheumatic diseases, over 2 years follow-up. It was obvious that those with positive anti-dsDNA had higher risk (2.45 times) to develop rheumatic diseases than those without. There was a statistically significant positive linear relationship between occurrence of disease in months and (age, anti-dsDNA, anti-CCP, RF, and duration of thyroiditis). Anti-dsDNA and RF are the most significant predictors (P < 0.0001). ATD is more associated with rheumatic

  2. Selenium and autoimmune thyroid diseases%硒与自身免疫性甲状腺疾病

    Institute of Scientific and Technical Information of China (English)

    张方华; 阎胜利

    2008-01-01

    The pathogenesis of autoimmune thyroid diseases is complexity,may relates to the radicalinduced oxidative stress and apoptosis.Selenium is one of the essential trace element to maintain mammals health.It plays an important role in the synthesis,activation,metabolism of thyroid hormone,thyroid antioxidant system and the immune system.The low level of serum selenium can induce or aggravate immune disorder and chronic inflammation in thyroid tissues.A certain amount of selenium Call ameliorate the inflammation in autoimmune thyroid diseases.Supplemental selenium may exploit a new way for treatment of autoimmune thyroid diseases.%自身免疫性甲状腺疾病(AITD)的发病机制十分复杂,可能与自由基诱发的氧化应激和凋亡有关.硒是哺乳动物维持正常功能必需的微量元素之一,其在甲状腺激素的合成、活化、代谢过程及甲状腺抗氧化系统和免疫系统中发挥重要作用.血清硒水平低可以引起或加重甲状腺组织的免疫紊乱与慢性炎性反应,引起AITD.补充一定剂量的硒可能改善AITD患者的炎性反应,为AITD的治疗开辟一条新的途径.

  3. Clinical progression of autoimmune thyroiditis in children and adolescents treated at the Instituto Nacional de Salud del Niño

    OpenAIRE

    Núñez Almache, Oswaldo; Facultad de Medicina, Universidad Nacional Federico Villarreal, Lima, Perú; Servicio de Endocrinología, Instituto Nacional de Salud del Niño, Lima, Perú; Del Aguila Villar, Carlos; Facultad de Medicina, Universidad Nacional Federico Villarreal, Lima, Perú; Servicio de Endocrinología, Instituto Nacional de Salud del Niño, Lima, Perú; Chavez Tejada, Eliana; Servicio de Endocrinología, Instituto Nacional de Salud del Niño (INSN), Lima; Espinoza Robles, Oscar; Servicio de Endocrinología, Instituto Nacional de Salud del Niño, Lima, Perú; Pinto Ibárcena, Paola; Servicio de Endocrinología, Instituto Nacional de Salud del Niño (INSN), Lima; Calagua Quispe, Martha; Servicio de Endocrinología, Instituto Nacional de Salud del Niño, Lima, Perú; De los Santos La Torre, Miguel; Servicio de Endocrinología, Instituto Nacional de Salud del Niño (INSN), Lima

    2016-01-01

    Introduction. Autoimmune thyroiditis is the most common cause of hypothyroidism in children. Clinical diagnosis depends on biochemical condition and monitoring is essential to adopt therapeutic measures and ensure proper growth and development. Objective. To describe the clinical progression of autoimmune thyroiditis in children and adolescents. Design. Retrospective, longitudinal series of cases study. Setting. Department of Endocrinology, Instituto Nacional de Salud del Niño, Lima, Peru (a ...

  4. Use of the immunomodulative influence of low-level laser radiation in the treatment of an autoimmune thyroiditis

    Science.gov (United States)

    Mikhailov, V. A.; Alexandrova, O. A.; Denisov, I. N.

    2000-06-01

    Use of LLLT for 42 patients with an autoimmune thyroiditis has shown that the helper function of lymphocytes has decreased, the suppressive activity has increased, the quantity of B-lymphocytes has decreased and the immunoregulative index has been normalized. The effect of LLLT application was active about 4 months in 78 percent of the patients. Soft semiconductor laser was used. The radiation was in the IR range of spectrum, wavelength - 890 nm. The technique included cutaneous irradiation of the thymus projection zones, vascular junction and thyroid gland. The total doze was made 2.42 J/cm2.

  5. Autoimmune diseases associated with neurofibromatosis type 1.

    Science.gov (United States)

    Nanda, Arti

    2008-01-01

    Associations of autoimmune diseases with neurofibromatosis type 1 have been rarely described. In the present report, we describe two patients of neurofibromatosis type 1 having an association with vitiligo in one, and alopecia areata and autoimmune thyroiditis in another. The associations of neurofibromatosis type 1 with vitiligo, alopecia areata, and autoimmune thyroiditis have not been reported earlier. Whether these associations reflect a causal relationship with neurofibromatosis type 1 or are coincidental needs to be settled.

  6. Thyroid-stimulating hormone-secreting pituitary adenoma presenting with recurrent hyperthyroidism in post-treated Graves’ disease: a case report

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    Ogawa Yoshikazu

    2013-01-01

    Full Text Available Abstract Introduction The coexistence of autoimmune hyperthyroid disease and thyroid-stimulating hormone-secreting pituitary adenoma is rare. The simple presumption of coincidence of these two diseases has a calculated incidence of less than one/several hundred million, and only four cases with histological confirmation have been reported. A rapid decrease in thyroid-stimulating hormone level after pituitary tumor removal may induce subsequent activation of autoimmune responses against the thyroid gland. We report the first case of a sequential and paradoxical occurrence of Graves’ disease and a thyroid-stimulating hormone-secreting pituitary adenoma. Case presentation A 32-year-old Japanese woman had recurrent hyperthyroidism. She had a history of Graves’ hyperthyroidism, which had been successfully treated with propylthiouracil. A head magnetic resonance imaging showed a less enhanced area in the left lateral wing of her sella turcica. Transsphenoidal surgery was performed, and the diagnosis was established as thyroid-stimulating hormone-secreting plurihormonal adenoma. A rapid reduction in thyroid hormone levels was achieved, and her blood pressure was normalized after the operation. Conclusion Although incidental occurrence is the most probable etiology, long and repeated followup examinations of both thyroid and pituitary gland should be performed in patients with an atypical clinical course.

  7. Thyroid follicular carcinoma presenting as metastatic skin nodules

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    Asad Jehangir

    2015-02-01

    Full Text Available Background: Follicular thyroid cancer (FTC metastasizes most commonly to the lungs and non-cranial bones. Skull and skin are uncommon sites and usually manifest well after the diagnosis of primary malignancy. Metastasis to skull and skin as the presenting feature of FTC is infrequently reported in the literature. Case presentation: A 65-year-old Caucasian woman with a history of thyroid nodule presented with the complaint of rapidly growing skull nodules which had been present for 3 years but were stable previously. She denied any fevers, chills, history of trauma, or weight loss. She denied any history of smoking or head and neck irradiation. On physical examination, she had two non-tender gray cystic lesions – one on her left temporal region and the other on the right parietal region. Biopsy was consistent with metastatic FTC. Magnetic resonance imaging of the brain demonstrated 7.1×3.8 cm and 3.7×4.5 cm fairly homogeneous, enhancing, relatively well-defined masses centered in the posterior and left anterior lateral calvarium with intracranial and extracranial extensions but without any vasogenic edema or mass effect on the brain. Thyroid ultrasound showed numerous nodules in both lobes. The patient underwent a total thyroidectomy. Histopathological studies of the thyroid gland revealed a well-differentiated FTC in the left lobe. Then she underwent resection of the tumor in multiple stages. She did not have any recurrence of the FTC or metastases during the follow-up period and will be receiving radioactive iodine treatment. Conclusion: Bone and lung are the common sites of metastasis from FTC, but involvement of skull or skin is unusual, particularly as the presenting feature. Metastases from FTC should be in the differential of patients with new osteolytic hypervascular skull lesions or cutaneous lesions in head and neck area.

  8. Interferon-alpha induced thyroid dysfunction: three clinical presentations and a review of the literature.

    Science.gov (United States)

    Koh, L K; Greenspan, F S; Yeo, P P

    1997-12-01

    Three patients who developed symptomatic, autoimmune-mediated thyroid dysfunction during treatment with interferon-alpha (IFN-alpha) for chronic active hepatitis C with liver cirrhosis, age-related macular degeneration with foveal involvement, and chronic myelogenous leukemia, respectively, are described. The first two patients developed autoimmune hypothyroidism that required thyroxine replacement, and the third developed autoimmune thyroiditis with transient thyrotoxicosis. The clinical manifestations were protean, and required a high index of suspicion for diagnosis, the failure of which led to significant morbidity. A literature review revealed that the mean incidence of IFN-alpha induced thyroid dysfunction was 6%. Spontaneous resolution occurred in more than half with discontinuation of IFN-alpha treatment. Hypothyroidism was induced more frequently than hyperthyroidism. At least one positive thyroid autoantibody titer was found in 17% of patients receiving IFN-alpha. Risk factors for developing thyroid dysfunction with IFN-alpha treatment were female sex, underlying malignancy or hepatitis C, higher doses of IFN-alpha for longer durations, combination immunotherapy (especially with interleukin-2), and the presence of thyroid autoantibodies prior to or during treatment.

  9. Vitamin D supplementation reduces thyroid peroxidase antibody levels in patients with autoimmune thyroid disease: An open-labeled randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Sandeep Chaudhary

    2016-01-01

    Full Text Available Background and Aims: Although Vitamin D deficiency has been linked to autoimmune thyroid disorders (AITD, the impact of Vitamin D supplementation on thyroid autoimmunity is not known. This study aimed to evaluate the impact of Vitamin D supplementation on thyroid autoimmunity (thyroid peroxidase antibody [TPO-Ab] titers in patients with newly diagnosed AITD in a randomized controlled trial. Materials and Methods: One hundred two patients with newly diagnosed AITD (TPO-Ab > 34 kIU/L and/or sonographic evidence of thyroiditis patients were randomized into Group-1 (intervention group and Group-2 (control group. Group-1 received cholecalciferol 60,000 IU weekly and calcium 500 mg/day for 8 weeks; Group-2 received calcium 500 mg/day for 8 weeks. Responders were defined as ≥25% fall in TPO-Ab titers. Individuals with at least 3-month follow-up were analyzed. Trial is registered at ctri.nic.in (CTRI/2015/04/005713. Results: Data from 100 AITD patients (68 with thyroid stimulating hormone [TSH] ≤10 mIU/L, 32 with TSH > 10 mIU/L, 93% having Vitamin D insufficiency, were analyzed. TPO-Ab titers were highest among patients in the lowest 25-hydroxyvitamin D quartile (P = 0.084. At 3 months follow-up, there was significant fall in TPO-Ab in Group-1 (−46.73% as compared to Group-2 (−16.6% (P = 0.028. Sixty-eight percentage patients in Group-1 were responders compared to 44% in Group-2 (P = 0.015. Kaplan–Meier analysis revealed significantly higher response rate in Group-1 (P = 0.012. Significantly greater reduction in TPO-Ab titers was observed in AITD with TSH ≤ 10 mIU/L compared to TSH > 10 mIU/L. Cox regression revealed Group-1 followed by TPO-Ab and free tetraiodothyronine levels to be a good predictor of response to therapy (P = 0.042, 0.069, and 0.074, respectively. Conclusion: Vitamin D supplementation in AITD may have a beneficial effect on autoimmunity as evidence by significant reductions in TPO-Ab titers.

  10. Autoimmun hypophysitis

    DEFF Research Database (Denmark)

    Krarup, Therese; Hagen, Claus

    2010-01-01

    Autoimmune hypophysitis (AH) - often referred to as lymphocytic hypophysitis - is a rare disease that affects the pituitary gland and causes inflammation. The disease enlarges the pituitary gland and the clinical presentations are lack of pituitary function and headaches. AH is mostly seen in women...... during pregnancy or postpartum, but also occurs in males and children. AH is often associated with other autoimmune diseases, most frequently with Hashimoto's thyroiditis. The symptoms are caused by enlargement of the pituitary gland and disturbances of the hormone function. Treatment is either...

  11. Characterization of Polyclonal Antibody Induced by Autoantibody TPO (Thyroidperoxidase) From Autoimmune Thyroid Disease (AITD) Serum with ELISA and Western Blotting

    OpenAIRE

    Maulidya Aulia Fiqriyana; Aulanni'am Aulanni'am; Anna Roosdiana

    2013-01-01

    Autoantibody TPO is a potential marker for early detection of autoimmune thyroid disease (AITD). Autoantibody TPO has a specifity and a sensitivity ranging from 82% to100% in comparison to other AITD serology markers. Concentration of autoantibody TPO in sera had a positive correlation with activities of chronic AITD. This research have been conducted to investigate the characteristic of polyclonal antibody TPO induced by autoantibody TPO from serum of AITD patients. The autoantibody TPO was ...

  12. Further Evidence on the Role of Thyroid Autoimmunity in Women with Recurrent Miscarriage

    Science.gov (United States)

    Lazzarin, Natalia; Moretti, Costanzo; De Felice, Giovanna; Vaquero, Elena; Manfellotto, Dario

    2012-01-01

    It has been twenty years since the first paper reporting the association between thyroid antibodies (TAIs) and spontaneous miscarriage was published. Following this observation, several studies have clearly demonstrated an increased prevalence of TAI in patients with recurrent miscarriage (RM). However, the exact mechanism underlying this association remains a matter of debate. The aim of the present study was to evaluate the thyroid function, throughout a specific test, in patient with RM and TAI focusing on the hypothesis that TAI should be an indirect sign of a mild thyroid dysfunction. 46 patients with RM and TAI were included in the study. All patients underwent short TRH stimulation test showing an abnormal response in the vast majority of cases (65%). Normal FT4 and FT3 mean values were found whereas TSH values were in the upper normal range (2.64 ± 1.3 mUI/L). Our data support the hypothesis that in patients with RM the presence of TAI is an indirect sign of a subtle thyroid dysfunction detectable by a specific test. This test give the possibility to identify women with RM in which specific therapeutic approaches could effectively improve the possibility for a successful pregnancy. PMID:22319528

  13. Further Evidence on the Role of Thyroid Autoimmunity in Women with Recurrent Miscarriage

    Directory of Open Access Journals (Sweden)

    Natalia Lazzarin

    2012-01-01

    Full Text Available It has been twenty years since the first paper reporting the association between thyroid antibodies (TAIs and spontaneous miscarriage was published. Following this observation, several studies have clearly demonstrated an increased prevalence of TAI in patients with recurrent miscarriage (RM. However, the exact mechanism underlying this association remains a matter of debate. The aim of the present study was to evaluate the thyroid function, throughout a specific test, in patient with RM and TAI focusing on the hypothesis that TAI should be an indirect sign of a mild thyroid dysfunction. 46 patients with RM and TAI were included in the study. All patients underwent short TRH stimulation test showing an abnormal response in the vast majority of cases (65%. Normal FT4 and FT3 mean values were found whereas TSH values were in the upper normal range (2.64±1.3 mUI/L. Our data support the hypothesis that in patients with RM the presence of TAI is an indirect sign of a subtle thyroid dysfunction detectable by a specific test. This test give the possibility to identify women with RM in which specific therapeutic approaches could effectively improve the possibility for a successful pregnancy.

  14. [Unusual presentation of juvenile idiopathic arthritis and autoimmune hepatitis].

    Science.gov (United States)

    Moreno Prieto, M; Carbonero Celis, M J; Cuadrado Caballero, M C

    2015-01-01

    The coexistence of autoimmune hepatitis and juvenile idiopathic arthritis is very rare. This is the case of an 18 month old female patient whose first sign of disease was torticollis due to an underlying atlanto-axial subluxation. Three months later, bilateral knee arthritis developed and she was diagnosed with Juvenile Idiopathic Arthritis. Throughout the disease a persistent elevation of liver enzymes was noted, combined with positive antinuclear antibodies and hypergammaglobulinemia, reaching the diagnosis of concomitant autoimmune hepatitis.

  15. cDNA immunization of mice with human thyroglobulin generates both humoral and T cell responses: a novel model of thyroid autoimmunity.

    Directory of Open Access Journals (Sweden)

    Eric M Jacobson

    Full Text Available Thyroglobulin (Tg represents one of the largest known self-antigens involved in autoimmunity. Numerous studies have implicated it in triggering and perpetuating the autoimmune response in autoimmune thyroid diseases (AITD. Indeed, traditional models of autoimmune thyroid disease, experimental autoimmune thyroiditis (EAT, are generated by immunizing mice with thyroglobulin protein in conjunction with an adjuvant, or by high repeated doses of Tg alone, without adjuvant. These extant models are limited in their experimental flexibility, i.e. the ability to make modifications to the Tg used in immunizations. In this study, we have immunized mice with a plasmid cDNA encoding the full-length human Tg (hTG protein, in order to generate a model of Hashimoto's thyroiditis which is closer to the human disease and does not require adjuvants to breakdown tolerance. Human thyroglobulin cDNA was injected and subsequently electroporated into skeletal muscle using a square wave generator. Following hTg cDNA immunizations, the mice developed both B and T cell responses to Tg, albeit with no evidence of lymphocytic infiltration of the thyroid. This novel model will afford investigators the means to test various hypotheses which were unavailable with the previous EAT models, specifically the effects of hTg sequence variations on the induction of thyroiditis.

  16. Lack of association between estrogen receptor β dinucleotide repeat polymorphism and autoimmune thyroid diseases in Japanese patients

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    Tomita Motowo

    2001-01-01

    Full Text Available Abstract Background The autoimmune thyroid diseases (AITDs, such as Graves' disease (GD and Hashimoto's thyroiditis (HT, appear to develop as a result of complex interactions between predisposing genes and environmental triggers. Susceptibility to AITDs is conferred by genes in the human leukocyte antigen (HLA and genes unlinked to HLA, including the CTLA-4 gene. Recently, estrogen receptor (ER β, located at human chromosome 14q23-24.1, was identifed. We analyzed a dinucleotide (CAn repeat polymorphism located in the flanking region of ERβ gene in patients with AITDs and in normal subjects. High heterozygosity makes this polymorphism a useful marker in the genetic study of disorders affecting female endocrine systems. We also correlated a ERβ gene microsatellite polymorphism with bone mineral density (BMD in the distal radius and biochemical markers of bone turnover in patients with GD in remission. Results Fourteen different alleles were found in 133 patients with GD, 114 patients with HT, and 179 controls subjects. The various alleles were designated as allele*1 through allele*14 according to the number of the repeats, from 18 to 30. There was no significant difference in the distributions of ERβ alleles between patient groups and controls. Although recent study demonstrated a significant relation between a allele*9 in the ERβ gene and BMD in postmenopausal Japanese women, there were no statistically significant interaction between this allele and BMD in the distal radius, nor biochemical markers in patients with GD in remission. Conclusions The present results do not support an association between the ERβ microsatellite marker and AITD in the Japanese population. We also suggest that the ERβ microsatellite polymorphism has at most a minor pathogenic importance in predicting the risk of osteoporosis as a complication of GD.

  17. Neurological deficit as a presentation of occult metastatic thyroid carcinoma.

    Science.gov (United States)

    Izzard, Mark; McIvor, Nicholas; Chaplin, John; Ianovski, Ilia

    2006-10-01

    Three cases of occult metastatic thyroid carcinoma presenting with neurological deficits are reviewed. In each case the patient's initial presentation was with symptoms of neurological deficiency secondary to a spinal cord compression. All patients received a combination of surgery, external beam radiotherapy and postoperative thyroxine treatment. Two of the three patients are alive and well, able to mobilize with minor neurological dysfunction. The diagnosis and management of the patients, as well as their outcomes are reviewed, with a discussion on further management issues alongside a review of the current published work.

  18. The Roles of the TSH Receptor Antibodies in Autoimmune Thyroid Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Chang Soon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-09-15

    To evaluate the clinical and pathogenetic roles of TSH receptor antibodies in autoimmune thyroid diseases, TBII were measured by TSH-radioreceptor assay methods in 352 patients with Graves disease, 108 patients with other thyroid diseases and 69 normal persons. The normal range of TBII activity was less than 15%. The frequencies of detectable TBIl in 169 patients with untreated Graves disease, 31 patients with hyperthyroidism under treatment and 70 patients with euthyroidism under treatment were 92.4%, 87.1% and 54.3% respectively. However 12 (21.8%) out of 55 patients who have been in remission more than one year after discontinuation of antithyroid drugs treatment had detectable TBII activities in their sera. In 196 patients with untreated Graves disease, the frequency of TBII increased by increasing size of goiter and the frequency of proptosis was significantly high in patients whose TBII activities were more than 60%. TBll activities were roughly correlated with total T{sub 3},T{sub 4} and free T{sub 4}, index but low gamma{sup 2} value(less than 0.1). In 67 patients with Graves' disease who were positive TB1I before antithyroid drugs treatment, TBII activities began to decrease from the third months and it was converted to negative in 35.8% of patients at 12 months after treatment. There were no significant differences of the declining and disappearing rates of TBII activities between high dose and conventional dose groups. TBII activities were significantly increased initially (2-4 months) and then began to decrease from 5-9 months after {sup 131}I treatment. There were two groups, one whose TBII activities decreased gradually and the other did not change until 12 months after subtotal thyroidectomy. Although preoperative clinical and laboratory findings of both groups were not different, TBII activities of non-decreasing group were significantly higher than those of decreasing group(74.6+18.6% vs 39.2+15.2%; P(0.01). Thirty three(55.9%) out of 59

  19. Thyroid Antibodies, Autoimmunity and Cognitive Decline: Is There a Population-Based Link

    Directory of Open Access Journals (Sweden)

    Kate Napthali

    2014-05-01

    Full Text Available Background: Autoimmunity is considered an uncommon but under-recognised cause of cognitive decline. Methods: Serum samples from 3,253 randomly selected subjects enrolled in the Hunter Community Study, aged 55-85 years, were assayed for thyrotropin stimulatory hormone, anti-thyroid peroxidase antibodies (TPO-Ab, anti-nuclear antibodies (ANA and extractable nuclear antigens (ENA. Cognitive function was assessed using the Audio Recorded Cognitive Screen (ARCS tool. Results: TPO-Ab were found in 8.4% and ANA in 27.9% of the study population, of whom 3% had positive ENA findings. No relationship was found between the ARCS score and either TPO-Ab (coefficient = 0.133; 95% CI -0.20, 0.82, p = 0.616, ANA at a low (coefficient = 1.01; 95% CI -2.58, 0.55, p = 0.203 or a high titre (coefficient = -0.65; 95% CI -2.59, 1.28, p = 0.508, or ENA antibodies (coefficient = 5.12; 95% CI -0.53, 10.77; p = 0.076. Conclusions: Autoantibody findings are common in an aging population and are not associated with cognitive decline.

  20. Herbal medicine Gamgungtang down-regulates autoimmunity through induction of TH2 cytokine production by lymphocytes in experimental thyroiditis model.

    Science.gov (United States)

    Sa, Eun-Ho; Jin, Un-Ho; Kim, Dong-Soo; Kang, Bong-Seok; Ha, Ki-Tae; Kim, June-Ki; Park, Won-Hwan; Kim, Cheorl-Ho

    2007-02-12

    The crude herbal formulation, Gamgungtang (GGT), has been shown to protect animals against a wide range of spontaneously developing or induced autoimmune diseases. We have previously reported that GGT shows marked down-regulation of several experimental autoimmune diseases. Although very effective at preventing thyroid infiltrates in mice immunized with mouse deglycosylated thyroglobulin and complete Freund's adjuvant and in spontaneous models of thyroiditis, it completely failed to modify experimental autoimmune thyroiditis (EAT) induced in mice immunized with mouse thyroglobulin and lipopolysaccharide. In this study, in an effort to elucidate the mechanisms by which GGT suppresses EAT, and autoimmunity in general, we investigated the in vivo effects of this drug on the Th1/Th2 lymphocyte balance, which is important for the induction or inhibition of autoreactivity. Naive SJL/J mice were treated orally for 5 days with GGT (80 mg/(kg day)). Spleen cells were obtained at various time points during the treatment period and were stimulated in vitro with concanavalin A. Interleukins IL-4, IL-10 and IL-12, transforming growth factor-beta (TGF-beta) and interferon-gamma (IFN-gamma) cytokine production was evaluated at the protein levels of the cytokines in the medium and mRNA expressions. A significant upregulation of IL-4, IL-10 and TGF-beta was observed following treatment with GGT, which peaked at day 5 (IL-10) or day 10 (IL-4). On the other hand, IL-12 and IFN-gamma production were either unchanged or decreased. It seems therefore that GGT induces in vivo a shift towards Th2 lymphocytes which may be one of the mechanisms of down-regulation of the autoimmune reactivity in EAT. Our observations indicate that down-regulation of TH1 cytokines (especially IL-12) and enhancement of Th2 cytokine production may play an important role in the control of T-cell-mediated autoimmunity. These data may contribute to the design of new immunomodulating treatments for a group of

  1. Peculiarities of myocardial diastolic function in patients with autoimmune thyroiditis divided according to the mild hypothyroidism range

    Directory of Open Access Journals (Sweden)

    T A Nekrasova

    2012-12-01

    Full Text Available The aim of the present study was to evaluate myocardial diastolic function in patients with autoimmune thyroiditis (AT against the TSH level within the reference range and subclinical interval as well as to determine whether it is related to the thyroid function or other metabolic and functional indices. METHODS. We studied diastolic function of left and right ventricles by the ratio of mitral and tricuspid annular early and late diastolic velocities (em/am and et/at respectively using tissue Doppler imaging; structural heart characteristics by echocardiography; lipid profile and peroxidation parameters; serum ferritin and iron concentrations in 132 middle-aged women. 36 of them were euthyroid controls, 96 had AT and were ranged according to their TSH value into 4 groups: women with “low- normal” (0.4–2.5 mU/L and “upper-normal” (2.5–4.0 mU/L TSH range; patients with subclinical hypothyroidism and TSH below and above 6 mU/L. RESULTS. The increase of TSH value within reference range and subclinical interval was associated with the parallel tendency to the em/am and et/at ratio decrease suggesting detrimental effect of the mildest thyroid failure on the left and right ventricles diastolic function. Thus, patients with TSH values >6 mU/L had significantly lower em/am and et/at ratio compared to the “low-normal” TSH group ( p < 0.05 and controls ( p < 0.01. Among them, the highest LDL cholesterol, myocardial mass index and oxidative stress rate were detected as well as lower iron and ferritin serum concentrations ( p < 0.05 compared to controls with regard to all the parameters listed above. Abnormalities in heart structure, lipid and iron metabolism correlated with alterations in ventricular relaxation suggesting that they can contribute, at least partly, to the diastolic dysfunction devel- opment CONCLUSION. The increase of TSH value within reference range and subclinical interval can affect diastolic function of the heart. Its

  2. Familial Aggregation and Segregation Analysis in Families Presenting Autoimmunity, Polyautoimmunity, and Multiple Autoimmune Syndrome

    Science.gov (United States)

    Castiblanco, John; Sarmiento-Monroy, Juan Camilo; Mantilla, Ruben Dario; Rojas-Villarraga, Adriana; Anaya, Juan-Manuel

    2015-01-01

    Studies documenting increased risk of developing autoimmune diseases (ADs) have shown that these conditions share several immunogenetic mechanisms (i.e., the autoimmune tautology). This report explored familial aggregation and segregation of AD, polyautoimmunity, and multiple autoimmune syndrome (MAS) in 210 families. Familial aggregation was examined for first-degree relatives. Segregation analysis was implemented as in S.A.G.E. release 6.3. Data showed differences between late- and early-onset families regarding their age, age of onset, and sex. Familial aggregation of AD in late- and early-onset families was observed. For polyautoimmunity as a trait, only aggregation was observed between sibling pairs in late-onset families. No aggregation was observed for MAS. Segregation analyses for AD suggested major gene(s) with no clear discernible classical known Mendelian transmission in late-onset families, while for polyautoimmunity and MAS no model was implied. Data suggest that polyautoimmunity and MAS are not independent traits and that gender, age, and age of onset are interrelated factors influencing autoimmunity. PMID:26697508

  3. Familial Aggregation and Segregation Analysis in Families Presenting Autoimmunity, Polyautoimmunity, and Multiple Autoimmune Syndrome.

    Science.gov (United States)

    Castiblanco, John; Sarmiento-Monroy, Juan Camilo; Mantilla, Ruben Dario; Rojas-Villarraga, Adriana; Anaya, Juan-Manuel

    2015-01-01

    Studies documenting increased risk of developing autoimmune diseases (ADs) have shown that these conditions share several immunogenetic mechanisms (i.e., the autoimmune tautology). This report explored familial aggregation and segregation of AD, polyautoimmunity, and multiple autoimmune syndrome (MAS) in 210 families. Familial aggregation was examined for first-degree relatives. Segregation analysis was implemented as in S.A.G.E. release 6.3. Data showed differences between late- and early-onset families regarding their age, age of onset, and sex. Familial aggregation of AD in late- and early-onset families was observed. For polyautoimmunity as a trait, only aggregation was observed between sibling pairs in late-onset families. No aggregation was observed for MAS. Segregation analyses for AD suggested major gene(s) with no clear discernible classical known Mendelian transmission in late-onset families, while for polyautoimmunity and MAS no model was implied. Data suggest that polyautoimmunity and MAS are not independent traits and that gender, age, and age of onset are interrelated factors influencing autoimmunity.

  4. Familial Aggregation and Segregation Analysis in Families Presenting Autoimmunity, Polyautoimmunity, and Multiple Autoimmune Syndrome

    Directory of Open Access Journals (Sweden)

    John Castiblanco

    2015-01-01

    Full Text Available Studies documenting increased risk of developing autoimmune diseases (ADs have shown that these conditions share several immunogenetic mechanisms (i.e., the autoimmune tautology. This report explored familial aggregation and segregation of AD, polyautoimmunity, and multiple autoimmune syndrome (MAS in 210 families. Familial aggregation was examined for first-degree relatives. Segregation analysis was implemented as in S.A.G.E. release 6.3. Data showed differences between late- and early-onset families regarding their age, age of onset, and sex. Familial aggregation of AD in late- and early-onset families was observed. For polyautoimmunity as a trait, only aggregation was observed between sibling pairs in late-onset families. No aggregation was observed for MAS. Segregation analyses for AD suggested major gene(s with no clear discernible classical known Mendelian transmission in late-onset families, while for polyautoimmunity and MAS no model was implied. Data suggest that polyautoimmunity and MAS are not independent traits and that gender, age, and age of onset are interrelated factors influencing autoimmunity.

  5. Importância da ecogenicidade da tireóide no diagnóstico da tireoidite crônica auto-imune Value of thyroid echogenicity in the diagnosis of chronic autoimmune thyroiditis

    Directory of Open Access Journals (Sweden)

    Danilo Bianchini Höfling

    2008-12-01

    Full Text Available A tireoidite crônica auto-imune é, atualmente, a principal causa de hipotireoidismo e seu diagnóstico baseia-se nas manifestações clínico-laboratoriais. O marcador laboratorial mais importante é a presença de anticorpos antitireoglobulina e antiperoxidase, sendo este último o teste mais sensível. A biópsia aspirativa apresenta alta sensibilidade e especificidade, porém, é um método invasivo e, por isso, reservado para quando há presença de nódulo ou bócio de crescimento rápido. A cintilografia é desnecessária para o diagnóstico, já que apresenta baixa sensibilidade e especificidade. A ultra-sonografia, tanto ao modo B como ao dúplex-Doppler colorido, evoluiu de forma muito rápida e tornou-se um método simples, não-invasivo, reprodutível e com alta sensibilidade para o diagnóstico da tireoidite crônica auto-imune. Ao modo B, a ecogenicidade é um parâmetro de extrema importância, já que, além de apresentar alta correlação com o quadro citopatológico, também apresenta alta sensibilidade para o diagnóstico da tireoidite crônica auto-imune. Embora este parâmetro não seja específico da tireoidite crônica auto-imune, pois também pode estar presente na doença de Graves, na tireoidite pós-parto e na tireoidite subaguda, tais desordens podem ser facilmente diferenciadas tanto pelo quadro clínico-laboratorial quanto pelo dúplex-Doppler colorido. Assim, este artigo tem o objetivo de revisar a importância do estudo da ecogenicidade no diagnóstico da tireoidite crônica auto-imune.Chronic autoimmune thyroiditis is currently considered as the main cause for hypothyroidism and its diagnosis is based on clinical manifestations and laboratory tests results. The most significant laboratory marker for this disease is the presence of anti-thyroperoxidase and anti-thyroglobulin antibodies, the latter being the most sensitive one. Aspiration biopsy shows high sensitivity and specificity but, considering the

  6. Analysis of the Expression of Fas, FasL and Bcl-2 in the Pathogenesis of Autoimmune Thyroid Disorders

    Institute of Scientific and Technical Information of China (English)

    Shenren Chen; S.M.Fazle Akbar; Zhichao Zhen; Yiping Luo; Lijuan Deng; Haihua Huang; Linxin Chen; Wei Li

    2004-01-01

    To investigate the expression of apoptosis-related protein (Fas, FasL, and Bcl-2) in the pathogenesis of autoimmune thyroid disorders (ATDs), immunohistochemical staining was performed on 20 Hashimoto's thyroiditis (HT), 20 Graves' disease (GD), and 20 thyroid follicular adenoma (TFA, as control). All the cases expressed Fas, mainly on the cell surface and cytoplasm. FasL was found in 17 cases of the TFA. Bcl-2 was detected in 15 cases of HT, 19 of GD and 17 of TFA. In TFA, a moderate Fas expression and a minimal or no FasL expression was detected on follicular cells. In HT, the follicles adjacent to infiltrating lymphocytes showed increased levels of Fas and FasL expression. A weaker staining of Fas and FasL was exhibited on infiltrating lymphocytes than on thyrocytes. In a comparison of GD with HT, thyrocytes and lymphocytes showed similar Fas staining, but for FasL the staining was rather weaker in HT. The expression of Bcl-2 was nearly identical in GD and TFA, but much weaker on the follicular cells in vicinity of lymphocytes and on the lymphocytes located in germinal centers of HT tissues. The expression of Fas, FasL, Bcl-2 in Hashimoto's thyroiditis and Graves' disease were almost same. FasL strong expression and Bcl-2 weak expression on the follicles in HT may induce apoptosis. These results provided evidence for expression of Fas, FasL and Bcl-2 in the pathogenesis of autoimmune thyroid disease. The lymphocytes seem not to be directly engaged in the process via their own FasL, but they may provide some cytokines that, in turn, upregulate Fas and/or FasL expression to induce apoptosis.

  7. Analysis of the Expression of Fas, FasL and Bcl-2 in the Pathogenesis of Autoimmune Thyroid Disorders

    Institute of Scientific and Technical Information of China (English)

    ShenrenChen; S.M.FazleAkbar; ZhichaoZhen; YipingLuo; LijuanDeng; HaihuaHuang; LinxinChen; WeiLi

    2004-01-01

    To investigate the expression of apoptosis-related protein (Fas, FasL, and Bcl-2) in the pathogenesis of autoimmune thyroid disorders (ATDs), immunohistochemical staining was performed on 20 Hashimoto's thyroiditis (HT), 20 Graves' disease (GD), and 20 thyroid follicular adenoma (TFA, as control). All the cases expressed Fas, mainly on the cell surface and cytoplasm. FasL was found in 17 cases of the TFA. Bcl-2 was detected in 15 cases of HT, 19 of GD and 17 of TFA. In T FA, a moderate Fas expression and a minimal or no FasL expression was detected on follicular cells. In HT, the follicles adjacent to infiltrating lymphocytes showed increased levels of Fas and FasL expression. A weaker staining of Fas and FasL was exhibited on infiltrating lymphocytes than on thyrocytes. In a comparison of GD with HT, thyrocytes and lymphocytes showed similar Fas staining, but for FasL the staining was rather weaker in HT. The expression of Bcl-2 was nearly identical in GD and TFA, but much weaker on the follicular cells in vicinity of lymphocytes and on the lymphocytes located in germinal centers of HT tissues. The expression of Fas, FasL, Bcl-2 in Hashimoto's thyroiditis and Graves' disease were almost same. FasL strong expression and Bcl-2 weak expression on the follicles in HT may induce apoptosis. These results provided evidence for expression of Fas, FasL and Bcl-2 in the pathogenesis of autoimmune thyroid disease. The lymphocytes seem not to be directly engaged in the process v/a their own FasL, but they may provide some cytokines that, in turn, upregulate Fas and/or FasL expression to induce apoptosis.

  8. Thyroid storm presenting as psychosis: masked by diabetic ketoacidosis

    Science.gov (United States)

    Memon, Raafia; Fan, WuQiang; Snyder, Richard; Krishnamurthy, Mahesh

    2016-01-01

    Introduction While extremely uncommon, diabetic ketoacidosis (DKA) and thyroid storm (TS) are endocrine emergencies that can coexist. We describe a case with a confounding clinical presentation that identifies these two emergencies within the setting of sepsis and influenza. Case A 69-year-old diabetic female was found by the paramedic staff to be disoriented. She demonstrated tachycardia and had a foul-smelling abdominal wound. Laboratory evaluation revealed DKA, leukocytosis, influenza B, and urinary tract infection. After appropriate management in the intensive care unit, the DKA resolved the following morning. However, the patient developed a fever, and her psychosis became more pronounced. Extensive analysis was performed but did not explain her mental status. The patient was found to have thyroid stimulating hormone of 0.06 mIU/mL, free T4 (thyroxine) of 2.38 ng/dL, and total T3 (triiodothyronine) of 72 ng/dL. Based on the Burch and Wartofsky criteria (score of 65), TS was diagnosed. Based on more recent diagnostic criteria suggested by Akamizu et al., the patient met criteria for TS grade 1. Within several hours of initiating treatment, the patient's mental state and tachycardia improved, and her psychosis resolved by the third day. Conclusion This case highlights the importance of recognizing the clinical diagnosis of TS, as the magnitude of thyroid hormone derangements may not correlate with clinical severity. While rare, DKA and TS can simultaneously occur and are associated with increased morbidity and mortality if not promptly recognized and treated. PMID:27609719

  9. Thyroid storm presenting as psychosis: masked by diabetic ketoacidosis

    Directory of Open Access Journals (Sweden)

    Raafia Memon

    2016-09-01

    Full Text Available Introduction: While extremely uncommon, diabetic ketoacidosis (DKA and thyroid storm (TS are endocrine emergencies that can coexist. We describe a case with a confounding clinical presentation that identifies these two emergencies within the setting of sepsis and influenza. Case: A 69-year-old diabetic female was found by the paramedic staff to be disoriented. She demonstrated tachycardia and had a foul-smelling abdominal wound. Laboratory evaluation revealed DKA, leukocytosis, influenza B, and urinary tract infection. After appropriate management in the intensive care unit, the DKA resolved the following morning. However, the patient developed a fever, and her psychosis became more pronounced. Extensive analysis was performed but did not explain her mental status. The patient was found to have thyroid stimulating hormone of 0.06 mIU/mL, free T4 (thyroxine of 2.38 ng/dL, and total T3 (triiodothyronine of 72 ng/dL. Based on the Burch and Wartofsky criteria (score of 65, TS was diagnosed. Based on more recent diagnostic criteria suggested by Akamizu et al., the patient met criteria for TS grade 1. Within several hours of initiating treatment, the patient's mental state and tachycardia improved, and her psychosis resolved by the third day. Conclusion: This case highlights the importance of recognizing the clinical diagnosis of TS, as the magnitude of thyroid hormone derangements may not correlate with clinical severity. While rare, DKA and TS can simultaneously occur and are associated with increased morbidity and mortality if not promptly recognized and treated.

  10. Thyroid inferno.

    Science.gov (United States)

    Bhargava, Amit; Kaur, Manmeet

    2014-01-01

    The key to uncovering the etiology of hyperthyroidism lies in a careful history and physical examination. Autoimmune markers provide additive information, but should not solely be used to make a diagnosis. Concern has been raised that the overzealous use of thyroid ultrasound, following abnormal thyroid function tests, diverts attention from the workup of the biochemical abnormality to the workup of an incidentally found thyroid nodule. If further imaging is needed, the use ofathyroidscanhas been suggestedbythe Endocrine Society and the American Association of Clinical Endocrinologists. However, in certain scenarios, this may be contraindicated. We present the case of a 28-year-old female with hyperthyroidism, as aplatform to discuss an important clinical sign present on Doppler ultrasound of the thyroid. By recognizing the clinical information gained from a Doppler ultrasound, physicians can avoid additional invasive workup and apply the use of ultrasound where most appropriate.

  11. Thyroid metastasis as initial presentation of clear cell renal carcinoma

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    César Pablo Ramírez-Plaza

    2015-01-01

    Conclusion: The possibility of finding of an incidental metastatic tumor in the thyroid gland from a previous unknown and non-diganosed primary (as CCRC in our case was is rare and account only for less than 1% of malignancies. Nonetheless, the thyroid gland is a frequent site of metastasis and the presence of “de novo” thyroid nodules in oncologic patients must be always considered and studied.

  12. Two simultaneous autoimmune processes in a patient presenting with respiratory insufficiency.

    Science.gov (United States)

    Troy, Lauren; Hamor, Paul; Bleasel, Jane; Corte, Tamera

    2014-03-01

    The idiopathic inflammatory myopathies, including dermatomyositis, are uncommon acquired autoimmune diseases, sometimes associated with interstitial lung disease. Myasthenia gravis, a separate autoimmune disorder involving the neuromuscular junction, has some overlapping clinical features but has only rarely been reported to occur simultaneously within the same patient. Here we present the first reported case of concomitant dermatomyositis, myasthenia gravis, and interstitial lung disease.

  13. UNCOMMON PRESENTATION OF FOLLICULAR THYROID CARCINOMA: WHEN CHRONIC BACK PAIN SHOULD RAISE A FLAG.

    Science.gov (United States)

    Alvarado, Milliette; Ramirez, Margarita; Lopez, Liurka; Marcos-Martinez, Maria J; Saavedra, Fanor M; Negron-Rivei, Juan C; Agosto, Marielba; Martinez, Meliza; Gonzalez, Rafael; Allende-Vigo, Myriam

    2014-01-01

    Follicular thyroid carcinoma is the second most common type of thyroid cancer, and its incidence has increased dramatically in recent years. Although it typically presents as a thyroid nodule, it can spread to distant sites via hematogenous dissemination. Spinal cord compression complicating thyroid carcinoma is rare with only few cases reported in the literature. This case illustrates a minimally invasive follicular carcinoma that showed such an aggressive behavior, and thus the importance of considering metastatic thyroid carcinoma in the differential diagnosis of chronic back pain, which may possibly progress to spinal cord compression carrying severe morbidity.

  14. Clinical studies on thyroid diseases

    NARCIS (Netherlands)

    Eskes, S.A.

    2014-01-01

    This thesis focuses on some aspects of thyroid disease: prevention of autoimmune thyroid disease (AITD), diagnosis of related conditions as autoimmune hypophysitis in autoimmune hypothyroidism (Hashimoto’s disease), and treatment of amiodarone-induced thyrotoxicosis (AIT).

  15. Identification of Novel Genetic Loci Associated with Thyroid Peroxidase Antibodies and Clinical Thyroid Disease

    NARCIS (Netherlands)

    M. Medici (Marco); E. Porcu (Eleonora); G. Pistis (Giorgio); A. Teumer (Alexander); S.J. Brown (Stephen); R.A. Jensen (Richard); R. Rawal (R.); G.L. Roef (Greet); T.S. Plantinga (Theo S.); S.H.H.M. Vermeulen (Sita); J. Lahti (Jari); M.C. Simmonds (Mark); L.L.N. Husemoen (Lise Lotte); R.M. Freathy (Rachel); B.M. Shields (Beverley); D. Pietzner (Diana); R. Nagy (Rebecca); L. Broer (Linda); L. Chaker (Layal); T.I.M. Korevaar (Tim); M.G. Plia (Maria Grazia); C. Sala (Cinzia); U. Völker (Uwe); J.B. Richards (Brent); F.C. Sweep (Fred); C. Gieger (Christian); T. Corre (Tanguy); E. Kajantie (Eero); L. Thuesen (Leif); Y.E. Taes (Youri); W.E. Visser (Wil Edward); A.T. Hattersley (Andrew); J. Kratzsch (Jürgen); A. Hamilton (Amy); W. Li (Wei); G. Homuth (Georg); M. Lobina (Monia); S. Mariotti (Stefano); N. Soranzo (Nicole); M. Cocca (Massimiliano); M. Nauck (Matthias); C. Spielhagen (Christin); H.A. Ross (Alec); A.M. Arnold (Alice); M. van de Bunt (Martijn); S. Liyanarachchi (Sandya); M. Heier (Margit); H.J. Grabe (Hans Jörgen); C. Masciullo (Corrado); T.E. Galesloot (Tessel); E.M. Lim (Ee Mun); G. Reischl (Gunilla); P.J. Leedman (Peter); S. Lai (Sandra); A. Delitala (Alessandro); A. Bremner (Alexandra); D.I.W. Philips (David I.); J.P. Beilby (John); A. Mulas (Antonella); M. Vocale (Matteo); G.R. Abecasis (Gonçalo); T. Forsen (Tom); A. James (Alan); E. Widen (Elisabeth); J. Hui (Jennie); H. Prokisch (Holger); E.E. Rietzschel (Ernst); A. Palotie (Aarno); W. Feddema (Wouter); S.J. Fletcher (Stephen); K. Schramm (Katharina); J.I. Rotter (Jerome); A. Kluttig (Alexander); D. Radke (Dörte); M. Traglia (Michela); G. Surdulescu (Gabriela); H. He (Hao); J.A. Franklyn (Jayne); D. Tiller (Daniel); B. Vaidya (Bijay); T. Meyer (Thorsten); T. Jorgensen (Torben); K. Hagen (Knut); P.C. O'Leary (Peter); E. Wichmann (Eric); A.R. Hermus (Ad); B.M. Psaty (Bruce); T. Ittermann (Till); A. Hofman (Albert); E. Bosi (Emanuele); D. Schlessinger (David); H. Wallaschofski (Henri); N. Pirastu (Nicola); Y.S. Aulchenko (Yurii); A. de la Chapelle (Albert); R.T. Netea-Maier (Romana ); J.E. Gough (Julie); H. Meyer zu Schwabedissen (Henriette); T.M. Frayling (Timothy); J.-M. Kaufman (Jean-Marc); A. Linneberg (Allan); K. Räikkönen (Katri); J.W.A. Smit (Jan); L.A.L.M. Kiemeney (Bart); F. Rivadeneira Ramirez (Fernando); A.G. Uitterlinden (André); J.P. Walsh (John); C. Meisinger (Christa); M. den Heijer (Martin); T.J. Visser (Theo); T.D. Spector (Timothy); S.G. Wilson (Scott); H. Völzke (Henry); A.R. Cappola (Anne); D. Toniolo (Daniela); S. Sanna (Serena); S. Naitza (Silvia); R.P. Peeters (Robin)

    2014-01-01

    textabstractAutoimmune thyroid diseases (AITD) are common, affecting 2-5% of the general population. Individuals with positive thyroid peroxidase antibodies (TPOAbs) have an increased risk of autoimmune hypothyroidism (Hashimoto's thyroiditis), as well as autoimmune hyperthyroidism (Graves' disease)

  16. Identification of novel genetic Loci associated with thyroid peroxidase antibodies and clinical thyroid disease

    NARCIS (Netherlands)

    Medici, M.; Porcu, E.; Pistis, G.; Teumer, A.; Brown, S.J.; Jensen, R.A.; Rawal, R.; Roef, G.L.; Plantinga, T.S.; Vermeulen, S.; Lahti, J.; Simmonds, M.J.; Husemoen, L.L.; Freathy, R.M.; Shields, B.M.; Pietzner, D.; Nagy, R.; Broer, L.; Chaker, L.; Korevaar, T.I.; Plia, M.G.; Sala, C.; Volker, U.; Richards, J.B.; Sweep, F.C.; Gieger, C.; Corre, T.; Kajantie, E.; Thuesen, B.; Taes, Y.E.; Visser, W.E.; Hattersley, A.T.; Kratzsch, J.; Hamilton, A.; Li, W.; Homuth, G.; Lobina, M.; Mariotti, S.; Soranzo, N.; Cocca, M.; Nauck, M.; Spielhagen, C.; Ross, A.; Arnold, A.; Bunt, M. van de; Liyanarachchi, S.; Heier, M.; Grabe, H.J.; Masciullo, C.; Galesloot, T.E.; Lim, E.M.; Reischl, E.; Leedman, P.J.; Lai, S.; Delitala, A.; Bremner, A.P.; Philips, D.I.; Beilby, J.P.; Mulas, A.; Vocale, M.; Abecasis, G.; Forsen, T.; James, A.; Widen, E.; Hui, J.; Prokisch, H.; Rietzschel, E.E.; Palotie, A.; Feddema, P.; Fletcher, S.J.; Schramm, K.; Rotter, J.I.; Kluttig, A.; Radke, D.; Traglia, M.; Surdulescu, G.L.; He, H.; Franklyn, J.A.; Tiller, D.; Vaidya, B.; Meyer, T.; Jorgensen, T.; Eriksson, J.G.; O'Leary, P.C.; Wichmann, E.; Hermus, A.R.M.M.; Psaty, B.M.; Ittermann, T.; Hofman, A.; Bosi, E.; Schlessinger, D.; Wallaschofski, H.; Pirastu, N.; Aulchenko, Y.S.; Chapelle, A. dela; Netea-Maier, R.T.; Gough, S.C.; Meyer Zu Schwabedissen, H.; Frayling, T.M.; Kaufman, J.M.; Smit, J.W.; Kiemeney, B.

    2014-01-01

    Autoimmune thyroid diseases (AITD) are common, affecting 2-5% of the general population. Individuals with positive thyroid peroxidase antibodies (TPOAbs) have an increased risk of autoimmune hypothyroidism (Hashimoto's thyroiditis), as well as autoimmune hyperthyroidism (Graves' disease). As the pos

  17. Two breast metastases from thyroid carcinoma presented 6 years later after total thyroidectomy: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Gene Hyuk; Kang, Bong Joo; Kim, Sung Hun; Lee, Ah Won [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Jung, Na Young [Dept. of Radiology, Bucheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Bucheon (Korea, Republic of)

    2016-04-15

    Thyroid carcinoma is usually indolent with good prognosis, as compared to other malignancy. Distant metastases from thyroid cancer are rare and usually manifest as multiple lesions especially in lungs, bones and lymph nodes, in advanced stages of the disease. Metastasis to the breast from thyroid carcinoma is extremely rare, with about 16 cases reported in the English literature. Herein, we reported a case of metastatic poorly differentiated thyroid carcinoma, which presented as 2 breast masses in a 72-year-old woman, 6 years after total thyroidectomy for papillary thyroid carcinoma. Although the computed tomography (CT) and ultrasonography (USG) image findings are nonspecific oval mass with circumscribed or partially indistinct margin, metastases from thyroid cancer should be included in the differential diagnosis when recurrence of thyroid carcinoma is suspected. Also, fusion images of CT and USG are helpful to the radiologists in localizing the targeted lesion and conducting accurate USG-guided biopsy.

  18. A Patient with Postpartum Hypopituitarism (Sheehan's Syndrome Developed Postpartum Autoimmune Thyroiditis (Transient Thyrotoxicosis and Hypothyroidism: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Nobuyuki Takasu

    2011-01-01

    Full Text Available A 36-year-old woman with postpartum hypopituitarism (Sheehan's syndrome: SS developed postpartum autoimmune thyroiditis (PPAT. She delivered a baby by Caesarean section (620 mL blood loss. At 1 month post partum, she developed thyrotoxicosis due to painless thyroiditis (autoimmune destructive thyroiditis. She was positive for antithyroid antibodies. Postpartum and hypoadrenalism-induced exacerbation of autoimmune thyroiditis caused the thyrotoxicosis due to autoimmune destructive thyroiditis. ACTH was undetectable. She had ACTH deficiency and secondary hypoadrenalism. Hydrocortisone was started. At 6 months post partum, she was referred to us with hypothyroidism. Thyroxine was administered. She had thyrotoxicosis at 1-2 months post partum and then hypothyroidism. She was diagnosed with PPAT. She had hypopituitarism, ACTH deficiency (secondary hypoadrenalism, low prolactin with agalactia, and low LH with failure to resume regular menses. She had empty sella on MRI. She was diagnosed with SS. Three cases with SS have been reported to develop PPAT. Postpartum immunological rebounds and hypoadrenalism-induced immunological alterations (or a combination of the two might have been responsible for the PPAT.

  19. A Patient with Postpartum Hypopituitarism (Sheehan's Syndrome) Developed Postpartum Autoimmune Thyroiditis (Transient Thyrotoxicosis and Hypothyroidism): A Case Report and Review of the Literature.

    Science.gov (United States)

    Takasu, Nobuyuki; Nakayama, Yoshirou

    2011-01-01

    A 36-year-old woman with postpartum hypopituitarism (Sheehan's syndrome: SS) developed postpartum autoimmune thyroiditis (PPAT). She delivered a baby by Caesarean section (620 mL blood loss). At 1 month post partum, she developed thyrotoxicosis due to painless thyroiditis (autoimmune destructive thyroiditis). She was positive for antithyroid antibodies. Postpartum and hypoadrenalism-induced exacerbation of autoimmune thyroiditis caused the thyrotoxicosis due to autoimmune destructive thyroiditis. ACTH was undetectable. She had ACTH deficiency and secondary hypoadrenalism. Hydrocortisone was started. At 6 months post partum, she was referred to us with hypothyroidism. Thyroxine was administered. She had thyrotoxicosis at 1-2 months post partum and then hypothyroidism. She was diagnosed with PPAT. She had hypopituitarism, ACTH deficiency (secondary hypoadrenalism), low prolactin with agalactia, and low LH with failure to resume regular menses. She had empty sella on MRI. She was diagnosed with SS. Three cases with SS have been reported to develop PPAT. Postpartum immunological rebounds and hypoadrenalism-induced immunological alterations (or a combination of the two) might have been responsible for the PPAT.

  20. Population of antithyroid autoantibodies as a source of antibodies of various levels of specificity and functionality: the clinical importance of a phenomenon of combination theory at monitoring of patients with autoimmune diseases of a thyroid gland

    Directory of Open Access Journals (Sweden)

    A V Andreeva

    2011-06-01

    Full Text Available The review of literature is dedicated to comparative analysis of pathogenetic and clinicodiagnostic significance of antithyroid autoantibodies (autoAB differing in their specificity (АB to thyroglobulin (anti-TG and АB to thyroid peroxidase (anti-TPO, anti-TGPO, and functionality TG- and TPO-antibodies, namely antibodies-proteases in pathogenesis autoimmune diseases thyroid gland and possibility of their use in modern diagnostics of autoimmune thyroid diseases.

  1. The link between thyroid autoimmunity (antithyroid peroxidase autoantibodies with anxiety and mood disorders in the community: a field of interest for public health in the future

    Directory of Open Access Journals (Sweden)

    Sardu Claudia

    2004-08-01

    Full Text Available Abstract Background To evaluate the association between mood and anxiety disorders and thyroid autoimmunity in a community sample. Methods: A community based sample of 222 subjects was examined. Psychiatric diagnoses were formulated using the International Composite Diagnostic Interview Simplified (CIDIS, according to DSM-IV criteria. All subjects underwent a complete thyroid evaluation including physical examination, thyroid echography and measure of serum free T4 (FT4, free T3 (FT3, thyroid-stimulating hormone (TSH and anti-thyroid peroxidase autoantibodies (anti-TPO. Results 16.6% of the overall sample had an anti-TPO value above the normal cut-off. Subjects with at least one diagnosis of anxiety disorders (OR = 4.2, C.L. 95% 1.9–38.8 or mood disorders (OR = 2.9, Cl 95% 1.4–6.6, P Conclusions The study seems to suggest that individuals in the community with thyroid autoimmunity may be at high risk for mood and anxiety disorders. The psychiatric disorders and the autoimmune reaction seem to be rooted in a same (and not easy correctable aberrancy in the immuno-endocrine system. Should our results be confirmed, the findings may be of great interest for future preventive and case finding projects.

  2. Papillary Thyroid Carcinoma Metastases Presenting as Ipsilateral Adrenal Mass and Renal Cyst

    Directory of Open Access Journals (Sweden)

    Serge Ginzburg

    2015-11-01

    Full Text Available Metastatic spread of differentiated thyroid cancer to genitourinary organs is rare. Synchronous presentation of renal and adrenal thyroid metastasis is even less common, this case being only the 3rd reported. We describe a case of a 60-year-old male with oligometastatic thyroid cancer, where adrenal and renal metastases were the only extracervical sites of disease and triggered the patient's presentation.

  3. Cytometric evaluation of intracellular IFN-γ and IL-4 levels in thyroid follicular cells from patients with autoimmune thyroid diseases

    Directory of Open Access Journals (Sweden)

    Bossowski Artur

    2011-09-01

    Full Text Available Abstract Background In recent few years is underlined that altered balance of pro- and anti-inflammatory cytokines play an important role in the pathogenesis of AITD. The aim of this study was to estimate intracellular INF-γ and IL-4 levels in thyroid-infiltrating lymphocytes and thyrocytes isolated from thyroid tissues in 54 adolescent patients aged 8-21 years, with Graves' disease (GD; n = 18, Hashimoto's thyroiditis (HT; n = 18 and non-toxic multinodular goiter (NTMG; n = 18. Methods Fresh thyroid tissues were taken on culture medium RPMI -1640, it was mechanically prepared. In next step were added cell activators -12- myristate 13- the acetate (PMA and Ionomycin as well as the inhibitor of transportation of proteins - Breferdin A. They were cultured 24 hours in 50 ml flasks at 37°C in a 5-95% CO2-air water-saturated atmosphere. After that, thyrocytes were identified by mouse mAb directed against human TPO epitope 64 conjugated with rabbit anti-mouse antibodies IgG (Fab'2 labeled by FITC. After incubation at room temperature to each of samples added reagent A fixative the cellular membrane. In next step into the cell suspensions were added reagent B to permeabilization of cellular membrane and specific anti-IL-4-PE or anti-IFN-γ-PE mAbs. Identification of intracellular cytokines in T lymphocytes was performed in the same procedure with application of anti-CD4-PerCP and anti-CD8-PerCP mAbs specific for T lymphocytes. The cells were analyzed in a flow cytometry (Coulter EPICS XL. Results In examined group of patients with GD we observed statistically significant higher mean percentage of cells with phenotype CD4+IL-4 (p Conclusions We conclude that human thyrocytes in autoimmune thyroid disorders could be a source of cytokine production and that their activation influences local interaction with T lymphocytes inflowing to the thyroid gland.

  4. Hashimoto's thyroiditis and papillary carcinoma in an adolescent girl: A case report.

    Science.gov (United States)

    Dong, Li-Qun; Sun, Xiao-Mei; Xiang, Cheng-Fa; Wu, Jin; Yu, Ping

    2016-07-01

    Hashimoto's thyroiditis with thyroid cancer in childhood is not as common in the adult population. Hashimoto's thyroiditis is an autoimmune disease associated with autoantibodies, and the association between Hashimoto's thyroiditis and papillary carcinoma of the thyroid remains controversial. The present study reported a 15-year-old adolescent girl with the diagnosis of Hashimoto's thyroiditis with thyroid cancer. With the complexity of the clinical manifestations of Hashimoto's thyroiditis, it can be expressed as not only hyperthyroidism or hypothyroidism, but also normal thyroid function. The long-term treatment, and for children with thyroid cancer, early diagnosis is particularly difficult. In the present case, the diagnosis of Hashimoto's thyroiditis is primarily based on clinical manifestations, anti-thyroglobulin antibody and anti-thyroid microsomal antibody. The only diagnostic imaging ultrasound was negative. The present study discussed the possible reason and the identification of this unique case of Hashimoto's thyroiditis with thyroid cancer.

  5. Present and future of robot-assisted endoscopic thyroid surgery

    Institute of Scientific and Technical Information of China (English)

    FAN Lin-jun; JIANG Jun

    2012-01-01

    Objective Robot-assisted endoscopic surgery has been increasingly accepted because of its unique three-dimensional vision and precise simulation-based technology.However,the utilization of robotic systems in thyroid surgery is limited.We conducted a systematic review to assess the application and development of robot-assisted endoscopic surgical technique in thyroid surgery.Data sources Articles published in PubMed before June,2011 about robot-assisted endoscopic surgery were selected.Study selection Original articles and critical reviews selected were related to robot-assisted (thyroid) surgery or endoscopic thyroid surgery,and a total of 3540 relevant articles were retrieved and 34 were finally cited.Results Robot-assisted operation of benign thyroid diseases were successfully performed,although the operation time is too long to exhibit its advantages.Nevertheless,the superiority of robot-assisted endoscopic surgical technique compared to conventional endoscopic surgery in the treatment of thyroid carcinoma were obvious,since robotic radical thyroidectomy with central and lateral neck lymph node dissection could be achieved while maintaining operative results and cosmetic outcomes equivalent to or better than conventional endoscopic surgery.Furthermore,the learning curve duration of robot-assisted endoscopic thyroid surgery was shorter than that of conventional endoscopy,especially for the novices without any endoscopic surgical basis.Conclusion Robot-assisted endoscopic thyroid surgery,with its safety,feasibility,thoroughness,cosmetic benefits,and ability to overcome the limitations of conventional endoscopic surgery,will be further improved and applied,and is worthy of attention.

  6. Increased genetic risk or protection for canine autoimmune lymphocytic thyroiditis in Giant Schnauzers depends on DLA class II genotype.

    Science.gov (United States)

    Wilbe, M; Sundberg, K; Hansen, I R; Strandberg, E; Nachreiner, R F; Hedhammar, A; Kennedy, L J; Andersson, G; Björnerfeldt, S

    2010-06-01

    Dogs represent an excellent comparative model for autoimmune thyroiditis as several dog breeds develop canine lymphocytic thyroiditis (CLT), which is clinically similar to Hashimoto's thyroiditis in human. We obtained evidence that dog leukocyte antigen (DLA) class II genotype function as either genetic risk factor that predisposes for CLT or as protective factor against the disease. Genetic diversity at their DLA-DRB1, -DQA1, and -DQB1 loci were defined and potential association to major histocompatibility complex II haplotypes and alleles was analyzed. Giant Schnauzers carrying the DLA-DRB1*01201/DQA1*00101/DQB1*00201 haplotype showed an increased risk (odds ratio of 6.5) for developing CLT. The same risk haplotype has, to date, been observed in three different breeds affected by this disease, Giant Schnauzer, Dobermann, and Labrador Retriever, indicating that it is a common genetic risk factor in a variety of breeds affected by this disease. Importantly, protection for development of the disease was found in dogs carrying the DLA-DRB1*01301/DQA1*00301/DQB1*00501 haplotype (odds ratio of 0.3).

  7. [Primary carcinoma of the thyroid growing in thyroglossal duct cyst: presentation of two cases].

    Science.gov (United States)

    Godlewska, Paulina; Bruszewska, Elzbieta; Kozłowicz-Gudzińska, Izabella; Prokurat, Andrzej I; Chrupek, Małgorzata; Zegadło-Mylik, Maria A; Kluge, Przemysław

    2007-01-01

    Thyroglossal duct remnants (TGDR), most often cysts, are the most common type of developmental abnormalities of the thyroid gland. In about 1 to 2% of TGDR neoplastic transformation occurs. Papillary carcinoma of the thyroid may be encountered in over 90% of such cases. Two cases of primary papillary carcinoma of the thyroid in TGDR in young girls are presented. The diagnostic and therapeutic problems are shared, and up-to-date management guidelines in similar cases are discussed.

  8. An uncommon presentation of follicular thyroid carcinoma: when chronic back pain should raise a flag.

    Science.gov (United States)

    Alvarado, Milliette; Ramirez-Vick, Margarita; Lopez, Liurka; Marcos-Martinez, Maria J; Saavedra, Fanor M; Negron-Rivera, Juan C; Agosto, Marielba; Martinez, Meliza; Gonzalez, Rafael; Allende-Vigo, Myriam

    2014-01-01

    Follicular thyroid carcinoma is the second most common type of thyroid cancer, and its incidence has increased dramatically in recent years. Although it typically presents as a thyroid nodule, it can spread to distant sites via hematogenous dissemination. Bone metastasis is diagnosed clinically in 2%-13% of patients with differentiated thyroid cancer; nevertheless spinal cord compression complicating thyroid carcinoma is rare and only few cases has been reported in the literature. This case illustrates a strange case of a minimally invasive follicular carcinoma that showed an aggressive behavior, and thus the importance of considering metastatic thyroid carcinoma in the differential diagnosis of chronic back pain progressing to spinal cord compression carrying a severe morbidity.

  9. Metastatic spinal cord compression as initial presentation of follicular thyroid carcinoma.

    Science.gov (United States)

    Goldberg, H; Stein, M E; Ben-Itzhak, O; Duek, D; Ravkin, A; Gaitini, D

    1998-03-01

    Follicular thyroid carcinoma, initially presenting as spinal cord compression due to metastatic lesions, is a less reported event. We present two cases of well-differentiated thyroid carcinoma that led to spinal cord compression. A thorough search of the literature revealed only five similar cases. We summarize the clinical characteristics of these cases, the therapeutic measures used, their outcome, and the prognosis.

  10. Hashimoto's thyroiditis presenting as hot and cold nodules

    Energy Technology Data Exchange (ETDEWEB)

    Sulimani, R.A.; el-Desouki, M. (King Saud Univ., Riyadh (Saudi Arabia))

    1990-05-01

    A case of Hashimoto's thyroiditis is presented. I-123 thyroid scintigraphy demonstrated a hot nodule in the left lobe and a cold nodule in the right, which was well visualized by Tl-201 imaging. This unusual scintigraphic appearance is demonstrated, and its possible explanation discussed.

  11. A Case of Painful Hashimoto Thyroiditis that Mimicked Subacute Thyroiditis.

    Science.gov (United States)

    Seo, Hye Mi; Kim, Miyeon; Bae, Jaeseok; Kim, Jo-Heon; Lee, Jeong Won; Lee, Sang Ah; Koh, Gwanpyo; Lee, Dae Ho

    2012-04-01

    Hashimoto thyroiditis (HT) is an autoimmune thyroid disorder that usually presents as a diffuse, nontender goiter, whereas subacute thyroiditis (SAT) is an uncommon disease that is characterized by tender thyroid enlargement, transient thyrotoxicosis, and an elevated erythrocyte sedimentation rate (ESR). Very rarely, patients with HT can present with painful, tender goiter or fever, a mimic of SAT. We report a case of painful HT in a 68-year-old woman who presented with pain and tenderness in a chronic goiter. Her ESR was definitely elevated and her thyroid laboratory tests suggested subclinical hypothyroidism of autoimmune origin. (99m)Tc pertechnetate uptake was markedly decreased. Fine needle aspiration biopsy revealed reactive and polymorphous lymphoid cells and occasional epithelial cells with Hürthle cell changes. Her clinical symptoms showed a dramatic response to glucocorticoid treatment. She became hypothyroid finally and is now on levothyroxine therapy.

  12. Autoimmune thyroid disorders in hepatitis C virus infection: Effect of interferon therapy

    Directory of Open Access Journals (Sweden)

    Zohreh Jadali

    2013-01-01

    Full Text Available The hepatitis C virus infection represents an important public health problem and is associated with various hepatic and extrahepatic manifestations. Symptoms outside of the liver can occur in multiple organ systems, including hematologic, renal, dermatologic, endocrine, and rheumatologic systems. Among these different organ systems, special attention has focused on the endocrine system because it affects almost every organ in the body. Among the endocrine disorders, thyroid problems are the most common and the thyroid is one of the principal target organs for extrahepatic manifestations in HCV infected patients. In addition, research data suggest that interferon treatment may be associated with immune-mediated thyroid lesions. However, case reports suggest that the response of thyroid extrahepatic manifestations to interferon in patients with chronic HCV is greatly different. The objective of this study was to summarize currently available data on thyroid conditions associated with chronic HCV infection. Moreover, we investigate the incidence of the development of immune mediated thyroid disorders during interferon therapy in these patients.

  13. Frequency Of Pancreatic Beta-Cell Autoimmunity Markers In Patients With Autoimmune Thyroid Disease Frecuencia de marcadores de autoinmunidad beta pancreática en pacientes con enfermedad tiroidea autoinmune

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    María E. Primo

    2008-02-01

    Full Text Available A total of 305 ambulatory patients recruited at the Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, with autoimmune thyroid disease (AITD were studied to search for associations between autoimmune thyroid disease and presence of serum markers of autoimmune diabetes mellitus. Screening for markers of pancreatic beta-cell autoimmunity was performed by radioligand binding assays (RBA as follows: autoantibodies to glutamic acid decarboxylase (GADA and proinsulin (PAA were determined in all sera, whereas autoantibodies to protein tyrosine phosphatase (IA-2A and insulin (IAA were additionally measured in 200 sera randomly selected from the total collection. In addition, every GADA positive serum among the remaining 105 sera was systematically tested for the presence of IA-2A and IAA. In the cohort of 305 AITD patients 22 (7.2% were previously diagnosed as type 1, type 2 or insulin-requiring type 2 diabetics. Ten of these patients presented serum marker positivity specific for β-cell autoantigens and 12 were marker negative. On the other hand, considering the majority of non-diabetic AITD patients (n=283, β-cell marker positivity was detected in 17 individuals (6.0%. The prevalence of autoimmune diabetes markers was much higher in the studied population than in the general population utilized as a control group, and GADA was the most frequent marker.Se investigó la asociación entre enfermedad tiroidea autoinmune y la presencia de marcadores séricos de diabetes mellitus en 305 pacientes ambulatorios con enfermedad tiroidea autoinmune reclutados en la División Endocrinología. La búsqueda de marcadores de autoinmunidad contra las células beta pancreáticas se realizó por la técnica de unión de radioligandos (RBA como se detalla a continuación: se determinaron autoanticuerpos contra la decarboxilasa del ácido glutámico (GADA y proinsulina (PAA en todos los sueros, mientras que los anticuerpos contra la prote

  14. Lack of specific association between gastric autoimmunity hallmarks and clinical presentations of atrophic body gastritis

    Institute of Scientific and Technical Information of China (English)

    Bruno Annibale; Edith Lahner; Riccardo Negrini; Flavia Baccini; Cesare Bordi; Bruno Monarca; Gianfranco Delle Fave

    2005-01-01

    AIM: To investigate the possible relationships between gastric autoimmune phenomena and clinical presentations of this disorder, in consecutive atrophic body gastritis patients.METHODS: A total of 140 atrophic body gastritis patients,diagnosed as consecutive outpatients presenting with macrocytic or iron deficiency anemia, or longstanding dyspepsia underwent gastroscopy with antral and body biopsies, assay of intrinsic factor, parietal cells and Helicobacter pylori(H pylori) antibodies. Gastritis was assessed according to Sydney System.RESULTS: Parietal cell antibodies were equally distributed in all clinical presentations, whereas the positivity of intrinsic factor antibodies (49/140, 35%) was significantly higher in pernicious anemia patients (49.2%) than in iron deficiency (21.1%) and dyspeptic patients (27.8%). No specific pattern of autoantibodies was related to the clinical presentations of atrophic body gastritis. A positive correlation was obtained between the body atrophy score and the intrinsic factor antibody levels (r = 0.2216,P = 0.0085). Associated autoimmune diseases were present in 25/140 (17.9%) patients, but the prevalence of autoimmune diseases was comparable, irrespective of the clinical presentations.CONCLUSION: The so-called hallmarks of gastric autoimmunity, particularly in intrinsic factor antibody cannot be usefully employed in defining an autoimmune pattern in the clinical presentations of ABG.

  15. Spinal cord compression as initial presentation of metastatic occult follicular thyroid carcinoma.

    Science.gov (United States)

    Khan, Md Nuruzzaman; Sharfuzzaman, Amsm; Mostafa, Md Golam

    2014-04-01

    Metastatic tumors are the most common tumors of the spine, accounting for 98% of all spine lesions. But spinal cord compression as the initial presentation of metastatic occult follicular carcinoma without any thyroid enlargement is unusual and relatively rare. This report describes a 35-years-old female patient presenting with paraplegia and urinary incontinence for the last two months. She had no thyroid enlargement; no thyroid related symptoms and her biochemical thyroid profile was normal. Magnetic resonance imaging (MRI) of spine shows a huge mass compressing the spinal cord at D11-D12 involving both the spinal and paraspinal areas. The patient was treated by surgery and radioiodine ablation as the histopathology showed metastatic follicular thyroid carcinoma. This case was reported because of the rarity of the disease. Early diagnosis and initiation of the treatment should promise a good prognosis for a patient with metastatic spinal cord compression.

  16. Spinal cord compression as initial presentation of metastatic occult follicular thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Md Nuruzzaman Khan

    2014-01-01

    Full Text Available Metastatic tumors are the most common tumors of the spine, accounting for 98% of all spine lesions. But spinal cord compression as the initial presentation of metastatic occult follicular carcinoma without any thyroid enlargement is unusual and relatively rare. This report describes a 35-years-old female patient presenting with paraplegia and urinary incontinence for the last two months. She had no thyroid enlargement; no thyroid related symptoms and her biochemical thyroid profile was normal. Magnetic resonance imaging (MRI of spine shows a huge mass compressing the spinal cord at D11-D12 involving both the spinal and paraspinal areas. The patient was treated by surgery and radioiodine ablation as the histopathology showed metastatic follicular thyroid carcinoma. This case was reported because of the rarity of the disease. Early diagnosis and initiation of the treatment should promise a good prognosis for a patient with metastatic spinal cord compression.

  17. Sciatica as a presenting feature of thyroid follicular adenocarcinoma in a 79-year-old woman.

    LENUS (Irish Health Repository)

    Ogbodo, Elisha

    2011-01-01

    The authors describe an unusual case of metastatic thyroid follicular adenocarcinoma presenting with sciatica in a 79-year-old woman. The primary thyroid tumour was undiagnosed until this clinical presentation. The patient gave a short history of back pain and right-sided sciatica, which was progressive and nocturnal in nature. Neuroimaging revealed an enhancing intradural mass lesion, which was completely excised through a right L1-L3 hemilaminectomy. Histopathological examination of the excised tissue revealed a follicular thyroid carcinoma. Subsequent metastatic investigation revealed a heterogeneously attenuating mixed solid cystic mass in a retrosternal thyroid gland, with multiple solid pulmonary nodules suggestive of metastatic disease. She opted for palliative radiotherapy for the primary thyroid cancer and made remarkable postoperative improvement. The authors conclude that surgical treatment of solitary metastatic lesion may produce good symptomatic relief irrespective of patient\\'s age and primary pathology, while emphasising the need for detailed clinical evaluation of patients with \\'red flag\\' symptoms.

  18. Sciatica as a presenting feature of thyroid follicular adenocarcinoma in a 79-year-old woman.

    Science.gov (United States)

    Ogbodo, Elisha; Kaliaperumal, Chandrasekaran; Keohane, Catherine; Bermingham, Niamh; Kaar, George

    2011-12-01

    The authors describe an unusual case of metastatic thyroid follicular adenocarcinoma presenting with sciatica in a 79-year-old woman. The primary thyroid tumour was undiagnosed until this clinical presentation. The patient gave a short history of back pain and right-sided sciatica, which was progressive and nocturnal in nature. Neuroimaging revealed an enhancing intradural mass lesion, which was completely excised through a right L1-L3 hemilaminectomy. Histopathological examination of the excised tissue revealed a follicular thyroid carcinoma. Subsequent metastatic investigation revealed a heterogeneously attenuating mixed solid cystic mass in a retrosternal thyroid gland, with multiple solid pulmonary nodules suggestive of metastatic disease. She opted for palliative radiotherapy for the primary thyroid cancer and made remarkable postoperative improvement. The authors conclude that surgical treatment of solitary metastatic lesion may produce good symptomatic relief irrespective of patient's age and primary pathology, while emphasising the need for detailed clinical evaluation of patients with 'red flag' symptoms.

  19. CASE OF SUBACUTE THYROIDITIS PRESENTING AS THE CAUSE OF PYREXIA OF UNKNOWN ORIGIN

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    Faiz

    2015-10-01

    Full Text Available : Pyrexia of unknown origin (PUO is not infrequently a diagnostic dilemma for clinicians. Endocrine causes of PUO are rare. The endocrine disorder likely to present as PUO is subacute thyroiditis. Subacute thyroiditis usually occurs in middle-aged women as viral prodrome, classic symptoms of thyrotoxicosis, and an elevated erythrocyte sedimentation rate. The patient may have abrupt onset of fever and chills with complaints of thyroid pain, or only low-grade fever with poorly characterized anterior neck pain. We present a case of PUO in a 40-year-old male who had fever for more than two month. Despite an extensive evaluation, the patient had persistent fever and no cause was found, with the exception of subacute thyroiditis. The fever resolved from the fifth day of treatment with low-dose steroid (Prednisolone, 10mg per day. This case illustrates that subacute thyroiditis should be considered in cases of FUO.

  20. A rare combination of type 3 autoimmune polyendocrine syndrome (APS-3) or multiple autoimmune syndrome (MAS-3)

    OpenAIRE

    Betterle, Corrado; Garelli, Silvia; Coco, Graziella; Burra, Patrizia

    2014-01-01

    Context Type 3 autoimmune polyendocrine syndrome (APS-3) is defined by the presence of an autoimmune thyroid disease and another autoimmune illness, excluding Addison’s disease; this is a frequent combination. Case presentation We report the case of a 55 years old female patient with APS-3, with seven clinical or latent autoimmune manifestations. At 49 years of age she was admitted at the General Hospital for leukopenia, weight loss, tremors, anxiety and diarrhea. The personal history reveale...

  1. Isolated Vitamin D Deficiency Is Not Associated with Nonthyroidal Illness Syndrome, but with Thyroid Autoimmunity

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    Muyesser Sayki Arslan

    2015-01-01

    Full Text Available Aim. This study aimed to compare thyroid functions, thyroid autoantibodies, and the existence of nonthyroidal illness syndrome (NTIS according to vitamin D level. Materials and Methods. The study included age- and BMI-matched healthy volunteers with and without vitamin D deficiency. In addition, the nonthyroidal illness syndrome status was evaluated. Results. Anti-TPO positivity was significantly more common in those with severe and moderate vitamin D deficiency, as compared to those with a normal 25(OHD level. Furthermore, TSH levels were significantly lower in those with severe and moderate vitamin D deficiency than in those with a normal 25(OHD level. In addition, there was a significant weak inverse correlation between anti-TPO positivity and the 25(OHD level and a positive correlation between the TSH level and 25(OHD level. Only 1 thyroid function test result was compatible with NTIS among the participants with moderate vitamin D deficiency; therefore the difference was not significant. Conclusions. The prevalence of thyroid autoantibody positivity was higher in those with severe and moderate vitamin D deficiency than in those with a normal 25(OHD level. Additional large-scale studies must be conducted to determine if vitamin D deficiency plays a causal role in the pathogenesis of Hashimoto’s thyroiditis and NTIS.

  2. Thyroid leiomyosarcoma: presentation of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Mehmet İlhan Şahin

    Full Text Available Abstract Introduction: Leiomyosarcoma is a tumor which is rarely seen in the thyroid gland. The diagnosis may be difficult and the treatment is controversial. Objective: The objective of the study is to review the literature about a rare malignant disease of the thyroid gland which has high mortality. Methods: Two cases of thyroid leiomyosarcoma are presented and the previous 23 cases in the current literature are reviewed. Results: A total of 25 cases of thyroid leiomyosarcoma are reviewed; the most common complaint was rapidly growing anterior neck mass, and ten of the 25 patients had distant metastasis at the initial admission. Fifteen of the 25 patients died with the disease in the first 12 months after the diagnosis. Conclusion: The differential diagnosis of thyroid leiomyosarcoma is important and should be performed with other malignancies of the gland, especially with anaplastic carcinoma. The prognosis is poor and there is no consensus regarding the treatment.

  3. Treated Autoimmune Thyroid Disease Is Associated with a Decreased Quality of Life among Young Persons with Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Alena Spirkova

    2015-01-01

    Full Text Available Type 1 diabetes (T1D in children and adolescents is relatively often accompanied by other immunopathological diseases, autoimmune thyroid disease (AITD or celiac disease (CD. Our aim was to assess whether these conditions are associated with changes in the health-related quality of life (HRQOL in pediatric patients with T1D. In a cross-sectional study we identified eligible 332 patients with T1D aged 8–18 years, of whom 248 (75% together with their parents responded to the PedsQL Generic and Diabetes Modules. Compared to 143 patients without thyroid autoantibodies, 40 patients with a thyroxine-treated AITD scored lower in the overall generic HRQOL (P=0.014, as well as in the overall diabetes-specific HRQOL (P=0.013. After adjustment for age, gender, duration of diabetes, type of diabetes treatment, and diabetes control, this association remained statistically significant for the generic HRQOL (P=0.023. Celiac disease was not associated with a change in the generic or diabetes-specific HRQOL (P=0.07  and   P=0.63, resp.. Parental scores showed no association with AITD or celiac disease, except a marginally significant decrease in the overall generic HRQOL (P=0.039 in the T1D + AITD compared to T1D group. Our study indicates that, in pediatric patients with T1D, concomitant thyroxine-treated AITD is associated with lower quality of life.

  4. B-Cell-Activating Factor Affects the Occurrence of Thyroid Autoimmunity in Chronic Hepatitis C Patients Treated with Interferon Alpha

    Directory of Open Access Journals (Sweden)

    Yusuke Kajiyama

    2012-01-01

    Full Text Available Chronic hepatitis C (CHC patients frequently suffer from thyroid disorders during interferon therapy. However, the mechanism remains unclear. In this study, we investigated the association between serum B-cell-activating factor belonging to the TNF family (BAFF levels and the presence of antithyroid peroxidase antibody (anti-TPO in CHC patients treated with pegylated interferon alpha and ribavirin combination therapy. Six months after the therapy, anti-TPO antibody was detected in 10 (males, 1; females, 9 of 50 patients. The mean age of these patients was higher than that of the anti-TPO-negative patients (61 yr versus 55 yr. Before treatment, the serum BAFF levels of the anti-TPO-positive patients were higher than those of the anti-TPO-negative patients. After starting therapy, the serum BAFF levels of both the anti-TPO-positive and -negative patient groups were elevated. Our findings suggest that the serum BAFF concentration before therapy can predict the risk of thyroid autoimmunity in elderly female patients with CHC.

  5. Autoimmune Pancreatitis Presenting as Simultaneous Masses in the Pancreatic Head and Gallbladder

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    Andrew A Gumbs

    2005-09-01

    Full Text Available Context Autoimmune pancreatitis is a rare variant of chronic pancreatitis characterized by pancreatic ductal narrowing and pancreatic parenchymal edema on computed tomography and rarely with intermittent attacks of abdominal pain. Recently, it has been found to be a systemic disease with lymphoplasmacytic infiltration that has been associated with several autoimmune diseases and described in multiple organs including the extrahepatic bile duct, liver and gallbladder. Case report We describe the clinical, radiographic and histopathologic aspects of a patient who presented with synchronous masses in the pancreatic head and gallbladder. Postoperatively, the patient's jaundice subsided and IgG4 levels, which were drawn one week postoperatively, were all within normal limits. Nonetheless, immunohistochemical staining for IgG4 was positive. Conclusion Autoimmune pancreatitis is the most common benign entity identified in patients that underwent pancreaticoduodenectomy for presumed pancreatic adenocarcinoma. Our patient with autoimmune pancreatitis presented with simultaneous inflamematory masses in the gallbladder and pancreatic head, an association not previously reported. Preoperative evaluation of IgG4 or autoantibody levels may have obviated the need for an operation. Therefore, we have begun screening for elevated serum IgG4 concentrations to identify patients with possible autoimmune pancreatitis who present without definitive pathological or radiographic evidence for malignancy. If preoperative diagnosis is not made, immunohistochemical staining of pathology specimens can confirm the diagnosis.

  6. Diagnosis and discrimination of autoimmune Graves' disease and Hashimoto's disease using thyroid-stimulating hormone receptor-containing recombinant proteoliposomes.

    Science.gov (United States)

    Fukushima, Hidetaka; Matsuo, Hideaki; Imamura, Koji; Morino, Kazuhiko; Okumura, Katsuzumi; Tsumoto, Kanta; Yoshimura, Tetsuro

    2009-12-01

    Graves' disease (GD) is an autoimmune disease of the thyroid gland caused by autoantibodies against thyroid-stimulating hormone receptor (TSHR). Currently, the diagnostic test for TSHR autoantibodies is based on an indirect competitive binding assay that measures the ability of TSHR autoantibodies to inhibit the binding of thyroid-stimulating hormone (TSH) to TSHR. Here, we have developed a specific and direct diagnostic method for autoantibodies in GD that incorporates immobilized TSHR-containing recombinant proteoliposomes into an enzyme-linked immunosorbent assay (ELISA). To reduce non-specific binding of autoantibodies to recombinant proteoliposomes, we investigated the effect of polyethylene glycol (PEG)-lipid on the binding of commercially available anti-TSHR antibodies (aTSHRAb). The incorporation of PEG-lipids into liposomes decreased non-specific binding, as compared to liposomes that did not contain PEG-lipids, and the addition of blocking reagents further decreased non-specific reactivity. aTSHRAb exhibited higher reactivity towards PEG-modified TSHR recombinant proteoliposomes than PEG-modified liposomes without TSHR (bare liposomes). Importantly, serum autoantibodies from patients with GD, which is associated with hyperthyroidism, exhibited remarkably specific binding to TSHR recombinant proteoliposomes. Serum autoantibodies from patients with Hashimoto's disease (HD), which is associated with hypothyroidism, also reacted specifically with proteoliposomal TSHR. These results suggest that immobilized TSHR recombinant proteoliposomes can serve as a direct diagnostic test for GD and HD. Furthermore, given that there is no competition test currently available for detecting autoantibodies in HD, the combination of TSHR recombinant proteoliposome ELISA and indirect competitive TSHR binding assay might be an effective way to discriminate between GD and HD.

  7. Primary mucosa-associated lymphoid tissue thyroid lymphoma: a rare thyroid neoplasm of extrathyroid origin

    Directory of Open Access Journals (Sweden)

    Dimitrios Hadjidakis

    2012-01-01

    Full Text Available Primary thyroid lymphoma is a rare malignancy, representing 2-8% of all thyroid malignancies and 1-2% of all extranodal lymphomas. The majority of cases concern non-Hodgkin`s lymphoma of B cell origin, following by Hodgkin’s disease, T cell lymphomas and rarely marginal zone B-cell mucosa-associated lymphoid tissue (MALT lymphomas. MALT lymphomas have been associated with long-standing autoimmune Hashimoto`s thyroiditis. We present the case of a 44-years-old woman with thyroid MALT lymphoma in the background of multinodular goiter of autoimmune origin.

  8. Sex differences in autoimmune diseases

    Directory of Open Access Journals (Sweden)

    Voskuhl Rhonda

    2011-01-01

    Full Text Available Abstract Women are more susceptible to a variety of autoimmune diseases including systemic lupus erythematosus (SLE, multiple sclerosis (MS, primary biliary cirrhosis, rheumatoid arthritis and Hashimoto's thyroiditis. This increased susceptibility in females compared to males is also present in animal models of autoimmune diseases such as spontaneous SLE in (NZBxNZWF1 and NZM.2328 mice, experimental autoimmune encephalomyelitis (EAE in SJL mice, thyroiditis, Sjogren's syndrome in MRL/Mp-lpr/lpr mice and diabetes in non-obese diabetic mice. Indeed, being female confers a greater risk of developing these diseases than any single genetic or environmental risk factor discovered to date. Understanding how the state of being female so profoundly affects autoimmune disease susceptibility would accomplish two major goals. First, it would lead to an insight into the major pathways of disease pathogenesis and, secondly, it would likely lead to novel treatments which would disrupt such pathways.

  9. Complicating autoimmune diseases in myasthenia gravis: a review.

    Science.gov (United States)

    Nacu, Aliona; Andersen, Jintana Bunpan; Lisnic, Vitalie; Owe, Jone Furlund; Gilhus, Nils Erik

    2015-01-01

    Myasthenia gravis (MG) is a rare autoimmune disease of skeletal muscle endplates. MG subgroup is relevant for comorbidity, but usually not accounted for. MG patients have an increased risk for complicating autoimmune diseases, most commonly autoimmune thyroid disease, systemic lupus erythematosus and rheumatoid arthritis. In this review, we present concomitant autoimmune disorders associated with the different MG subgroups, and show how this influences treatment and prognosis. Concomitant MG should always be considered in patients with an autoimmune disorder and developing new neuromuscular weakness, fatigue or respiratory failure. When a second autoimmune disorder is suspected, MG should be included as a differential diagnosis.

  10. Well-being and depression in individuals with subclinical hypothyroidism and thyroid autoimmunity

    DEFF Research Database (Denmark)

    Fjaellegaard, Katrine; Kvetny, Jan; Allerup, Peter N.

    2014-01-01

    BACKGROUND: The association between subclinical hypothyroidism (SCH), with and without raised thyroid peroxidase antibodies (anti-TPO), and well-being or depression is still controversial, in spite of many studies on the topic. AIMS: In this large general population study of 8214 individuals, we...

  11. An inflammatory gene-expression fingerprint in monocytes of autoimmune thyroid disease patients

    NARCIS (Netherlands)

    L. Heul-Nieuwenhuijsen (Leonie); R.C. Padmos (Roos); R.C. Drexhage (Roos); H.J. de Wit (Harm); A. Berghout (Arie)

    2010-01-01

    textabstractContext: In monocytes of patients with autoimmune diabetes, we recently identified a gene expression fingerprint of two partly overlapping gene clusters, a PDE4B-associated cluster (consisting of 12 core proinflammatory cytokine/compound genes), a FABP5-associated cluster (three core gen

  12. Different levels of thyroid autoimmune antibody in four kinds of thyroid diseases%甲状腺自身免疫抗体在四种甲状腺疾病中水平差异的研究

    Institute of Scientific and Technical Information of China (English)

    马建宏; 莫巧璇; 严永智; 陈晓丽; 梁雪冰

    2015-01-01

    目的::观察自身免疫抗体甲状腺球蛋白抗体( TGAb)、抗甲状腺过氧化物酶抗体( TPOAb)和促甲状腺素受体抗体( TRAb)在4种甲状腺疾病中的水平差异。方法:将2012年1月至2014年6月在佛山市中医院内分泌科门诊就诊的506例4种甲状腺疾病患者作为研究对象,定量检测患者血液中TGAb、TPOAb和TRAb抗体水平。结果:桥本甲状腺炎患者血液中TGAb和TPOAb值、阳性率最高,分别为1439.0 IU/mL、87.7%和427.5 IU/mL、97.7%;Graves病患者血液中TRAb值和阳性率最高,为34.44 IU/L和100%;单纯性甲状腺肿及亚急性甲状腺炎患者血液中,甲状腺自身免疫抗体也有不同程度的升高。4种甲状腺疾病患者TGAb、TPOAb和TRAb抗体水平两两比较,除了亚急性甲状腺炎与桥本甲状腺炎患者的TRAb水平外,差异均有统计学意义( P<0.05)。结论:甲状腺自身免疫抗体TGAb、TPOAb和TRAb水平在不同甲状腺疾病中存在差异,结合分析对于甲状腺疾病尤其是自身免疫性甲状腺疾病具有重要的诊断价值。%Objective:To determine the different levels of the thyroid autoimmune antibodies, including thyroglobulin antibody (TGAb) and antithyroid peroxidase antibody (TPOAb) and thyroid stimulating hormone receptor antibody ( TRAb) in four kinds of thyroid diseases. Methods:A total of 506 patients with four kinds of thyroid diseases, who were hospitalized in Department of Endocrinology, Foshan Hospital of Traditional Chinese Medicine between January 2012 and June 2014, were included as the subjects in the study. The levels of plasma TGAb, TPOAb and TRAb antibodies in all patients were quantitatively determined. Results: The values and positive rates of plasma TGAb and TPOAb in patients with Hashimoto thyroiditis were the highest, which were 1439.0IU/ml, 87.7% and 427.5IU/ml, 97.7%, respectively. The plasma TRAb value and positive rate were the highest in patients with Graves, which

  13. Papillary carcinoma thyroid presenting as a choroidal metastasis. Report of a case and brief review of literature.

    Directory of Open Access Journals (Sweden)

    Singh Usha

    2003-01-01

    Full Text Available A patient of papillary thyroid carcinoma, who initially presented with a choroidal metastasis and secondary intractable glaucoma is reported. The orange-coloured tumour posed a diagnostic difficulty, until histopathology of the enucleated eye confirmed the metastasis from the thyroid. The initial presentation of distant metastasis in patients with thyroid cancer is rare.

  14. Eye findings and immunological markers in probands and their euthyroid relatives from a single family with multiple cases of thyroid autoimmunity

    Directory of Open Access Journals (Sweden)

    Ardley Melissa

    2012-06-01

    Full Text Available Abstract Background Ophthalmopathy is a common manifestation of Graves’ disease (GD occurring in up to 50% of patients. Mild eye signs are also common in patients with Hashimoto’s thyroiditis. Whilst a genetic predisposition to GD has been demonstrated this is not the case for the ophthalmopathy which often runs a separate course. Objective We determined the prevalences of eye and eyelid signs and positive thyroid and orbital antibody tests in first and second degree relatives from a single family with multiple cases of Graves’ disease, ophthalmopathy and Hashimoto’s thyroiditis. Design The study cohort comprised 16 subjects from the same family, 4 probands namely, 3 with GD and one with Hashimoto’s thyroiditis and hypothyroidism and 12 of their euthyroid first or second degree relatives. We measured antibodies against calsequestrin (CASQ1 and collagen XIII in an enzyme-linked-immunosorbent assays and TSH-Receptor (TSH-R antibodies as i TSH-R binding inhibiting immunoglobulin (TBII and ii thyroid stimulating immunoglobulin (TSI. Eye signs were classified and quantified using the clinical activity score (CAS, NOSPECS classes, Nunery types 1 and 2 and the margin-reflex-distance (MRD as a measure of upper eyelid retraction (UER. Main outcomes Whilst significant ophthalmopathy was uncommon in the relatives, mild eye signs, in particular UER, were demonstrated in about a third of them. The presence of eye signs was moderately, but not significantly, associated with the detection of CASQ1 and collagen XIII antibodies, but not TSH-R antibodies. Conclusion Our study demonstrates a significant prevalence of positive orbital antibody tests and ophthalmopathy in probands with thyroid autoimmunity and their euthyroid relatives, favouring a role of genetic factors in the development of ophthalmopathy in patients with thyroid autoimmunity.

  15. Environmental triggers of thyroiditis: hepatitis C and interferon-α.

    Science.gov (United States)

    Menconi, F; Hasham, A; Tomer, Y

    2011-01-01

    Autoimmune thyroid diseases (AITD) are postulated to develop as a result of a complex interplay between several genetic and environmental influences. The pathogenesis of AITD is still not clearly defined. However, among the implicated triggers (e.g. iodine, infections, medications), more recent data confirmed strong associations of AITD with the hepatitis C virus (HCV) infection and interferon-α (IFNα) therapy. Moreover, it is likely that HCV and IFN act in synergism to trigger AITD in patients. Indeed, approximately 40% of HCV patients develop either clinical or subclinical disease while receiving IFNα. Interferon induced thyroiditis (IIT) can manifest as non-autoimmune thyroiditis (presenting as destructive thyroiditis, or non-autoimmune hypothyroidism), or autoimmune thyroiditis [presenting with clinical features of Graves' disease (GD) or Hashimoto's thyroiditis (HT)]. Although not yet clearly understood, it is thought that IFNα can induce thyroiditis via both immune stimulatory and direct toxic effects on the thyroid. In view of the high frequency of IIT, routine screening and surveillance of HCV patients receiving IFNα is recommended to avoid the complications, such as cardiac arrhythmias, associated with thyrotoxicosis. In summary, IIT is a common clinical problem that can be readily diagnosed with routine thyroid function screening of HCV patients receiving IFN. The treatment of IIT consists of the standard therapy for differing clinical manifestations of IIT such as GD, HT, or destructive thyroiditis. However, anti-thyroid medications are not recommended in this setting since they can potentially be hepatotoxic.

  16. Thyrocytes responding to IFN-gamma are essential for development of lymphocytic spontaneous autoimmune thyroiditis and inhibition of thyrocyte hyperplasia.

    Science.gov (United States)

    Yu, Shiguang; Sharp, Gordon C; Braley-Mullen, Helen

    2006-01-15

    IFN-gamma promotes the development of lymphocytic spontaneous autoimmune thyroiditis (L-SAT) in NOD.H-2h4 mice and inhibits the development of thyrocyte hyperplasia and proliferation (TEC H/P). The precise mechanisms by which IFN-gamma promotes L-SAT and inhibits TEC H/P are unknown. To determine whether responsiveness of lymphocytes or thyrocytes to IFN-gamma is important for the development of these lesions, IFN-gammaR-/- mice, which develop TEC H/P similar to IFN-gamma-/- mice, were used as recipients for adoptive cell transfer. Wild-type (WT) splenocytes or bone marrow induced L-SAT and inhibited TEC H/P in IFN-gamma-/-, but not IFN-gammaR-/- recipients. IFN-gammaR-/- recipients of WT cells developed severe TEC H/P, but did not develop L-SAT, suggesting that thyrocytes responding to IFN-gamma are important for inhibition of TEC H/P. Unexpectedly, IFN-gammaR-/- splenocytes or bone marrow did not induce L-SAT in IFN-gamma-/- or WT mice even though IFN-gammaR-/- lymphocyte donors produced as much IFN-gamma as lymphocytes from WT donors, and thyrocytes could respond to IFN-gamma. Real-time PCR indicated that recipients of IFN-gammaR-/- bone marrow expressed less mRNA for IFN-gamma-inducible chemokines compared with recipients of WT bone marrow. This might limit the migration of IFN-gammaR-/- lymphocytes to thyroids. Few IFN-gammaR-/- lymphocytes infiltrated thyroids even in the presence of WT lymphocytes, suggesting that lymphocytes unable to respond to IFN-gamma are not induced to migrate to thyroids. These results suggest that thyrocytes must be able to respond to IFN-gamma for the development of L-SAT and inhibition of TEC H/P, and lymphocytes must be able to respond to IFN-gamma to induce L-SAT.

  17. Ocular myasthenia gravis coincident with thyroid ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Yaman A

    2003-01-01

    Full Text Available Graves' disease and myasthenia gravis are both auto-immune diseases and the coexistence of these two diseases is well recognized. Myasthenia gravis is more frequent in patients with thyroid disease. Here we present a case of thyroid ophthalmopathy and ocular myasthenia.

  18. Comparison between clinical, ultrasound, CT, MRI, and pathology findings in dogs presented for suspected thyroid carcinoma.

    Science.gov (United States)

    Taeymans, Olivier; Penninck, Dominique G; Peters, Rachel M

    2013-01-01

    This study compares clinical, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and pathology findings in 16 prospectively, and seven retrospectively recruited dogs presented for suspected thyroid carcinoma. Of these, 17 were confirmed thyroid carcinoma, while six were initially misdiagnosed. These included four carotid body tumors, one para-esophageal abscess, and one undifferentiated squamous cell carcinoma. Thyroid carcinomas occurred in older dogs without evidence of sex predilection, and were more often unilateral. All were large, heterogeneous, moderately to strongly vascularized, and most commonly contained areas of dystrophic mineralization and/or fluid accumulations. On MRI, thyroid carcinomas appeared hyperintense compared to surrounding musculature in all imaging sequences used, while on CT they had a lower attenuation value than normal thyroid gland tissue. Histologically confirmed tumor capsule disruption with invasion of the surrounding structures was most commonly detected with MRI. Palpation was not an accurate predictor of locally invasive vs. well-encapsulated masses. Computed tomography had the highest specificity (100%) and MRI had the highest sensitivity (93%) in diagnosing thyroid carcinoma, while ultrasound had considerably lower results. We conclude that ultrasound is adequate for use as a screening tool for dogs with suspected thyroid carcinoma, but recommend either CT or MRI for preoperative diagnosis and staging.

  19. 自身免疫性甲状腺疾病临床研究进展%The Clinical Research Progression of Autoimmune Thyroid Disease

    Institute of Scientific and Technical Information of China (English)

    张铮; 郑旭琴; 杨涛

    2016-01-01

    Autoimmune thyroid disease (AITD) are organ specific autoimmune disease mediated by a group of T cell - mediated, most commonly with Graves' disease (GD) and Hashimoto's thyroiditis (HT) , were characterized with hyperthyroidism and hypothyroidism. Statistics show that the global AITD prevalence rate is near 5%, those with the expression of anti thyroid antibody positive and asymptomatic subclinical AITD ratio will have a higher incidence rate, especially in women 30 to 40 years of age. The mechanism of inducing autoimmune thyroid disease is very complicated, and the interaction between genetic susceptibility and environmental factors is the key reason of AITD. In addition, the data show that AITD is associated with the occurrence of thyroid tumors, therefore, in time and accurate diagnosis and treatment is necessary. This article will make a brief introduction about the progress of AITD and the idea of inducing the immune tolerance of autoimmune disease.%自身免疫性甲状腺疾病(autoimmune thyroid disease,AITD)是一组T细胞介导器官特异性自身免疫病,临床上以Graves病(Graves'disease,GD)和桥本甲状腺炎(Hashimoto thyroiditis,HT)最为多见,分别以甲状腺功能亢进和甲状腺功能低下为特征。研究统计显示,全球AITD患病率接近5%,仅表现为抗甲状腺抗体阳性而无症状的亚临床AITD的比例会更高,尤其以30至40岁的女性多见。诱发自身免疫攻击甲状腺的机制很复杂,其中,遗传易感性和环境诱发因素是的相互作用认为是导致AITD发病的关键原因。另外,有数据显示, AITD与甲状腺肿瘤发生相关,因此,及时准确的诊治很有必要。本文将就AITD的临床进展及诱导自身免疫病的免疫耐受思路进行简要介绍。

  20. Regulatory B and T cell responses in patients with autoimmune thyroid disease and healthy controls

    DEFF Research Database (Denmark)

    Kristensen, Birte; Hegedüs, Laszlo

    2016-01-01

    frequencies of B10 cells. Accordingly, B10 cells may not be confined to one phenotype or subset of B cells. In the third paper, we studied the balance between IL-17-producing CD4+ T cells (Th17 cells) and IL-10-producing CD4+ T cells (Th10 cells) in healthy donors and patients with GD or HT. In HT patients......, we found increased proportions of naïve Th17 cells after stimulation with the thyroid self-antigen thyroid peroxidase (TPO) and the Escherichia coli lipopolysaccharide (E. coli LPS). The proportions of Th10 cells were similar in healthy donors and in HT patients after antigen-specific stimulation....... After TG stimulation, an increased Th17:Th10 ratio was found in HT patients within the naïve T cell compartment. Taken together, these data indicate that the thyroid self-antigens TG and TPO induced a skewed Th17:Th10 differentiation in HT patients. IL-6 and TGF-β have been reported to be important...

  1. Pediatric Autoimmune Hepatitis in a Patient Who Presented With Erythema Nodosum: A Case Report

    Directory of Open Access Journals (Sweden)

    Zohreh Kavehmanesh

    2012-01-01

    Full Text Available Background: Autoimmune hepatitis (AIH is a form of chronic hepatitis with unclear causative factors and is characterized by immunological and auto-immunological manifestations. Several extrahepatic manifestations, such as other autoimmune disorders, are associated with AIH. AIH with dermatological conditions as the initial manifestation is rare. We report the case of AIH in which erythema nodosum (EN was the first manifestation.Case Presentation: An 8-year-old girl with several persistent dermatological lesions was referred to our hospital several months ago. Her skin had nodular, painful, dry, and erythematous lesions, predominantly on the extensor areas of both the legs, with some erythematous patches on her face. Physical examination revealed that she had hepatosplenomegaly as well. Skin biopsy indicated EN. The results of the laboratory tests showed increased levels of several liver enzymes. The patient's International Autoimmune Hepatitis Group (IAIHG score was a definite indicator of AIH. The results of liver biopsy indicated AIH. Other causes of EN and abnormal liver function were ruled out. The only obvious cause of skin lesions was chronic inflammation due to an autoimmune response. The patient was treated for AIH, and her skin lesions along with other signs and symptoms resolved.Conclusions: AIH can present with protean clinical manifestations, and is thus associated with the risk of delayed diagnosis. Dermatological manifestations, including EN, could indicate a serious disease, and further investigation might be required. AIH should be considered as the possible diagnosis in such cases.

  2. Neurofibromatosis Type 1 Associated with Hashimoto’s Thyroiditis: Coincidence or Possible Link

    OpenAIRE

    Junaid Nabi

    2013-01-01

    Introduction. Hashimoto's thyroiditis is a common form of chronic autoimmune thyroid disease (AITD) and often coexists with other autoimmune diseases, but Hashimoto's thyroiditis associated with an autosomal dominant neurofibromatosis type 1 is exceedingly rare. Case Presentation. A 30-year-old Bengali woman presented to the OPD with complaints of aching pain and tingling sensation in her hands and feet. Physical examination revealed dysmorphic facies, nodular swelling in the neck, cafe-au-la...

  3. Aberrant Levels of Hematopoietic/Neuronal Growth and Differentiation Factors in Euthyroid Women at Risk for Autoimmune Thyroid Disease.

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    Elske T Massolt

    Full Text Available Subjects at risk for major mood disorders have a higher risk to develop autoimmune thyroid disease (AITD and vice-versa, implying a shared pathogenesis. In mood disorder patients, an abnormal profile of hematopoietic/neuronal growth factors is observed, suggesting that growth/differentiation abnormalities of these cell lineages may predispose to mood disorders. The first objective of our study was to investigate whether an aberrant profile of these hematopoietic/neuronal growth factors is also detectable in subjects at risk for AITD. A second objective was to study the inter relationship of these factors with previously determined and published growth factors/cytokines in the same subjects.We studied 64 TPO-Ab-negative females with at least 1 first- or second-degree relative with AITD, 32 of whom did and 32 who did not seroconvert to TPO-Ab positivity in 5-year follow-up. Subjects were compared with 32 healthy controls (HCs. We measured serum levels of brain-derived neurotrophic factor (BDNF, Stem Cell Factor (SCF, Insulin-like Growth Factor-Binding Protein 2 (IGFBP-2, Epidermal Growth Factor (EGF and IL-7 at baseline.BDNF was significantly lower (8.2 vs 18.9 ng/ml, P<0.001, while EGF (506.9 vs 307.6 pg/ml, P = 0.003 and IGFBP-2 (388.3 vs 188.5 ng/ml, P = 0.028 were significantly higher in relatives than in HCs. Relatives who seroconverted in the next 5 years had significantly higher levels of SCF than non-seroconverters (26.5 vs 16.7 pg/ml, P = 0.017. In a cluster analysis with the previously published growth factors/cytokines SCF clustered together with IL-1β, IL-6 and CCL-3, of which high levels also preceded seroconversion.Relatives of AITD patients show aberrant serum levels of 4 hematopoietic/neuronal growth factors similar to the aberrancies found in mood disorder patients, suggesting that shared growth and differentiation defects in both the hematopoietic and neuronal system may underlie thyroid autoimmunity and mood disorders. A

  4. The thyroxine-containing thyroglobulin peptide (aa 2549-2560) is a target epitope in iodide-accelerated spontaneous autoimmune thyroiditis.

    Science.gov (United States)

    Kolypetri, Panayota; Carayanniotis, Karen; Rahman, Shofiur; Georghiou, Paris E; Magafa, Vassiliki; Cordopatis, Paul; Carayanniotis, George

    2014-07-01

    Enhanced iodide ingestion is known to accelerate the incidence and severity of spontaneous autoimmune thyroiditis [iodide-accelerated spontaneous autoimmune thyroiditis (ISAT)] in NOD.H2(h4) mice. CD4+ cells are required for the development and maintenance of ISAT, but their target epitopes remain unknown. In this study, we show that the previously identified thyroglobulin (Tg) T cell epitope p2549-2560 containing thyroxine at position 2553 (T4p2553) induces thyroiditis as well as strong specific T and B cell responses in NOD.H2(h4) mice. In ISAT, activated CD4+ T cells specific for T4p2553 are detected before the disease onset in thyroid-draining cervical lymph nodes only in mice placed on an iodide-rich diet and not in age-matched controls. In addition, selective enrichment of CD4+ IFN-γ+ T4p2553-specific cells is observed among cervical lymph node cells and intrathyroidal lymphocytes. T4p2553 was equally detectable on dendritic cells obtained ex vivo from cervical lymph node cells of NaI-fed or control mice, suggesting that the iodide-rich diet contributes to the activation of autoreactive cells rather than the generation of the autoantigenic epitope. Furthermore, spontaneous T4p2553-specific IgG are not detectable within the strong Tg-specific autoantibody response. To our knowledge, these data identify for the first time a Tg T cell epitope as a spontaneous target in ISAT.

  5. Prevalence of autoantibodies and the risk of autoimmune thyroid disease in children with chronic hepatitis C virus infection treated with interferon-α

    Institute of Scientific and Technical Information of China (English)

    Stephan Gehring; Ulrike Kullmer; Sabine Koeppelmann; Patrick Gerner; Philip Wintermeyer; Stefan Wirth

    2006-01-01

    AIM: To evaluate the prevalence of autoantibodies in chronic hepatitis C virus (HCV)-infected children focusing on thyroid autoimmunity.METHODS: We investigated the prevalence of autoantibodies in 123 chronic HCV-infected children before,during and after monotherapy with interferon-alpha (TFN-α) or combined treatment with interferon-α or peginterferon-α and ribavirin. Besides antibodies against smooth muscle (SMA), nuclei (ANA), and liver/kidney microsomes (LKM), the incidence of antithyroid peroxidase antibodies as well as thyroid function parameters (TSH, FT3 and FT4) were determined.RESULTS: We found that 8% of children had autoantibodies before treatment. During treatment,18% of children were found positive for at least one autoantibody; 15.5% of children developed pathologic thyroid values during IFN-α treatment compared to only one child before therapy. Six children had to be substituted while developing laboratory signs of hypothyroidism.CONCLUSION: Our data indicate a strong correlation between interferon-α treatment and autoimmune phenomena, notably the emergence of thyroid antibodies. The fact that some children required hormone replacement underlines the need of close monitoring in particularly those who respond to therapy and have to be treated for more than 6 mo.

  6. Multiple SNPs in intron 41 of thyroglobulin gene are associated with autoimmune thyroid disease in the Japanese population.

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    Yoshiyuki Ban

    Full Text Available BACKGROUND: The etiology of the autoimmune thyroid diseases (AITDs, Graves' disease (GD and Hashimoto's thyroiditis (HT, is largely unknown. However, genetic susceptibility is believed to play a major role. Two whole genome scans from Japan and from the US identified a locus on chromosome 8q24 that showed evidence for linkage with AITD and HT. Recent studies have demonstrated an association between thyroglobulin (Tg polymorphisms and AITD in Caucasians, suggesting that Tg is a susceptibility gene on 8q24. OBJECTIVES: The objective of the study was to refine Tg association with AITD, by analyzing a panel of 25 SNPs across an extended 260 kb region of the Tg. METHODS: We studied 458 Japanese AITD patients (287 GD and 171 HT patients and 221 matched Japanese control subjects in association studies. Case-control association studies were performed using 25 Tg single nucleotide polymorphisms (SNPs chosen from a database of the Single Nucleotide Polymorphism Database (dbSNP. Haplotype analysis was undertaken using the computer program SNPAlyze version 7.0. PRINCIPAL FINDINGS AND CONCLUSIONS: In total, 5 SNPs revealed association with GD (P<0.05, with the strongest SNP associations at rs2256366 (P = 0.002 and rs2687836 (P = 0.0077, both located in intron 41 of the Tg gene. Because of the strong LD between these two strongest associated variants, we performed the haplotype analysis, and identified a major protective haplotype for GD (P = 0.001. These results suggested that the Tg gene is involved in susceptibility for GD and AITD in the Japanese.

  7. Auto-immune thyroid disease%自身免疫性甲状腺疾病

    Institute of Scientific and Technical Information of China (English)

    林汉华

    2003-01-01

    @@ 自身免疫性甲状腺病包括慢性淋巴细胞性甲状腺炎(chronic lymphocytic thyroiditis, CLT)和毒性弥漫性甲状腺肿(又称Graves病,GD),是造成小儿甲状腺肿大最常见的原因,其发病率有上升的趋势.近年来随着对该病认识的加深和诊断方法的进步,本病的正确诊断率有所提高.

  8. De Quervain thyroiditis in the course of H1N1 influenza infection

    OpenAIRE

    Michas, G.; Alevetsovitis, G; Andrikou, I; Tsimiklis, S; Vryonis, E.

    2014-01-01

    Background/aim: Viral infections have been frequently associated with subacute (De Quervain) thyroiditis and autoimmune thyroid diseases. In the present case report we document a rare case of De Quervain thyroiditis in the course of H1N1 influenza infection.

  9. Incidence rate of symptomatic painless thyroiditis presenting with thyrotoxicosis in Denmark as evaluated by consecutive thyroid scintigraphies

    DEFF Research Database (Denmark)

    Schwartz, Frederik; Bergmann, Natasha; Zerahn, Bo;

    2013-01-01

    Painless thyroiditis (PT) is a transient kind of thyrotoxicosis, with lack of uptake on a thyroid scintigraphy in a non-tender thyroid gland, elevated anti-TPO antibodies, no fever, no history of increased iodine intake, and a normal sedimentation rate. The prevalence of PT varies hugely in the l......Painless thyroiditis (PT) is a transient kind of thyrotoxicosis, with lack of uptake on a thyroid scintigraphy in a non-tender thyroid gland, elevated anti-TPO antibodies, no fever, no history of increased iodine intake, and a normal sedimentation rate. The prevalence of PT varies hugely...

  10. Ocorrência de doenças autoimunes tireoidianas em pacientes com doenças reumáticas Autoimmune thyroid disease in patients with rheumatic diseases

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    Teresa Cristina Martins Vicente Robazzi

    2012-06-01

    Full Text Available Anormalidades na função tireoidiana e presença de autoanticorpos da tireoide têm sido frequentemente descritas em pacientes com doenças reumatológicas autoimunes, como síndrome de Sjögren, artrite reumatoide, lúpus eritematoso sistêmico e esclerodermia. São limitados os dados sobre prevalência e características clínicas de tireoidite autoimune em outras doenças reumatológicas, tais como febre reumática e lúpus eritematoso sistêmico juvenil. Os autores revisaram as associações de doenças autoimunes endócrinas e reumáticas, avaliando as diversas faixas etárias e condições clínicas. O levantamento bibliográfico foi realizado por meio de busca por artigos científicos indexados em bancos de dados de ciências da saúde em geral, como Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS, Medline/PubMed e Scientific Eletronic Library Online (SciELO. Utilizaram-se os seguintes descritores: "rheumatic autoimmune diseases and autoimmune thyroid diseases", "thyroid disorders and rheumatic diseases", "thyroiditis and rheumatic diseases", "autoimmune diseases and thyroid", e "pediatric rheumatic diseases and autoimmune thyroid diseases". Este estudo mostrou que, apesar de resultados contraditórios na literatura, há maior prevalência da associação entre doenças autoimunes da tireoide e doenças reumáticas, destacando-se a possibilidade de mecanismos patogênicos comuns entre as doenças.Thyroid function abnormalities and thyroid autoantibodies have been frequently described in patients with rheumatologic autoimmune diseases, such as Sjögren's syndrome, rheumatoid arthritis, systemic lupus erythematosus and scleroderma. Limited data are available regarding the prevalence and clinical characteristics of autoimmune thyroiditis in other rheumatologic disorders, such as rheumatic fever and juvenile systemic lupus erythematosus. The authors review the association of endocrine autoimmune and rheumatic

  11. Lymphocytic profiling in thyroid cancer provides clues for failure of tumor immunity.

    Science.gov (United States)

    Imam, Shahnawaz; Paparodis, Rodis; Sharma, Deepak; Jaume, Juan Carlos

    2014-06-01

    Thyroid cancers are usually surrounded by a significant number of immune-reactive cells. Tumor-associated lymphocytes as well as background lymphocytic thyroiditis are frequently mentioned in pathology reports of patients who have undergone surgery for thyroid cancer. The nature of this lymphocytic reaction is not well understood. The fact that cancer can survive in this adverse microenvironment is indicative of immune regulation. We characterized the lymphocytic infiltration that accompanies thyroid cancer and compared it with that present in thyroid autoimmunity. We found that double-negative (DN) T cells were significantly more abundant in thyroid cancer than in thyroid autoimmunity. Although FOXP3(+) regulatory T cells were also present, DN T cells were the dominant cell type, associated with thyroid cancer. Furthermore, upon stimulation, the DN T cells associated with cancer remained unchanged, while the few (20%). CD25 expression on DN T cells remained unchanged after stimulation, which indicates that the increase in the absolute number of DN T cells in thyroid autoimmunity was at the expense of inactivation of single-positive T cells. We concluded that in the setting of thyroid cancer, DN T cells appear to suppress tumor immunity. In contrast, in thyroid autoimmunity, DN T cells were barely present and only increased at the expense of inactivated, single-positive T cells upon induction. Together, these findings indicate that thyroid cancer-associated DN T cells might regulate proliferation and effector function of T cells and thereby contribute to tumor tolerance and active avoidance of tumor immunity.

  12. Papillary thyroid microcarcinoma in Graves′ disease presenting as a cystic neck mass

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    Milind Patil

    2015-01-01

    Full Text Available The presentation of papillary thyroid microcarcinoma (PTMC as a solitary cystic neck mass is uncommon. Additionally, its association with Graves′ disease is very rare. We report a case of occult PTMC, who presented with a cystic neck mass in the background of Graves′ disease without any goiter. Imaging like ultrasound of neck, single photon emission computed tomography-CT (SPECT-CT, and technetium scan failed to detect any lesion in the thyroid, which was picked up only by the contrast-enhanced computed tomography (CECT of neck. The patient underwent total thyroidectomy with right modified lymph node dissection. Our case highlights the presentation of metastatic PTMC as a differential diagnosis of a cystic neck mass even in a patient with Graves′ disease without any thyroid enlargement.

  13. Thyroid carcinoma presenting as a dural metastasis mimicking a meningioma: A case report

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    El Mehdi Tazi

    2011-01-01

    Full Text Available Context: Follicular thyroid cancer rarely manifests itself as a distant metastatic lesion. Case Report: We report a case of a 41-year old man presented with a solid mass located in the left temporo-occipital region. The 3D computed tomography showed a large solid mass with high vascularity, skull erosion and supra-infratentorial epidural mass effect. After magnetic resonance imaging (MRI a suspect diagnosis of meningioma was made. The patient underwent surgery where a soft mass with transverse sinus invasion was encountered; the tumour was successfully resected employing microsurgical techniques. Histological examination revealed a thyroid follicular neoplasm with positive staining for follicular carcinoma in immunohistochemical analysis. Postoperatively levels of thyroid hormones were normal. Treatment was planned for the thyroid gland, patient receiving 6 courses of chemotherapy including paclitaxel. Conclusions: The present case emphasizes that although they are uncommon, dural metastasis can be mistaken for meningiomas. The definitive diagnosis of a meningioma should be established only after the histopathological analysis. Thyroid follicular carcinoma should be included in the differential diagnosis in cases of extrinsic tumoral lesions.

  14. PREVALENCE OF AUTOIMMUNE THYROIDITIS AND THYROID DYSFUNCTION IN HEALTHY ADULT MEXICANS WITH A SLIGHTLY EXCESSIVE IODINE INTAKE.

    Science.gov (United States)

    Flores-Rebollar, Armando; Moreno-Castañeda, Lidia; Vega-Servín, Norman S; López-Carrasco, Guadalupe; Ruiz-Juvera, Aída

    2015-08-01

    Objetivo: el objetivo del presente estudio fue evaluar la prevalencia de tiroiditis autoinmune y disfunción tiroidea en individuos sanos sin enfermedad tiroidea conocida, de un área urbana de la ciudad de México. Material y métodos: el estudio se realizó en voluntarios sin enfermedad tiroidea conocida. Se reclutaron 427 individuos entre personal médico y administrativo del hospital. A todos se les realizó ultrasonido (US) tiroideo, TSH, T4 libre (FT4), T3 total (TT3), anticuerpos anti-peroxidasa tiroidea (TPOAb) y anti tiroglobulina (TgAb). Dentro de la evaluación por US se incluyó la hipoecogenicidad y el volumen tiroideo. También se midió la excreción urinaria de yodo (UI). Resultados: la frecuencia de tiroiditis autoinmune fue de 8,4% (36/427), las mujeres fueron más afectadas que los hombres (11,6 vs. 4,3%, respectivamente, P = 0,008), cuando se sumó la tiroides atrófica, esta frecuencia se elevó al 15,7% (67/427) de los estudiados. El hipotiroidismo clínico fue detectado en el 1,2% (5/427) y el subclínico en el 5,6%. El hipertiroidismo clínico solo se observó en el 0,5% (2/427) y el subclínico en el 1,9%. El bocio se identificó en el 5,9% (25/427) de los voluntarios. La mediana de la UI fue de 267 μg/L, RIQ (161,3 – 482,5). Conclusiones: a pesar de las limitaciones de nuestro estudio, es clara la frecuencia incrementada de tiroiditis autoinmune en la población estudiada. Son necesarios más estudios que definan tanto la prevalencia de enfermedad tiroidea autoinmune como el estatus nutricional de yodo actual en nuestro país.

  15. Achalasia and thyroid disease

    Institute of Scientific and Technical Information of China (English)

    Mohammad Hassan Emami; Mostafa Raisi; Jaleh Amini; Hamed Daghaghzadeh

    2007-01-01

    AIM: To investigate some possible etiologies of achalasia by screening patients with achalasia for some autoimmune diseases such as thyroid disease.METHODS: We examined 30 known cases of achalasia (20 females, 10 males). Their age ranged 15-70 years.All of them were referred to our institute for treatment.Their sera were evaluated to detect some possible associations with rheumatoid disease, thyroid disease,inflammatory process, anemia, etc.RESULTS: Seven out of 30 patients (23%) had thyroid disease including four patients with hypothyroidism (13.3%), two patients with hyperthyroidism (6.6%),and one had only thyroid nodule but was in euthyroid state (3.3%). Two of these hypothyroid patients had no related clinical symptoms (subclinical) and two had clinical manifestations of hypothyroidism. There were no correlations between the intensity of thyroid diseases and the severity of achalasia symptoms.CONCLUSION: The etiology of achalasia is unknown although autoimmunity has been implicated and is supported by several studies. Thyroid disease presents concomitantly with achalasia in about one fourth of our patients who may have a common etiology.

  16. A Case Report Demonstrating How the Clinical Presentation of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Can Mimic Benign Riedel’s Thyroiditis

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    Jennifer Walsh

    2015-01-01

    Full Text Available A 44-year-old female presented with a two-month history of a neck mass, sore throat, hoarseness, and intermittent dysphagia. Examination revealed a “woody” hard swelling arising from the right lobe of the thyroid. Clinically this was felt to be classical Riedel’s thyroiditis (RT. Thyroid ultrasound showed a diffusely enlarged, low echogenicity thyroid with a multinodular goitre. An abnormal nodule extending across the isthmus was noted. Following a nondiagnostic fine needle aspiration, an open core biopsy was performed. This showed dense sclerotic fibrosis punctuated by nodular mononuclear inflammatory cells, which obscured follicular epithelial cells consistent with a fibrosing thyroiditis (Riedel’s thyroiditis. A biopsy of pretracheal lymph nodes showed a sclerotic process throughout the lymph nodes and nests of epithelium bands with squamous differentiation obscured by a fibrous process. These findings raised the differential diagnosis of diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC with metastasis to lymph nodes. A total thyroidectomy and pretracheal lymph node dissection were performed. The final histological diagnosis was DSV-PTC. When managing a patient with presumed RT it is important to consider malignancy in the differential. DSV-PTC is one of the more aggressive forms of thyroid cancer but with early diagnosis and appropriate treatment patients may have excellent outcomes.

  17. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish General Suburban Population Study

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    Anne-Dorthe Feldthusen

    2015-01-01

    Full Text Available Introduction. The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb, and mild (subclinical hypothyroidism in women from The Danish General Suburban Population Study (GESUS on the number of children born, the number of pregnancies, and the number of spontaneous abortions. Methods. Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. Results. 6.7% had mild (subclinical hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism TPOAb was significantly elevated and age at first child was older compared to controls. TSH and TPOAb were negatively linearly associated with the number of children born and the number of pregnancies in the full cohort in age-adjusted and multiadjusted models. TSH or TPOAb was not associated with spontaneous abortions. Mild (subclinical hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous abortions. Conclusion. Impaired fertility is associated with TSH, TPOAb, and mild (subclinical hypothyroidism in a Danish population of women.

  18. Diffusion and ADC-map images detect ongoing demyelination on subcortical white matter in an adult metachromatic leukodystrophy patient with autoimmune Hashimoto thyroiditis.

    Science.gov (United States)

    Miura, Akiko; Kumabe, Yuri; Kimura, En; Yamashita, Satoshi; Ueda, Akihiko; Hirano, Teruyuki; Uchino, Makoto

    2010-12-01

    Adult-onset metachromatic leukodystrophy (MLD) often shows schizophrenia- or encephalopathy-like symptoms at an early stage, such as behavioural abnormalities, cognitive impairment, mood disorders and hallucinations. The authors report the case of an adult woman with MLD who had been given antipsychotic medication for schizophrenia. In the differential diagnosis, screening of auto-antibodies was important for ruling out other encephalopathies as she had a euthyroid Hashimoto thyroiditis. Diagnosis was based the results of MRI, nerve conduction velocity, sensory evoked potential, motor evoked potential, lysosomal enzyme activity and gene analysis studies. Brain MRI showed diffuse demyelination spreading from the deep white matter to subcortical area as high signals at the edges of these lesions in diffusion and apparent diffusion coefficient-map images with the U-fibres conserved. The authors diagnosed adult-onset MLD coexisting with euthyroid autoimmune Hashimoto thyroiditis.

  19. Research progress in autoimmune thyroid disease dependent nephronia%自身免疫性甲状腺病相关肾病的研究进展

    Institute of Scientific and Technical Information of China (English)

    楚能武; 吴庆彬; 章秋

    2009-01-01

    自身免疫性甲状腺病(autoimmune thyroid disease,AITD)包括Graves病、桥本氏甲状腺炎(Hashimoto's thyroiditis)和原发性甲状腺功能减退症(甲减).1976年,O'Regan S报道一例Hashimoto's thyroiditis患者出现蛋白尿、肾病综合征,首次提出AITD相关性肾病[1].其临床表现复杂易误诊,最终可致肾功能衰竭.目前报道病例数较少,下面就近年来逐渐受到关注的AITD相关肾病的临床表现、发病机制及诊断治疗作一综述.

  20. Prevalence of thyroid autoimmunity in patients with pemphigus vulgaris Prevalencia de autoinmunidad tiroidea en pacientes con pénfigo vulgar

    Directory of Open Access Journals (Sweden)

    Fabián Pitoia

    2005-08-01

    Full Text Available Among bullous diseases, pemphigus vulgaris (PV is a classical variety of this type of skin disorders. To establish the real prevalence of thyroid abnormalities in such a disease, a prospective study was developed. For this reason, thyroid evaluation was performed in 15 consecutive patients who attended the Dermatology Clinic for PV and in a group of 15 healthy volunteers (Control Group matched by age and gender. Thyroid function was evaluated by measuring T3, T4 and TSH. The presence or absence of goiter was searched by palpation, while thyroid autoimmunity was investigated through the assay of thyroperoxidase antibodies (TPO-Ab. In each group there were 9 women and 6 men, aging 25-65 years (mean = 48.3 y in the PV Group, and 25-69 years (mean = 45.4 y in the Control Group. It was found that 7 patients (46.6% of the PV Group and 1 subject (6.7% of the Control Group (p El pénfigo vulgar (PV es una enfermedad ampollar clásica de etiología autoinmune que se caracteriza por la presencia de lesiones intraepiteliales. Para establecer la prevalencia de anormalidades tiroideas en el PV, realizamos un estudio prospectivo en 15 pacientes consecutivos que consultaron a la División Dermatología debido a PV y en un grupo de 15 voluntarios sanos (Grupo Control. La función tiroidea se evaluó a través de la medición de T3, T4 y TSH y la presencia de bocio se determinó por medio de la palpación tiroidea. La autoinmunidad se investigó usando un ensayo IRMA para la medición de anticuerpos antitiroperoxidasa (ATPO. En cada grupo había 9 mujeres y 6 hombres que fueron apareados por edad y sexo, con edades comprendidas entre 25 y 65 años (promedio 48.2 años en el grupo PV, y entre 25 y 69 años (promedio 45.4 años en el grupo control. Se encontró que 7 pacientes (46.6% del grupo PV y uno (6.6% del grupo control presentaron alteraciones tiroideas, (p<0.015. La presencia de ATPO positivos se observó en 6 pacientes con PV y en un voluntario del grupo

  1. ANA-Negative Presentation of SLE in Man with Severe Autoimmune Neutropenia

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    Melissa Zhao

    2016-01-01

    Full Text Available Background. Systemic lupus erythematosus (SLE is a chronic, inflammatory, connective tissue disease that commonly affects the joints and a variety of organs due to an overactivation of the body’s immune system. There is wide heterogeneity in presentation of SLE patients, including lung, central nervous system, skin, kidney, and hematologic manifestations. Case Presentation. We report a case of atypical manifestation of SLE in a 53-year-old man who presented with neutropenic fever. Physical findings of interest included oral ulcers on the lower lip, a malar-like rash across the bridge of the nose, and a discoid-like rash on extensor surfaces of the elbows and knees. Labs include ANC <100, weakly positive anti-dsDNA, negative ANA, ferritin 1237 ng/mL, low C3/C4, and positive direct Coombs’ test. A thorough workup for infection and hematologic malignancy was negative. Two days after initiation of therapy with 25 mg IV solumedrol twice a day, the patient’s daily fevers resolved. ANC drastically improved to 2000 after two weeks of steroid treatment. He was later found to have a high titer of anti-neutrophil antibodies. Discussion. Autoimmune leukopenia is a common presentation in SLE, occurring in 50–60% of patients. Severe autoimmune neutropenia is uncommon and may correlate with high anti-neutrophil antibody activity despite a negative ANA. As neutropenia is usually mild, there are currently no guidelines for therapy. For our patient, we started him on low dose IV solumedrol and found that he responded drastically to treatment. Given strongly positive nonspecific anti-neutrophil antibodies in the setting of a negative ANA noted in our patient, it is likely that there are other currently unknown antibodies associated with SLE which may correlate strongly with autoimmune neutropenia.

  2. ANA-Negative Presentation of SLE in Man with Severe Autoimmune Neutropenia.

    Science.gov (United States)

    Zhao, Melissa

    2016-01-01

    Background. Systemic lupus erythematosus (SLE) is a chronic, inflammatory, connective tissue disease that commonly affects the joints and a variety of organs due to an overactivation of the body's immune system. There is wide heterogeneity in presentation of SLE patients, including lung, central nervous system, skin, kidney, and hematologic manifestations. Case Presentation. We report a case of atypical manifestation of SLE in a 53-year-old man who presented with neutropenic fever. Physical findings of interest included oral ulcers on the lower lip, a malar-like rash across the bridge of the nose, and a discoid-like rash on extensor surfaces of the elbows and knees. Labs include ANC ANA, ferritin 1237 ng/mL, low C3/C4, and positive direct Coombs' test. A thorough workup for infection and hematologic malignancy was negative. Two days after initiation of therapy with 25 mg IV solumedrol twice a day, the patient's daily fevers resolved. ANC drastically improved to 2000 after two weeks of steroid treatment. He was later found to have a high titer of anti-neutrophil antibodies. Discussion. Autoimmune leukopenia is a common presentation in SLE, occurring in 50-60% of patients. Severe autoimmune neutropenia is uncommon and may correlate with high anti-neutrophil antibody activity despite a negative ANA. As neutropenia is usually mild, there are currently no guidelines for therapy. For our patient, we started him on low dose IV solumedrol and found that he responded drastically to treatment. Given strongly positive nonspecific anti-neutrophil antibodies in the setting of a negative ANA noted in our patient, it is likely that there are other currently unknown antibodies associated with SLE which may correlate strongly with autoimmune neutropenia.

  3. Autoimmune oophoritis: A rarely encountered ovarian lesion

    Directory of Open Access Journals (Sweden)

    Sunitha Jacob

    2015-01-01

    Full Text Available Autoimmune oophoritis is a rare disorder causing ovarian failure clinically characterized by amenorrhea and infertility. It often occurs in a setting of autoimmune polyendocrine syndromes. A 38-year-old female presented with a 3 years history of secondary amenorrhea. She was on treatment for Hashimoto′s thyroiditis and Addison′s disease. The ovaries were cystic and histologically featured by folliculotropic lymphoplasmacytic inflammatory infiltrate concentrated in the theca interna layer of developing follicles, but sparing the primordial follicles.

  4. Atypical presentation of autoimmune lymphoproliferative syndrome due to CASP10 mutation.

    Science.gov (United States)

    Tripodi, Serena Ilaria; Mazza, Cinzia; Moratto, Daniele; Ramenghi, Ugo; Caorsi, Roberta; Gattorno, Marco; Badolato, Raffaele

    2016-09-01

    Herein we describe the case of a 8-years-old boy with diagnosis of atypical autoimmune lymphoproliferative syndrome (ALPS), carrying heterozygous mutation of CASP10 gene (I406L). He presented with multiple non-invasive infections of the skin, that were associated to chronic non-malignant non-infectious lymphadenopathy, failure to thrive, weakness, arthralgia, relapsing oral aftosis, and expansion of TCRαβ(+) CD4(-)/CD8(-) T cells. This observation suggests that cutaneous infections can be observed in ALPS patients carrying CASP10 mutations.

  5. Occult Langerhans Cell Histiocytosis Presenting with Papillary Thyroid Carcinoma, a Thickened Pituitary Stalk and Diabetes Insipidus

    Science.gov (United States)

    2016-01-01

    Etiologies of a thickened stalk include inflammatory, neoplastic, and idiopathic origins, and the underlying diagnosis may remain occult. We report a patient with a thickened pituitary stalk (TPS) and papillary thyroid carcinoma (PTC) whose diagnosis remained obscure until a skin lesion appeared. The patient presented with PTC, status postthyroidectomy, and I131 therapy. PTC molecular testing revealed BRAF mutant (V600E, GTC>GAG). She had a 5-year history of polyuria/polydipsia. Overnight dehydration study confirmed diabetes insipidus (DI). MRI revealed TPS with loss of the posterior pituitary bright spot. Evaluation showed hypogonadotropic hypogonadism and low IGF-1. Chest X-ray and ACE levels were normal. Radiographs to evaluate for extrapituitary sites of Langerhans Cell Histiocytosis (LCH) were unremarkable. Germinoma studies were negative: normal serum and CSF beta-hCG, alpha-fetoprotein, and CEA. Three years later, the patient developed vulvar labial lesions followed by inguinal region skin lesions, biopsy of which revealed LCH. Reanalysis of thyroid pathology was consistent with concurrent LCH, PTC, and Hashimoto's thyroiditis within the thyroid. This case illustrates that one must be vigilant for extrapituitary manifestations of systemic diseases to diagnose the etiology of TPS. An activating mutation of the protooncogene BRAF is a potential unifying etiology of both PTC and LCH. PMID:27656301

  6. Sydenham chorea and Hashimoto thyroiditis: an unusual association.

    Science.gov (United States)

    Yildiz, Ozlem Kayim; Gokcay, Ahmet; Gokcay, Figen; Karasoy, Hatice

    2010-06-01

    Sydenham chorea is an immune-mediated neuropsychiatric disorder associated with group A beta-hemolytic streptococci infection. The authors present a 12-year-old female patient with Sydenham chorea and Hashimoto thyroiditis. Although Hashimoto thyroiditis has been associated with other autoimmune disorders, the association of Sydenham chorea and Hashimoto thyroiditis has not been previously reported. Immunological processes are suggested to be implicated in the pathogenesis of this association; however, the exact mechanism remains unclear.

  7. Hypopituitarism and AutoimmuneThyroiditis Following Snake Bite: An Unusual Clinical Scenario.

    Science.gov (United States)

    Shetty, Sahana; Abi, Manesh S; Hickson, Ravali; David, Thambu; Rajaratnam, Simon

    2014-11-01

    Snake venom can cause local tissue damage and lead to coagulopathy, shock, neurotoxicity and acute kidney injury. Hypopituitarism is a rare complication following snake bite. It has been described following Russell's viper bite from Burma and South India. Herein we describe a patient who presented with severe thyrotoxicosis and partial hypopituitarism following snake bite.

  8. Lymphocytic adrenal medullitis and lymphocytic thyroiditis in a laboratory beagle dog.

    Science.gov (United States)

    Doi, Takuya; Tomonari, Yuki; Kawasako, Kazufumi; Yamada, Naoaki; Tsuchitani, Minoru

    2017-02-04

    Lymphocytic adrenal medullitis characterized by inflammation and atrophy in the medulla of the bilateral adrenal glands was observed in an 18-month-old male laboratory beagle dog. It might be that the present lymphocytic adrenal medullitis is an autoimmune-mediated disease as the histological characteristics are consistent with an autoimmune pathogenesis. However, the actual cause remains unclear as the existence of serum autoantibodies against the adrenal medulla could not be confirmed. Although this dog also contracted lymphocytic thyroiditis along with serum thyroglobulin autoantibodies, indicating that the thyroiditis occurred with an autoimmune basis; the relation between the adrenal medullitis and thyroiditis is unknown.

  9. 自身免疫性甲状腺炎对妊娠结局的影响%Effects of autoimmune thyroiditis on pregnant outcome

    Institute of Scientific and Technical Information of China (English)

    张道文; 徐书杭; 刘超; 蔡可英

    2013-01-01

    自身免疫性甲状腺炎(AIT)的发病受遗传、环境等多重因素影响,其在育龄期女性中的患病率颇高,可增加孕早期流产、早产、死胎、辅助生殖技术(ART)时流产等不良妊娠结局及低体重儿的患病率,其可能与免疫异常、甲状腺功能紊乱以及孕妇高龄等因素有关.其治疗措施主要包括免疫调节、甲状腺功能干预,二者效果如何仍待进一步研究.%A mixture of genetic and environmental factors act in the cause of autoimmunity thyroiditis(AIT),and women of reproductive age have a high morbidity of it.AIT may increase the incidence of abortion in first trimester,premature birth,stillbirth,abortion of assisted reproductive technology and low birth weight infants.Immune disorder,thyroid function disorder,aging might be associated with the poor pregnant outcome.Therefore,immune regulation,thyroid function intervention can be used to deal with it.However,more research about the effectiveness is still needed.

  10. Relationship between Adult ̄onset Latent Autoimmune Diabetes and Thyroid Autoimmunity%成人隐匿性自身免疫糖尿病与甲状腺自身免疫的关系

    Institute of Scientific and Technical Information of China (English)

    王筱菁; 朱翠颜

    2014-01-01

    Objective To discusses the relationship between adult-onset latent autoimmune dia-betes (LADA)and thyroid autoimmunity. Methods 300 cases of diabetic patients including 94 cases of LADA patients, 100 T1DM patients, 106 T2DM patients, were compared with 100 cases of healthy people. They are detected thyroglobulin antibody (TG ̄Ab) and thyroid peroxidase anti-body detection (TPO ̄Ab), at the same time patients with diabetes accepted glutamic acid decar-boxylase (GAD ̄Ab) detection, compared the differences of test. Results (1)The positive detection rate of LADA group was higher than normal control group (P0.05). (2)For LADA patients, ab-normal thyroid function rate in patients with thyroid antibody detection positive rate was higher than the negative antibody detection, there was no significant difference between two groups (P>0.05).Conclusion By thyroid antibody detection, the risk of thyroid dysfunction in patients is big-ger, it's easy to merge their own immune thyroid disorders.%目的:对成人隐匿性自身免疫糖尿病(LADA)与甲状腺自身免疫之间的关系进行探讨。方法选取在我院就诊的300例糖尿病患者,其中包括94例LADA患者,100例1型糖尿病(T1DM)患者,106例2型糖尿病(T2DM)患者,并与100例健康人群相对照,对健康人群与患病人群均进行甲状腺球蛋白抗体(TG ̄Ab)及甲状腺过氧化物酶抗体检测(TPO ̄Ab)检测,糖尿病患者还需进行谷氨酸脱羧酶检测(GAD ̄Ab),比较检查结果的差异性。结果(1)LADA组的阳性检出率均较正常对照组高(P<0.05),同时与T2DM组相比,LADA组与T1DM组的TPO-Ab检出率更高(P<0.05),而LADA组与T1DM组的检出率之间无显著性差异(P>0.05)。(2)对于LADA患者,甲状腺抗体检测阳性的患者其甲状腺功能异常发生率高于抗体检测阴性者,两组之间无显著性差异(P>0.05)。结论通过甲状腺抗体检测,发现LADA患者的

  11. A novel human STAT3 mutation presents with autoimmunity involving Th17 hyperactivation

    NARCIS (Netherlands)

    Wienke, Judith; Janssen, Willemijn; Scholman, Rianne; Spits, Hilde; Gijn, Marielle van; Boes, Marianne; van Montfrans, Joris; Moes, Nicolette; de Roock, Sytze

    2015-01-01

    Mutations in STAT3 have recently been shown to cause autoimmune diseases through increased lymphoproliferation. We describe a novel Pro471Arg STAT3 mutation in a patient with multiple autoimmune diseases, causing hyperactivation of the Th17 pathway. We show that IL-17 production by primary T cells w

  12. [Coexistence of autoimmune polyglandular syndrome type 3 with diabetes insipidus].

    Science.gov (United States)

    Krysiak, Robert; Okopień, Bogusław

    2015-01-01

    Autoimmune polyglandular syndromes are conditions characterized by the combination of two or more organ-specific disorders. The underestimation oftheir real frequency probable results from physicians' inadequate knowledge of these clinical entities and sometimes their atypical clinical presentation. Because they comprise a wide spectrum of autoimmune disorders, autoimmune polyglandular syndromes are divided into four types, among which type-3 is the most common one. In this article, we report the case of a young female, initially diagnosed with diabetes mellitus who several years later developed full-blown autoimmune polyglandular syndrome type 3 consisting of autoimmune thyroid disorder and latent autoimmune diabetes in adults.The discussed case suggests that in selected patients diabetes insipidus may coexist with autoimmune endocrinopathies and nonendocrine autoimmunopathies, as well as that in some patients idiopathic diabetes insipidus may be secondary to lymphocytic infiltration and destruction of the hypothalamic supraoptic and paraventricular nuclei and/or the supraoptic-hypophyseal tract

  13. The effect of Alfacalcidol has on thyroid autoimmunity state%阿法骨化醇对甲状腺自身免疫状态的影响

    Institute of Scientific and Technical Information of China (English)

    王静霞; 刘秀坤; 李庆妍

    2015-01-01

    目的:探讨补充阿法骨化醇对甲状腺自身免疫状态的影响。方法选取2013年6月-2015年3月就诊的未经治疗的甲状腺自身免疫患者[血清抗甲状腺过氧化物酶抗体( TPOAb)﹥34μIU/ ml,即单纯 TPOAb 阳性],根据 TPOAb 水平分为 TPOAb ﹤500μIU/ ml 组、TPOAb 500~1000μIU/ ml 组及 TPOAb ﹥1000μIU/ ml 组,每组再依据阿法骨化醇给药剂量分为0.5μg 组和1.0μg 组,每3个月测定1次患者的甲状腺功能水平(TSH、FT3、FT4)和 TPOAb水平,共12个月。结果阿法骨化醇可以降低 TPOAb 水平,且0.5μg 组和1.0μg 组相比,TPOAb 水平下降例数无统计学差异(P ﹥0.05);3个不同 TPOAb 水平组相比,TPOAb 水平下降例数差异无统计学意义(P ﹥0.05)。结论自身免疫性甲状腺疾病(AITD)补充阿法骨化醇可能有助于降低血清甲状腺自身抗体 TPOAb 水平,抑制甲状腺自身免疫反应的作用。%Objective Investigate the effect of Alfacalcidol has on Thyroid Autoimmunity State. Methods Select un-treated patients with autoimmune thyroid disease in hospital from July,2013 to March,2015(TPOAb ﹥ 34μIU/ ml,ie. purely TPOAb positive). Divide the sample TPOAb into tthree groups:TPOAb ﹤ 500μIU/ ml、TPOAb500 ~ 1 000μIU/ ml and TPOAb ﹥ 1 000μIU/ ml. Each group taking Alfacalcidol capsules 0. 5μg/ group and1. 0μg/ group for 12 months,then detecting TPOAb、FT3、FT4 levels in their serum. Results Alfacalcidol lowers TPOAb,with no significant differences between 0. 5μg/group and1. 0μg/ group(P ﹥ 0. 05).In addition,in TPOAb ﹤ 500 μIU/ m group 、TPOAb500 ~ 1 000μIU/ ml group and TPO-Ab ﹥ 1 000 group,TPOAb in patients who take Alfacalcidol goes down with no significant differences in decreasing ratio(P ﹥0. 05). Conclusion The supplement of Alfacalcidol in autoimmune thyroid disease patients probably may help to reduce thy-roid autoantibodies and inhibit the thyroid autoimmune response.

  14. Tiroiditis autoinmune inducida por interferón en pacientes con infección por virus de la hepatitis C. Interferon-induced autoimmune thyroiditis in a patient with hepatitis C virus infection

    Directory of Open Access Journals (Sweden)

    José L. Pinto

    2011-06-01

    Full Text Available Se reporta el caso de un varón de 43 años de edad, sin antecedentes patológicos de importancia, que acudió por elevación asintomática de la alanino aminotransferasa (ALT. El paciente negó ser bebedor crónico de alcohol. Se hizo el diagnóstico serológico de infección activa por hepatitis C y la biopsia de hígado reveló inflamación crónica activa. Con estos resultados, se inició tratamiento con interferón-alfa y ribavirina. Durante el tratamiento de 48 semanas, el paciente presentó anticuerpos antitiroideos positivos con variaciones en sus niveles de tirotropina (TSH y hormonas tiroideas. En el seguimiento postratamiento, el paciente continuó con hipertiroidismo por enfermedad de Graves. La tiroiditis autoinmune es una complicación frecuente del uso de interferón en pacientes con hepatitis C. En algunos casos se presenta como hipertiroidismo por enfermedad de Graves. Se debe evaluar la función tiroidea y los anticuerpos antitiroideos antes y durante el tratamiento con interferón.A 43 year old man presented with asymptomatic elevation of alanine aminotransferase (ALT and no relevant past history. The patient denied being a chronic alcohol drinker. Work-up revealed an active hepatitis C, and liver biopsy showed active inflammation. Treatment was started with interferon-alfa and ribavirin. During the 48 weeks of treatment, the patient developed positive thyroid antibodies with varying level of thyrotropin (TSH and thyroid hormones. At follow-up after treatment, the patient continued with hyperthyroidism due to Graves’ disease. Autoimmune thyroiditis is a common complication of using interferon in patients with hepatitis C. In some cases, it is presented as hyperthyroidism because of Graves’ disease. Thyroid function and thyroid antibodies should be evaluated before and during treatment with interferon.

  15. 成人斑秃与甲状腺自身免疫的关系分析%Association analysis between alopecia areata and thyroid autoimmunity in adults

    Institute of Scientific and Technical Information of China (English)

    杨竹生; 杨秀敏; 金星姬; 李娅娣; 周晓谦

    2015-01-01

    目的 评估成人斑秃患者甲状腺功能异常及甲状腺自身抗体的发生率,分析成人斑秃与甲状腺自身免疫的关系.方法 按照预先设计的调查表收集斑秃患者人口学信息、病史、斑秃一级亲属家族史,并检测甲状腺功能和甲状腺过氧化物酶抗体(TPO-Ab).结果 共有209例患者入选,6.7%的患者伴发甲状腺疾病,20.6%的患者TPO-Ab阳性.与TPO-Ab阴性的患者比较,TPO-Ab阳性的患者斑秃首次发病年龄<18岁(P=0.025)、发生全秃和(或)普秃(AT/AU)的概率更大(P=0.006)、合并甲状腺疾病的概率更大(P=0.002)、有更多的一级直系亲属成员患有斑秃(P=0.001).结论 斑秃患者TPO-Ab阳性率较高,即使无甲状腺受累的临床表现,也需对斑秃患者进行甲状腺功能及甲状腺自身抗体检测.%Objective To estimate the prevalence of thyroid dysfunction and thyroid autoantibodies in adults with alopecia areata (AA), and to analyze the relationship between alopecia areata (AA) and thyroid autoimmunity in adults.Methods A predesigned questionnaire was used to collect data on demographic information, medical history,and family history of AA in first-degree relatives from patients with AA.Thyroid function was evaluated, and anti-thyroid peroxidase antibody (TPO-Ab) was screened in all the patieuts.Statistical analysis was carried out by the chi-square test and Fisher's exact test.Results Totally, 209 patients with AA were enrolled.Of these patients, 6.7% were complicated by thyroid diseases, 20.6% were positive for TPO-Ab.Compared with the patients without TPO-Ab, those with TPO-Ab showed a significant increase in the proportion of patients with early-onset (< 18 years) AA (x2 =5.589, P =0.025),prevalence rate of alopecia totalis/alopecia universalis (x2 =9.990, P=0.006) and thyroid diseases (x2 =12.279, P =0.002), and incidence rate of AA in first-degree relatives (x2 =14.426, P =0.001).Conclusions The positive rate of TPO-Ab is

  16. Expression of the RET/PTC fusion gene as a marker for papillary carcinoma in Hashimoto's thyroiditis

    DEFF Research Database (Denmark)

    Wirtschafter, A; Schmidt, R; Rosen, D

    1997-01-01

    -polymerase chain reaction (RT-PCR) assay, we found messenger RNA (mRNA) expression for the RET/PTC1 and RET/PTC3 oncogenes in 95% of the Hashimoto's patients studied. All Hashimoto's patients presenting without histopathologic evidence of papillary thyroid cancer showed molecular genetic evidence of cancer......Hashimoto's thyroiditis is an inflammatory disease of the thyroid gland with autoimmune etiology. Patients afflicted with Hashimoto's have a higher risk of thyroid malignancies such as papillary thyroid carcinoma. In the present study, we investigated the frequency of papillary thyroid carcinoma...

  17. Optimizing management in autoimmune hepatitis with liver failure at initial presentation

    Institute of Scientific and Technical Information of China (English)

    Jonathan R Potts; Sumita Verma

    2011-01-01

    Autoimmune hepatitis (AIH) is a disease of unknown etiology, its hallmark being ongoing hepatic inflamma-tion. By its very nature, it is a chronic condition, al-though increasingly, we are becoming aware of patients with acute presentations, some of whom may have liver failure. There are very limited published data on patients with AIH with liver failure at initial diagnosis, which consist mostly of small retrospective studies. As a consequence, the clinical features and optimal management of this cohort remain poorly defined. A subset of patients with AIH who present with liver failure do respond to corticosteroids, but for the vast majority, an urgent liver transplantation may offer the only hope of long-term survival. At present, there is uncertainty on how best to stratify such a cohort into responders and non-responders to corticosteroids as soon as possible after hospitalization, thus optimizing their management. This editorial attempts to answer some of the unre-solved issues relating to management of patients with AIH with liver failure at initial presentation. However, it must be emphasized that, at present, this editorial is based mostly on small retrospective studies, and it is an understatement that multicenter prospective studies are urgently needed to address this important clinical issue.

  18. Autoimmune pancreatitis and cholangitis

    Institute of Scientific and Technical Information of China (English)

    Niraj; Jani; James; Buxbaum

    2015-01-01

    Autoimmune pancreatitis(AIP) is part of a systemic fibrosclerotic process characterized by lymphoplasmacytic infiltrate with immunoglobulin G subtype-4(Ig G4) positive cells. It characteristically presents with biliary obstruction due to mass-like swelling of the pancreas. Frequently AIP is accompanied by extra-pancreaticmanifestations including retroperitoneal fibrosis, thyroid disease, and salivary gland involvement. Auto-antibodies, hypergammaglobulemia, and prompt resolution of pancreatic and extrapancreatic findings with steroids signify its autoimmune nature. Refractory cases are responsive to immunomodulators and rituximab. Involvement of the biliary tree, termed IgG 4 associated cholangiopathy, mimics primary sclerosing cholangitis and is challenging to manage. High IgG 4 levels and swelling of the pancreas with a diminutive pancreatic duct are suggestive of autoimmune pancreatitis. Given similarities in presentation but radical differences in management and outcome, differentiation from pancreatic malignancy is of paramount importance. There is controversy regarding the optimal diagnostic criterion and steroid trials to make the diagnosis. Additionally, the retroperitoneal location of the pancreas and requirement for histologic sampling, makes tissue acquisition challenging. Recently, a second type of autoimmune pancreatitis has been recognized with similar clinical presentation and steroid response though different histology, serologic, and extrapancreatic findings.

  19. Epitope recognition patterns of thyroid peroxidase autoantibodies in healthy individuals and patients with Hashimoto's thyroiditis*

    DEFF Research Database (Denmark)

    Nielsen, Claus H; Brix, Thomas H; Gardas, Andrzej;

    2008-01-01

    Thyroid peroxidase antibodies (TPOAb) are markers of autoimmune thyroid disease (AITD), including Hashimoto's thyroiditis (HT), but naturally occurring TPOAb are also detectable in healthy, euthyroid individuals. In AITD, circulating TPOAb react mainly with two immunodominant regions (IDR), IDR...

  20. Endocrine autoimmunity in Turner syndrome

    Science.gov (United States)

    2013-01-01

    Background Turner syndrome is caused by numeric and structural abnormalities of the X chromosome. An increased frequency of autoimmunity as well as an elevated incidence of autoantibodies was observed in Turner patients. The aim of this study was to conduct a retrospective analysis of the incidence of autoimmunity in 66 Italian patients affected by Turner syndrome. Methods Sixty-six unselected and consecutive Italian Turner patients were recruited. The association between age, karyotype and the presence of clinical/pre-clinical autoimmune disorders and of autoantibodies was examined. Results Out of the 66 Turner patients, 26 had thyroid autoimmune disorders (39.4%), 14 patients had Hashimoto’s thyroiditis with clinical or subclinical hypothyroidism (21.2%) and 12 patients had circulating anti-thyroid antibodies, echographic pattern of diffuse hypoechogenicity and normal thyroid hormone levels (18.2%). None were affected by Graves’ disease. We analyzed the overall incidence of thyroid autoimmunity within the 3 different age groups 0–9.9, 10–19.9 and 20–29.9 years. No statistically significant difference was observed in the incidence of thyroid autoimmunity within the age-groups (χ2-test p > 0.05). Out of the 66 patients, 31 patients had the 45,X karyotype; within this first group 14 out of 31 patients were affected by autoimmune thyroid disease. A second group of 29 patients included 19 patients with mosaicism, 5 patients with deletions and 5 patients with ring chromosome; out of these 29 patients 7 were affected by autoimmune thyroid disease. A third group included 6 patients with X isochromosome; 5 out of 6 were affected by autoimmune thyroid disease. A statistically significant difference in the frequency of thyroid autoimmunity within the different karyotype groups was observed (χ2-test p = 0.0173). When comparing the X isochromosome group with the pooled group of other karyotypes, of note, the frequency of thyroid autoimmunity was

  1. Cytometric analysis of perforin expression in NK cells, CD8+, and CD4+ lymphocytes in children with autoimmune Hashimoto's thyroiditis--a preliminary study.

    Science.gov (United States)

    Popko, Katarzyna; Osińska, Iwona; Kucharska, Anna; Demkow, Urszula

    2015-07-01

    Perforin plays an essential role in cytotoxicity of natural killers (NK) and CD8+ lymphocytes. Cytotoxicity of T and NK cells is one of the mechanisms of destruction of cells in Hashimoto's disease (HD). The aim of this study was analysis of the expression of perforin in CD8+, CD4+, and NK cells and cytotoxic abilities of these cells in children with HD compared to healthy controls. The expression of perforin and surface antigens, as well as cytotoxicity were analyzed with a flow cytometry. Lower expression of perforin in CD8+ and NK was found in HD compared to controls (p=0.01; p=0.004). A significant correlation between perforin expression in CD8+ lymphocytes and in NK was observed (p=0.05). The spontaneous cytotoxicity of NK was significantly higher in HD compared to controls (p=0.04). Our results suggest that perforin plays an important role in the pathogenesis of autoimmune Hashimoto's thyroiditis.

  2. Intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: present status and practical therapeutic guidelines.

    Science.gov (United States)

    Dalakas, M C

    1999-11-01

    This review summarizes the current status of intravenous immunoglobulin (IVIg) in the treatment of autoimmune neuromuscular disorders and the possible mechanisms of action of the drug based on work in vivo, in vitro, and in animal models. Supply of idiotypic antibodies, suppression of antibody production, or acceleration of catabolism of immunoglobulin G (IgG) are relevant in explaining the efficacy of IVIg in myasthenia gravis (MG), Lambert-Eaton myasthenic syndrome (LEMS), and antibody-mediated neuropathies. Suppression of pathogenic cytokines has putative relevance in inflammatory myopathies and demyelinating neuropathies. Inhibition of complement binding and prevention of membranolytic attack complex (MAC) formation are relevant in dermatomyositis (DM), Guillain-Barré syndrome (GBS), and MG. Modulation of Fc receptors or T-cell function is relevant in chronic inflammatory demyelinating polyneuropathy (CIDP), GBS, and inflammatory myopathies. The clinical efficacy of IVIg, based on controlled clinical trials conducted in patients with GBS, CIDP, multifocal motor neuropathy (MMN), DM, MG, LEMS, paraproteinemic IgM anti-myelin-associated glycoprotein (anti-MAG) demyelinating polyneuropathies, and inclusion body myositis is summarized and practical issues related to each disorder are addressed. The present role of IVIg therapy in other disorders based on small controlled or uncontrolled trials is also summarized. Finally, safety issues, risk factors, adverse reactions, spurious results or serological tests, and practical guidelines associated with the administration of IVIg in the treatment of neuromuscular disorders are presented.

  3. Relationship between gestational diabetes and thyroid autoimmunity%妊娠糖尿病与甲状腺自身免疫的相关性研究

    Institute of Scientific and Technical Information of China (English)

    乔艳花; 张丹丹; 王倩

    2015-01-01

    目的 研究妊娠糖尿病与甲状腺功能异常及甲状腺自身抗体阳性的相关性.方法 选取妊娠糖尿病患者共80例作为妊娠糖尿病组,另外选择糖耐量正常孕妇36名作为正常对照组.同时选择产后18 ~ 120个月曾诊断为妊娠糖尿病者作为曾患妊娠糖尿病组(36例),并以产后18~96个月的正常妊娠者28名作为随访对照组.检测4组受试者空腹血糖、餐后2h血糖、游离T4、促甲状腺激素(TSH)、血脂水平,以及谷氨酸脱羧酶65(GAD65)抗体、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb).曾患妊娠糖尿病组根据甲状腺自身抗体情况分为甲状腺自身抗体阳性组与阴性组,统计两个亚组糖代谢异常的发生情况.结果 妊娠糖尿病组空腹血糖、餐后2h血糖高于其他组(P均’<0.05),4组间血脂水平差异没有统计学意义(P均>0.05).与正常对照组相比,妊娠糖尿病组游离T4、TSH水平差异均没有统计学意义(P均>0.05).妊娠糖尿病组GAD65抗体阳性者有4例,曾患妊娠糖尿病组有3例.分别与正常对照组及随访对照组相比,妊娠糖尿病组及曾患妊娠糖尿病组TPOAb、TgAb阳性发生率均增加(x2=7.459,P<0.05).曾患妊娠糖尿病组总体TSH水平异常的发生率、同时存在TSH水平异常及甲状腺自身抗体阳性的发生率显著高于其他3组(x2=5.925,8.766,P均<0.05).曾患妊娠糖尿病组47.2%(17/36)在随访时发生高血糖,甲状腺抗体阳性组60.0%(6/10)出现糖代谢异常,而甲状腺抗体阴性组42.3%(11/26)有糖代谢异常,但两组间差异没有统计学意义(P>0.05).结论 产后甲状腺自身免疫与糖代谢受损无关.妊娠糖尿病可能是发生甲状腺自身免疫异常的危险因素.%Objective To investigate the relationship between thyroid dysfunction,positive thyroid autoimmune antibodies and gestational diabetes.Methods Eighty patients with gestational diabetes were chosen as

  4. Pemphigus vulgaris with solitary toxic thyroid nodule.

    Science.gov (United States)

    Alfishawy, Mostafa; Anwar, Karim; Elbendary, Amira; Daoud, Ahmed

    2014-01-01

    Background. Pemphigus vulgaris is an autoimmune vesiculobullous disease, affecting the skin and mucous membranes. It is reported to be associated with other autoimmune diseases including autoimmune thyroid diseases. However we report herein a case of pemphigus vulgaris associated with autonomous toxic nodule. Case Presentation. A 51-year-old woman was evaluated for blisters and erosions that develop on her trunk, face, and extremities, with a five-year history of progressively enlarging neck mass, and a past medical history of pemphigus vulgaris seven years ago. The condition was associated with palpitation, dyspnea, and heat intolerance. Thyroid function tests and thyroid scan were compatible with the diagnosis of thyrotoxicosis due to autonomous toxic nodule. Exacerbation of pemphigus vulgaris was proved by skin biopsy from the patient which revealed histologic picture of pemphigus vulgaris. Conclusion. Autoimmune thyroid diseases are reported to associate pemphigus vulgaris. To our knowledge, this case is the first in the English literature to report association between pemphigus vulgaris and autonomous toxic nodule and highlights the possibility of occurrence of pemphigus vulgaris with a nonautoimmune thyroid disease raising the question: is it just a coincidence or is there an explanation for the occurrence of both conditions together?

  5. Pemphigus Vulgaris with Solitary Toxic Thyroid Nodule

    Directory of Open Access Journals (Sweden)

    Mostafa Alfishawy

    2014-01-01

    Full Text Available Background. Pemphigus vulgaris is an autoimmune vesiculobullous disease, affecting the skin and mucous membranes. It is reported to be associated with other autoimmune diseases including autoimmune thyroid diseases. However we report herein a case of pemphigus vulgaris associated with autonomous toxic nodule. Case Presentation. A 51-year-old woman was evaluated for blisters and erosions that develop on her trunk, face, and extremities, with a five-year history of progressively enlarging neck mass, and a past medical history of pemphigus vulgaris seven years ago. The condition was associated with palpitation, dyspnea, and heat intolerance. Thyroid function tests and thyroid scan were compatible with the diagnosis of thyrotoxicosis due to autonomous toxic nodule. Exacerbation of pemphigus vulgaris was proved by skin biopsy from the patient which revealed histologic picture of pemphigus vulgaris. Conclusion. Autoimmune thyroid diseases are reported to associate pemphigus vulgaris. To our knowledge, this case is the first in the English literature to report association between pemphigus vulgaris and autonomous toxic nodule and highlights the possibility of occurrence of pemphigus vulgaris with a nonautoimmune thyroid disease raising the question: is it just a coincidence or is there an explanation for the occurrence of both conditions together?

  6. Gene-gene and gene-sex epistatic interactions of DNMT1, DNMT3A and DNMT3B in autoimmune thyroid disease.

    Science.gov (United States)

    Cai, Tian-Tian; Zhang, Jian; Wang, Xuan; Song, Rong-Hua; Qin, Qiu; Muhali, Fatuma-Said; Zhou, Jiao-Zhen; Xu, Jian; Zhang, Jin-An

    2016-07-30

    The aim of this study was to investigate the associations of DNA methyltransferases (DNMTs) polymorphisms with susceptibility to autoimmune thyroid diseases (AITDs) and to test gene-gene/gene-sex epistasis interactions. Eight single-nucleotide polymorphisms (SNPs) in DNMT1, DNMT3A and DNMT3B were selected and genotyped by multiplex polymerase chain reaction combined with ligase detection reaction method (PCR-LDR). A total of 685 Graves' disease (GD) patients, 353 Hashimoto's thyroiditis (HT) patients and 909 healthy controls were included in the final analysis. Epistasis was tested by additive model, multiplicative model and general multifactor dimensionality reduction (general MDR). Rs2424913 (DNMT3B) and rs2228611 (DNMT1) were associated with susceptibility to AITD and GD in the dominant and overdominant model, respectively (rs2424913: P=0.009 for AITD, P=0.0041 for GD; rs2228611: P=0.035 for AITD, P=0.043 for GD). Multiplicative and multiple high dimensional gene-gene or gene-sex interactions were also observed in this study. We have found evidence for a potential role of rs2424913 (DNMT3B) and rs2228611 (DNMT1) in AITD susceptibility and identified novel gene-gene/gene-sex interactions in AITD. Our study may highlight sex and genes of DNMTs family as contributors to the pathogenesis of AITD.

  7. Unfavorable Course of Subclinical Hypothyroidism in Children with Hashimoto’s Thyroiditis Compared to Those with Isolated Non-Autoimmune Hyperthyrotropinemia

    Science.gov (United States)

    2017-01-01

    Subclinical hypothyroidism (SCH) is a common problem in pediatric population, and the natural history of SCH varies depending on its etiology. Whether Hashimoto’s thyroiditis (HT) negatively affects the natural course of SCH was investigated in pediatric patients without concomitant diseases. Predictors for levothyroxine medication were also evaluated. Medical records of 109 children with SCH (91 girls, 5−18 years) diagnosed between 2005 and 2014 were retrospectively reviewed. Patients were classified into HT (n = 37) and isolated non-autoimmune hyperthyrotropinemia (iso-NAHT, n = 72). During median 2 years of follow-up, only 10.1% of SCH patients eventually initiated levothyroxine, and HT patients showed a higher probability of requiring levothyroxine medication than iso-NAHT patients (21.6% vs. 4.2%). Underlying HT independently predicted deterioration of thyroid function, leading to levothyroxine medication (hazard ratios [HRs], 4.6 vs. iso-NAHT, P = 0.025). High titers of anti-thyroglobulin antibodies (TGAbs) predicted later medication in the HT group (HRs, 28.2 vs. normal TGAbs, P = 0.013). Most pediatric SCH showed benign and self-remitting courses. Underlying HT significantly increases the risk for levothyroxine medication, especially with high titers of TGAbs. PMID:27914141

  8. Ectopic thyroid papillary carcinoma of nasopharynx associated with adenoid hypertrophy: an unusual presentation.

    Science.gov (United States)

    Tian, Linli; Jiao, Yufei; Liu, Ming; Li, Minghua; Yao, Hongchao

    2014-09-20

    Ectopic thyroid tissue of nasopharynx is an uncommon phenomenon and papillary thyroid carcinoma arising from the tissue is extremely rare. The authors report a rare case of 16-year-old girl with papillary thyroid carcinoma of nasopharynx. Clinicians were ever confused by adenoid hypertrophy and solved the diagnostic dilemma by adequate examinations. In the case, we mainly emphasize that surgeons should be aware of and actively consider such a possibility of ectopic papillary thyroid carcinoma of nasopharynx in children and adolescents with long-term nasal obstruction, even if thyroid carcinoma is a rare tumor.

  9. le syndrome auto-immun thyrogastrique: ses effets sur les micronutriments et la tumorigénèse gastrique.

    OpenAIRE

    2013-01-01

    Summary : The thyrogastric autoimmune syndrome (TAS) was described in patients in whom the serum cross-reacted both with gastric parietal cells antigens and thyroid antigens. We report two cases illustrating the spectrum of pathogical features of TAS. The first case associates Hashimoto’s thyroiditis and anemia perniciosa,and develops a gastric neuroendocrine tumor during follow up. The second case presents with a Graves’ disease and an autoimmune reversible gastritis, se...

  10. Efficacy of a food supplement in patients with hashimoto thyroiditis.

    Science.gov (United States)

    Nordio, M; Basciani, S

    2015-01-01

    Thyroid inflammation has been commonly seen in recent decades, due to a series of factors and is considered as the most frequent thyroid illness. It is characterized by some distinctive traits, which include morphological and hormonal modifications, often in association with an elevated anti-thyroid autoantibody title. The aim of the therapy is to improve symptoms as fast as possible, treating inflammation and subsequent hypothyroidism, when present. Therefore, we evaluated the efficacy of a Food Supplement (FS) containing enzymes which is commonly used in various inflammatory processes and is able to modulate immune reactions during inflammation in a very rapid and efficacious way. An open, controlled study was then designed and 45 patients with Hashimoto thyroiditis were enrolled and divided into 3 groups (FS alone; thyroid hormones alone; FS plus thyroid hormones). Blood, morphological and subjective parameters were considered. The results obtained indicate that the FS used in our study is efficacious and safe when used alone and/or in combination with thyroid hormones in the treatment of autoimmune thyroiditis, as documented by the improvement of the majority of the parameters considered. The efficacy was considered faster than thyroid hormones alone as far as subjective symptomatology is considered. In conclusion, the use of the food supplement evaluated herein during inflammation may be considered an additional tool in clinicians’ hands, when facing patients with autoimmune thyroiditis, especially in presence of subjective symptomatology, in order to rapidly alleviate it.

  11. Unusual presentation of Warthin variant of Papillary thyroid carcinoma with lymph nodal metastases in a patient of Graves' disease.

    Science.gov (United States)

    Padma, Subramanyam; Sundaram, Palaniswamy Shanmuga; Arun, B R

    2015-01-01

    Warthin-like Papillary thyroid carcinoma (WPTC) is a rare variant of papillary carcinoma of thyroid, PTC which derives its name by closely resembling Warthin's tumor of salivary gland. Hallmark histological feature of this variant is papillary folding lined by oncocytic neoplastic cells with clear nuclei and nuclear pseudoinclusions, accompanied by prominent lymphocytic infiltrate in the papillary stalks. It is thought to be one of those differentiated thyroid cancers with favorable prognosis. We report a case of Graves' disease with a cold nodule harboring WPTC with initial presentation of lymph nodal metastases. It is important to identify this peculiar variant of PTC as 5 to 10% of them undergo dedifferentiation and 30% have the lymph nodal metastases and extra thyroidal extension.

  12. The Repertoires of Peptides Presented by MHC-II in the Thymus and in Peripheral Tissue: A Clue for Autoimmunity?

    Science.gov (United States)

    Collado, Javier A.; Guitart, Carolina; Ciudad, M. Teresa; Alvarez, Iñaki; Jaraquemada, Dolores

    2013-01-01

    T-cell tolerance to self-antigens is established in the thymus through the recognition by developing thymocytes of self-peptide-MHC complexes and induced and maintained in the periphery. Efficient negative selection of auto-reactive T cells in the thymus is dependent on the in situ expression of both ubiquitous and tissue-restricted self-antigens and on the presentation of derived peptides. Weak or inadequate intrathymic expression of self-antigens increases the risk to generate an autoimmune-prone T-cell repertoire. Indeed, even small changes of self-antigen expression in the thymus affect negative selection and increase the predisposition to autoimmunity. Together with other mechanisms, tolerance is maintained in the peripheral lymphoid organs via the recognition by mature T cells of a similar set of self-peptides in homeostatic conditions. However, non-lymphoid peripheral tissue, where organ-specific autoimmunity takes place, often have differential functional processes that may lead to the generation of epitopes that are absent or non-presented in the thymus. These putative differences between peptides presented by MHC molecules in the thymus and in peripheral tissues might be a major key to the initiation and maintenance of autoimmune conditions. PMID:24381570

  13. The Repertoires of Peptides Presented by MHC-II in the Thymus and in Peripheral Tissue: A Clue for Autoimmunity?

    Science.gov (United States)

    Collado, Javier A; Guitart, Carolina; Ciudad, M Teresa; Alvarez, Iñaki; Jaraquemada, Dolores

    2013-12-17

    T-cell tolerance to self-antigens is established in the thymus through the recognition by developing thymocytes of self-peptide-MHC complexes and induced and maintained in the periphery. Efficient negative selection of auto-reactive T cells in the thymus is dependent on the in situ expression of both ubiquitous and tissue-restricted self-antigens and on the presentation of derived peptides. Weak or inadequate intrathymic expression of self-antigens increases the risk to generate an autoimmune-prone T-cell repertoire. Indeed, even small changes of self-antigen expression in the thymus affect negative selection and increase the predisposition to autoimmunity. Together with other mechanisms, tolerance is maintained in the peripheral lymphoid organs via the recognition by mature T cells of a similar set of self-peptides in homeostatic conditions. However, non-lymphoid peripheral tissue, where organ-specific autoimmunity takes place, often have differential functional processes that may lead to the generation of epitopes that are absent or non-presented in the thymus. These putative differences between peptides presented by MHC molecules in the thymus and in peripheral tissues might be a major key to the initiation and maintenance of autoimmune conditions.

  14. Neurofibromatosis Type 1 Associated with Hashimoto’s Thyroiditis: Coincidence or Possible Link

    Directory of Open Access Journals (Sweden)

    Junaid Nabi

    2013-01-01

    Full Text Available Introduction. Hashimoto's thyroiditis is a common form of chronic autoimmune thyroid disease (AITD and often coexists with other autoimmune diseases, but Hashimoto’s thyroiditis associated with an autosomal dominant neurofibromatosis type 1 is exceedingly rare. Case Presentation. A 30-year-old Bengali woman presented to the OPD with complaints of aching pain and tingling sensation in her hands and feet. Physical examination revealed dysmorphic facies, nodular swelling in the neck, cafe-au-lait spots, and neurofibromas covering the entire surface of her body. Her thyroid hormones were within normal limits. Thyroid ultrasound revealed a cystic area in the left lobe of the gland, and ultrasound-guided fine needle aspiration cytology revealed lymphocytic infiltration of the gland, suggesting Hashimoto’s thyroiditis. High levels of autoimmune antibodies such as antithyroglobulin and antimicrosomal antibodies confirmed the diagnosis. Conclusion. When encountered with a patient of Neurofibromatosis type 1, a physician should be careful about the possibility of a concomitant autoimmune disease. Clinical presentation of neurofibromatosis and Noonan syndrome often overlaps and recent studies have implicated a mutation in NF1 gene in the etiology of NFNS. More extensive reports and further investigations of such patients having combination of neurofibromatosis type 1 and autoimmune thyroiditis will certainly provide better understanding of this link in the near future.

  15. Autoinmunidad tiroidea: Mecanismos patogénicos comunes y distintivos en tiroiditis de Hashimoto y enfermedad de Graves Thyroid Autoimmunity: Common and Distinctive Pathogenic Mechanisms in Hashimoto's Thyroiditis and Graves' Disease

    Directory of Open Access Journals (Sweden)

    G Astarita

    2012-09-01

    Full Text Available Las enfermedades tiroideas autoinmunes (ETA son los desórdenes más frecuentes que llevan a la disfunción de la glándula tiroidea. Incluyen varias formas clínicas como Tiroiditis de Hashimoto (TH y Enfermedad de Graves (EG. La relación entre TH y EG ha sido objeto de debate por décadas. Si bien, muy diferentes en su clínica, algunos las consideran los lados opuestos de una misma moneda. En su patogénesis tienen aspectos en común, como la predisposición genética demostrado por la ocurrencia en una misma familia y en un mismo individuo. Sin embargo, diferencias en el microambiente local determinan la diferente expresión fenotípica o el viraje de una a otra patología. El objetivo de esta monografía es investigar similitudes y diferencias entre TH y EG en las distintas etapas que llevan al desarrollo de autoinmunidad. Los autores declaran no poseer conflictos de interés.Autoimmune thyroid disease (ATD is the most common disorder that leads to thyroid gland dysfunction. ATD manifests in various clinical forms, such as Hashimoto's Thyroiditis (HT and Graves' Disease (GD. The relation between HT and GD has been discussed for decades. Even if they greatly differ in their clinical features and treatment, some people believe they are the opposite sides of the same coin. In their pathogenesis, they share some mechanisms, such as genetic susceptibility, shown by the fact that they tend to occur both in the same person and within the same family. However, differences in the local micro-environment can determine the distinct phenotypic expression or the switch from one disease to the other. The aim of this monograph was to investigate similarities and differences between HT and GD at the diverse stages leading to the development of autoimmunity. No financial conflicts of interest exist.

  16. Rare cases of autoimmune hypothyroidism in young children.

    Science.gov (United States)

    Tronconi, Giulia Maria; Caiulo, Silvana; Di Frenna, Marianna; Vigone, Maria Cristina; Chiumello, Giuseppe; Weber, Giovanna

    2013-01-01

    Acquired autoimmune hypothyroidism is common in late childhood and adolescence but is very rare in the first 3 years of life. We report on three cases of autoimmune thyroiditis (AT) in young children who presented with constipation, decreased appetite, and increased hours of sleep. Our cases highlight that AT may remain undiagnosed for a long time in young children owing to the rarity of the disease.

  17. The Diffuse Sclerosing Variant of Papillary Thyroid Cancer Presenting as Innumerable Diffuse Microcalcifications in Underlying Adolescent Hashimoto's Thyroiditis: A Case Report.

    Science.gov (United States)

    Jeong, Sun Hye; Hong, Hyun Sook; Lee, Eun Hye; Kwak, Jeong Ja

    2016-03-01

    Hashimoto's thyroiditis is the most common diffuse thyroid disease and is characterized by diffuse lymphocytic infiltration. However, the ultrasonographic findings of papillary thyroid carcinomas that arise from Hashimoto's thyroiditis in the pediatric and adolescent population are not well known.We report a rare ultrasonographic finding in a 22-year-old woman diagnosed with the diffuse sclerosing variant of papillary thyroid carcinoma that arose from underlying Hashimoto's thyroiditis: innumerable diffuse microcalcifications instead of a typical malignant-appearing nodule.

  18. The possible role of CD4⁺CD25(high)Foxp3⁺/CD4⁺IL-17A⁺ cell imbalance in the autoimmunity of patients with Hashimoto thyroiditis.

    Science.gov (United States)

    Xue, Haibo; Yu, Xiurong; Ma, Lei; Song, Shoujun; Li, Yuanbin; Zhang, Li; Yang, Tingting; Liu, Huan

    2015-12-01

    Hashimoto thyroiditis (HT) is a prototypic organ-specific autoimmune thyroid disease, for which the exact etiology remains unclear. The aim of this study was to investigate dynamic changes in regulatory T cell (Treg) and T helper 17 cell (Th17) populations in patients with HT at different stages of thyroid dysfunction, as well as to analyze the possible correlation between the Treg/Th17 cell axis and autoimmune status in HT. We assessed thyroid function and autoantibody serology both in HT patients and in healthy controls (HCs) and divided HT patients into three subgroups according to thyroid function. We then determined the percentages of Treg and Th17 cells in peripheral blood mononuclear cells and analyzed mRNA expression of the Treg and Th17 cell-defining transcription factors Foxp3 and RORγt. In addition, serum levels of TGF-β and IL-17A were assessed. We found that the percentage of Treg cells, Foxp3 mRNA levels, and the ratio of Treg/Th17 cells were all significantly lower in HT patients, while Th17 cell percentages and RORγt mRNA levels were significantly higher. Interestingly, we also observed significant differences in these measurements between HT patient subgroups. Serum IL-17A levels were markedly increased in HT patients, while serum concentrations of TGF-β were lower, compared to HCs. The ratio of Treg/Th17 cells was negatively correlated with the levels of serum thyroperoxidase antibody, thyroglobulin antibody, and thyrotropin (TSH) in HT patients. Taken together, our data suggest that the balance between Treg and Th17 cells shifts in favor of Th17 cells during clinical progression of HT, which is negatively correlated with levels of thyroid-specific autoantibodies and TSH, implying that Treg/Th17 cell imbalance may contribute to thyroid damage in HT.

  19. Medullary Thyroid Carcinoma Presenting as a Predominantly Cystic Mass on Ultrasonography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young; Kim, Ah Hyun; Moon, Hee Jung; Kim, Eun Kyung; Kwak, Jin Young [Yonsei University College of Medicine, Seoul (Korea, Republic of); Choi, Jun Jeong [Wonju College of Medicine, Wonju (Korea, Republic of); Kim, Myung Hyun [Gangnam MizMedi Hospital, Seoul (Korea, Republic of)

    2012-03-15

    Most medullary thyroid carcinomas show suspicious malignant features such as hypoechogenicity, a spiculated margin and/or intranodular calcifications, which are well known features of papillary carcinoma. We report here on a case of medullary carcinoma that was seen as a predominantly cystic thyroid mass on ultrasonography. This type of case is not common in the literature and we discuss the way to diagnose a medullary thyroid carcinoma

  20. Incidence of vitiligo in children with Graves' disease and Hashimoto's thyroiditis

    Directory of Open Access Journals (Sweden)

    Prindaville Brea

    2011-11-01

    Full Text Available Abstract Background Limited data are available on the association between vitiligo and autoimmune thyroid disease in pediatric patients. In addition, reported studies of pediatric patients have been based on a population known to have vitiligo and subsequently evaluated for the presence of thyroid function abnormalities. Methods A retrospective chart review was performed on 333 children who had been followed for thyroid disorders by endocrinologists at the Yale Pediatric Thyroid Center over the last 5 years for autoimmune thyroid disease. Demographical and clinical features of patients found to have thyroid disease and vitiligo were recorded. These studies were approved by the Yale Human Investigation Committee. Results Of the total 333 children and adolescents, 9 (2.7% were noted to have vitiligo. Four patients (44% had Graves' disease and 5 patients (66% had Hashimoto's thyroiditis. For patients with Graves' disease and vitiligo, the average age of onset of thyroid disease was young at 4 ± 0.7 years, and the diagnosis of vitiligo usually preceded that of thyroid disease. For children with Hashimoto's thyroiditis and vitiligo, thyroid disease was diagnosed at an average age of 13.25 ± 2.8 years. Conclusion In our population, 4.6% of children with Graves' disease and 2.0% of children with Hashimoto's thyroiditis had vitiligo. Interestingly, when vitiligo presents with Graves' disease, it occurs in younger rather than older children.

  1. Thyroid Nodule in an Eighteen-Year-Old Man as the First Presentation of Acute Lymphoblastic Leukemia

    Science.gov (United States)

    Valizadeh, Majid; Moghimi, Minoush; Feizi, Abdolamir; Radmand, Farbod; Piri, Zahra

    2014-01-01

    Introduction: Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood. Patients with ALL commonly present with easy bruising and infections due to medullary involvement. The extra medullary involvements of ALL manifests as hepatosplenomegaly, lymphadenopathy, and testicular enlargement. Among extramedullary manifestations of the ALL, thyroid involvement is rare. Herein, we reported a case of ALL that manifested as a thyroid nodule. Case Presentation: An 18-year-old young man with a thyroid nodule presented without any other symptom or sign. The excisional biopsy of the nodule was planned by the surgeon. After two months of lost to follow-up, the patient returned with a complaint of continuous bleeding after a tooth extraction. Peripheral blood smear (PBS) study and bone marrow aspiration proposed ALL and the flow cytometry confirmed the diagnosis. The R-Hyper-CVAD induction chemotherapeutic regimen (rituximab in combination with cyclophosphamide, vincristine, doxorubicin, and dexamethasone) was used for treatment. Interestingly, thyroid sonography and Tc99m scan showed resolution of the thyroid nodule after chemotherapy. Discussion: In this patient, poor interdisciplinary communication and the rarity of this manifestation led to a delayed diagnosis. Therefore, we insist on more careful clinical examinations, reassessment of unusual FNA reports, and closer communication between clinicians and pathologists in such cases. This approach would lead to accurate and earlier diagnosis and would prevent unnecessary interventions. PMID:25237325

  2. An unusual case of Hashimoto′s thyroiditis with four lobed thyroid gland

    Directory of Open Access Journals (Sweden)

    Rayees Ahmad Dar

    2012-01-01

    Full Text Available Hashimoto′s thyroiditis (HT, an autoimmune disorder, is the most prevalent cause of subclinical or overt hypothyroidism in areas with sufficient iodine intake. The gland is often diffusely enlarged, and the parenchyma is coarsened, hypoechoic, and often hypervascular on ultrasonograpy. Histopathologic appearance of HT includes lymphocyte aggregates with germinal centers, small thyroid follicles, presence of Hurthle cells, and variable fibrosis. We present a case of a 40-year-old female with suspected follicular neoplasm on fine-needle aspiration cytology of neck swelling. Intraoperatively, thyroid gland was found having four lobes separated from each other. Total thyroidectomy was done and histopathology from all four lobes revealed HT. At present, there is no literature to support the fact that such distorted thyroid anatomy may be due to the underlying disease. If we consider it as thyroid gland anomaly, no such anomaly has been mentioned in the literature till date.

  3. Vitamin D and autoimmune thyroid disease%维生素D与自身免疫性甲状腺疾病

    Institute of Scientific and Technical Information of China (English)

    韩钧凌; 孙嘉

    2009-01-01

    近年来较多的研究表明,维生素D具有调节免疫的特性,在一些自身免疫性疾病动物模型中表现出一定的防治作用.自身免疫性甲状腺疾病(AITD)是一种器官特异性自身免疫性疾病.研究证实,维生素D相关基因多态性与AITD相关,如维生素D受体基因、1α-羟化酶(CYP2781)基因、维生素D结合蛋白基因等.AITD患者存在维生素D缺乏,一些研究表明应用维生素D对AITD具有一定的防治作用.维生素D及其类似物防治AITD的可能机制在于它们能够调节AITD患者的细胞因子表达,并对其甲状腺细胞凋亡具有调节作用.因此认为,维生素D及其类似物在AITD的临床应用前景广阔.%In recent years,the role of vitamin D in the immune system has been investigated. The immunomodulatory properties of vitamin D compounds were illustrated by their ability to either prevent or suppress animal models of autoimmune disease. Autoimmune thyroid diseases (AITD) are organ-specific an-toimmune diseases. It was testified that AITD were associated with the polymorphisms of vitamin D related genes, such as vitamin D receptor gene,25-hydroxyvitamin D3-1α-hydroxylase (CYP27B1) gene, vitamin D-binding protein gene, etc. Patients with AITD were coexisted with vitamin D deficiency and vitamin D supple-mentation benefited for the prevention and treatment of AITD. The probable mechanisms of vitamin D and its analogs in AITD maybe include modulating the expression of many cytokines in AITD and regulating apopto-sis of thyroid cells. Thus we postulate that vitamin D and its analogs have a broad prospect in the clinical ap-plication for AITD.

  4. Association of Cytotoxic T-Lymphocyte-Associated Protein 4 (CTLA4) Gene Polymorphisms with Autoimmune Thyroid Disease in Children and Adults: Case-Control Study

    Science.gov (United States)

    Lo, Fu-Sung; Wang, Chao-Hung; Huang, Chi-Yu; Lin, Chiung-Ling; Lin, Wen-Shan; Chang, Tzu-Yang; Yang, Horng-Woei; Chen, Wei-Fang; Lien, Ya-Ping; Cheng, Bi-Wen; Lin, Chao-Hsu; Chen, Chia-Ching; Wu, Yi-Lei; Hung, Chen-Mei; Li, Hsin-Jung; Chan, Chon-In; Lee, Yann-Jinn

    2016-01-01

    Autoimmune thyroid disease (AITD), including Graves disease (GD) and Hashimoto disease (HD), is an organ-specific autoimmune disease with a strong genetic component. Although the cytotoxic T-lymphocyte-associated protein 4 (CTLA4) polymorphism has been reported to be associated with AITD in adults, few studies have focused on children. The aim of our study was to investigate whether the CTLA4 polymorphisms, including -318C/T (rs5742909), +49A/G (rs231775), and CT60 (rs3087243), were associated with GD and HD in Han Chinese adults and children. We studied 289 adult GD, 265 pediatric GD, 229 pediatric HD patients, and 1058 healthy controls and then compared genotype, allele, carrier, and haplotype frequencies between patients and controls. We found that CTLA4 SNPs +49A/G and CT60 were associated with GD in adults and children. Allele G of +49A/G was significantly associated with GD in adults (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.21–1.84; corrected P value [Pc] < 0.001) and children (OR, 1.42; 95% CI, 1.15–1.77; Pc = 0.002). Allele G of CT60 also significantly increased risk of GD in adults (OR, 1.63; 95% CI, 1.27–2.09; Pc < 0.001) and GD in children (OR, 1.58; 95% CI, 1.22–2.04; Pc < 0.001). Significant linkage disequilibrium was found between +49A/G and CT60 in GD and control subjects (D’ = 0.92). Our results showed that CTLA4 was associated with both GD and HD and played an equivalent role in both adult and pediatric GD in Han Chinese population. PMID:27111218

  5. Association of Cytotoxic T-Lymphocyte-Associated Protein 4 (CTLA4 Gene Polymorphisms with Autoimmune Thyroid Disease in Children and Adults: Case-Control Study.

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    Wei-Hsin Ting

    Full Text Available Autoimmune thyroid disease (AITD, including Graves disease (GD and Hashimoto disease (HD, is an organ-specific autoimmune disease with a strong genetic component. Although the cytotoxic T-lymphocyte-associated protein 4 (CTLA4 polymorphism has been reported to be associated with AITD in adults, few studies have focused on children. The aim of our study was to investigate whether the CTLA4 polymorphisms, including -318C/T (rs5742909, +49A/G (rs231775, and CT60 (rs3087243, were associated with GD and HD in Han Chinese adults and children. We studied 289 adult GD, 265 pediatric GD, 229 pediatric HD patients, and 1058 healthy controls and then compared genotype, allele, carrier, and haplotype frequencies between patients and controls. We found that CTLA4 SNPs +49A/G and CT60 were associated with GD in adults and children. Allele G of +49A/G was significantly associated with GD in adults (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.21-1.84; corrected P value [Pc] < 0.001 and children (OR, 1.42; 95% CI, 1.15-1.77; Pc = 0.002. Allele G of CT60 also significantly increased risk of GD in adults (OR, 1.63; 95% CI, 1.27-2.09; Pc < 0.001 and GD in children (OR, 1.58; 95% CI, 1.22-2.04; Pc < 0.001. Significant linkage disequilibrium was found between +49A/G and CT60 in GD and control subjects (D' = 0.92. Our results showed that CTLA4 was associated with both GD and HD and played an equivalent role in both adult and pediatric GD in Han Chinese population.

  6. THE CHARACTERISTICS OF BLOOD LIPIDS OF MENOPAUSAL WOMEN WITH THE COMPENSATED HYPOTHYROIDISM WHICH RESULTS FROM AUTOIMMUNE THYROIDITIS

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    Yu. A. Malyshenko

    2014-01-01

    Full Text Available Purpose: to study the lipid profile, including of non-high-density lipoproteins cholesterol (non-HDL-C, in postmenopausal women with compensated hypothyroidism. The causes of hypothyroidism included Hashimoto thyroiditis.45 women with hypothyroidism participated in the study (mean ± sd, age (57.4 ± 7.7 years, disease duration (8.0 ± 6.4 years, the duration of postmenopause (6.4 ± 3.5 years. The mean dose of L-T4 (84.3 ± 28.5 μg/d. The control group – 85 women (mean ± sd, age (58.4 ± 5.4 years no abnormalities of the thyroid gland, as well as other chronic diseases, which could have an impact on lipid metabolism.The main and control group were matched for age. Average BMI basic group than in controls: (31.6 ± 3.4 and (28.7 ± 4.6 kg/m2 respectively (p = 0.001. Obtained statistical differences in terms of TSH in the study and control groups: 2.15 and 1,22 mU/L (p = 0.001. Upon reaching euthyrosis against the background of hormone replacement therapy with thyroid hormones do not reach the target total cholesterol (TC, low density lipoproteins cholesterol (LDL-C: 5.81 ± 1.14, 3.67 ± 1.06 respectively.We obtain lower high-density lipoproteins cholesterol (HDL-C levels in women with drug euthyroidism compared with the control group. Do not get the difference in the values non-HDL-C in the groups studied. In postmenopausal women with compensated hypothyroidism is defined negative correlation ATTPO with HDL-C. Mean values of blood TC, non-HDL-C, LDL-C levels in the groups exceed the optimal ones.

  7. Silent thyroiditis

    Science.gov (United States)

    ... lymphocytic thyroiditis; Painless thyroiditis; Postpartum thyroiditis; Thyroiditis - silent; Hyperthyroidism - silent thyroiditis ... earliest symptoms result from an overactive thyroid gland ( hyperthyroidism ). These symptoms may last for up to 3 ...

  8. Diffuse sclerosing variant of thyroid papillary carcinoma: diagnostic challenges occur with Hashimoto's thyroiditis.

    Science.gov (United States)

    Chen, Chien-Chin; Chen, Wen-Chung; Peng, Shu-Ling; Huang, Shih-Ming

    2013-06-01

    Diffuse sclerosing papillary thyroid carcinoma (DSPTC) is a relatively rare variant of papillary thyroid carcinoma with distinct histological features, radiological characteristics, and biological aggressiveness. Compared with conventional papillary thyroid carcinoma, DSPTC is characterized by scattered microscopic tumor islands, diffuse fibrosis, calcification, and abundant lymphocytic aggregation. A preoperative diagnosis is challenging in the absence of nodules and scanty fine needle aspiration cytology samples. We describe a unique DSPTC patient, an 18-year-old woman who presented with a neck mass that grew slowly for 2 years. The palpable neck mass was nontender, well defined, firm, and unmovable. Laboratory studies showed normal thyroid function and positive autoimmune markers: antithyroglobulin antibody = 1:1600 and antimicrosomal antibody = 1:1600. A neck ultrasound showed diffusely prominent microcalcifications with one small vague nodule. Hashimoto's thyroiditis with an accompanying malignancy was suspected. Based on the result of intraoperative pathology reports, the patient was given a total thyroidectomy. Lymph node dissection and histological analysis revealed bilateral DSPTC in addition to lymphocytic thyroiditis in nonmalignant areas of the thyroid. Clinical and histological diagnostic challenges usually occur when DSPTC presents with a diffuse thyroid enlargement, dispersed microscopic tumor islands (frequently without mass formation), extensive fibrosis, and abundant lymphocytic infiltration mimicking thyroiditis.

  9. Autoimmune disease and multiple autoantibodies in 42 patients with RASopathies.

    Science.gov (United States)

    Quaio, Caio R D C; Carvalho, Jozélio F; da Silva, Clovis A; Bueno, Cleonice; Brasil, Amanda S; Pereira, Alexandre C; Jorge, Alexander A L; Malaquias, Alexsandra C; Kim, Chong A; Bertola, Débora R

    2012-05-01

    The association of RASopathies [Noonan syndrome (NS) and Noonan-related syndromes] and autoimmune disorders has been reported sporadically. However, a concomitant evaluation of autoimmune diseases and an assessment of multiple autoantibodies in a large population of patients with molecularly confirmed RASopathy have not been performed. The clinical and laboratory features were analyzed in 42 RASopathy patients, the majority of whom had NS and five individuals had Noonan-related disorders. The following autoantibodies were measured: Anti-nuclear antibodies, anti-double stranded DNA, anti-SS-A/Ro, anti-SS-B/La, anti-Sm, anti-RNP, anti-Scl-70, anti-Jo-1, anti-ribosomal P, IgG and IgM anticardiolipin (aCL), thyroid, anti-smooth muscle, anti-endomysial (AE), anti-liver cytosolic protein type 1 (LC1), anti-parietal cell (APC), anti-mitochondrial (AM) antibodies, anti-liver-kidney microsome type 1 antibodies (LKM-1), and lupus anticoagulant. Six patients (14%) fulfilled the clinical criteria for autoimmune diseases [systemic lupus erythematous, polyendocrinopathy (autoimmune thyroiditis and celiac disease), primary antiphospholipid syndrome (PAPS), autoimmune hepatitis, vitiligo, and autoimmune thyroiditis]. Autoimmune antibodies were observed in 52% of the patients. Remarkably, three (7%) of the patients had specific gastrointestinal and liver autoantibodies without clinical findings. Autoimmune diseases and autoantibodies were frequently present in patients with RASopathies. Until a final conclusion of the real incidence of autoimmunity in Rasopathy is drawn, the physicians should be alerted to the possibility of this association and the need for a fast diagnosis, proper referral to a specialist and ultimately, adequate treatment.

  10. Follicular Thyroid Cancer Presenting as a Pelvic Mass: A Case Report

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    Halit Karaca

    2011-03-01

    Full Text Available AbstractDistant metastasis is uncommon in differentiated thyroid cancer (DTC and 7% to 23% of DTC patients develop distant metastasis. The remarkably good prognosis and long-term survival in DTC are significantly reduced in patients with distant metastasis as those at the pelvic site. We report the rare case of a patient wth follicular thyroid cancer initially diagnosed as a pelvic mass. Turk Jem 2011; 15: 23-5

  11. Thyroid hormone antibodies and Hashimoto's thyroiditis in mongrel dogs

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    Rajatanavin, R.; Fang, S.L.; Pino, S.; Laurberg, P.; Braverman, L.E.; Smith, M.; Bullock, L.P.

    1989-05-01

    Abnormally elevated serum T3 concentrations measured by RIA were observed in 19 clinically euthyroid or hypothyroid mongrel dogs. The serum T4 concentrations in these sera were low, normal, or high. Measurement of the intensity of thyroid hormone binding to serum proteins was determined by equilibrium dialysis. A marked decrease in the percent free T3 was observed in these abnormal sera. Polyacrylamide gel electrophoresis, pH 7.4, of normal dog serum enriched with tracer /sup 125/I-labeled thyroid hormones demonstrated binding of (/sup 125/I)T4 to transthyretin, thyroid hormone-binding globulin, and albumin and of (/sup 125/I)T3 primarily to thyroid hormone-binding globulin. In all abnormal sera, polyacrylamide gel electrophoresis demonstrated strikingly higher binding of T3 to immunoglobulin (Ig). Eleven of 16 abnormal sera had minimal to moderate binding of T4 to Ig. The percent free T4 was lower only in dogs whose sera demonstrated markedly increased binding of T4 to Ig. All abnormal sera tested had positive antithyroglobulin antibodies, consistent with the diagnosis of autoimmune lymphocytic thyroiditis. As in humans, antibodies to thyroid hormones in dogs are more common in the presence of Hashimoto's thyroiditis and should be considered when elevated serum thyroid hormone concentrations are observed in the absence of clinical thyrotoxicosis. When an antibody to only one thyroid hormone is present, a marked discrepancy in the serum concentrations of T3 and T4 will be observed.

  12. Bilateral optic nerve edema presenting as initial manifestation of thyroid eye disease.

    Science.gov (United States)

    Wilson, Michelle E; Kim, Charles; Carrasco, Jacqueline

    2016-10-01

    A 48-year-old smoker with a history of hyperthyroidism treated 10 years prior to presentation with radioactive iodine ablation of the thyroid gland presented to his ophthalmologist with a 2-week history of transient loss of vision in the right eye occurring for 1 to 2 hours each morning. He denied ocular pain, diplopia or change in the prominence of one or both eyes. Examination revealed 2 mm of relative proptosis on the right, bilateral temporal flare and lower lid retraction. There was minimal upper lid retraction and no evidence of lid lag. Ocular motility was full. Dilated fundoscopic examination revealed bilateral optic nerve edema, right more than left. CT of the orbit demonstrated enlargement of the extraocular muscles bilaterally with marked enlargement of the right medial rectus and left inferior rectus muscles resulting in crowding at the orbital apex bilaterally. Laboratory testing revealed the patient to be hyperthyroid. The patient was treated with high dose oral steroids followed by orbital radiation. Hyperthyroidism was managed by the patient's primary care physician. Visual symptoms rapidly improved with oral steroids and orbital radiation. Optic nerve edema completely resolved. Repeat CT imaging demonstrated a reduction in the enlargement of the extraocular muscles with relief of bilateral optic nerve compression.

  13. Hashimoto thyroiditis: clinical and diagnostic criteria.

    Science.gov (United States)

    Caturegli, P; De Remigis, A; Rose, N R

    2014-01-01

    Hashimoto thyroiditis (HT), now considered the most common autoimmune disease, was described over a century ago as a pronounced lymphoid goiter affecting predominantly women. In addition to this classic form, several other clinico-pathologic entities are now included under the term HT: fibrous variant, IgG4-related variant, juvenile form, Hashitoxicosis, and painless thyroiditis (sporadic or post-partum). All forms are characterized pathologically by the infiltration of hematopoietic mononuclear cells, mainly lymphocytes, in the interstitium among the thyroid follicles, although specific features can be recognized in each variant. Thyroid cells undergo atrophy or transform into a bolder type of follicular cell rich in mitochondria called Hürthle cell. Most HT forms ultimately evolve into hypothyroidism, although at presentation patients can be euthyroid or even hyperthyroid. The diagnosis of HT relies on the demonstration of circulating antibodies to thyroid antigens (mainly thyroperoxidase and thyroglobulin) and reduced echogenicity on thyroid sonogram in a patient with proper clinical features. The treatment remains symptomatic and based on the administration of synthetic thyroid hormones to correct the hypothyroidism as needed. Surgery is performed when the goiter is large enough to cause significant compression of the surrounding cervical structures, or when some areas of the thyroid gland mimic the features of a nodule whose cytology cannot be ascertained as benign. HT remains a complex and ever expanding disease of unknown pathogenesis that awaits prevention or novel forms of treatment.

  14. The association between chronic lymphocytic thyroiditis and thyroid tumors.

    Science.gov (United States)

    Tamimi, Dalal M

    2002-04-01

    An association between lymphocytic thyroiditis and thyroid papillary carcinoma is still controversial. To assess the relationship, a histopathologic analysis of surgically resected thyroid tumors together with the frequency and severity of chronic lymphocytic infiltration of the thyroid among patients with follicular adenoma, follicular carcinoma, and papillary carcinoma was performed. The prevalence of lymphocytic infiltrate, which is indicative of autoimmune thyroiditis, was significantly higher in patients with papillary carcinoma (58%) than in patients with follicular carcinoma (20%) or follicular adenoma (14%). The lymphocytic infiltration within the tumor compared with the severity of thyroiditis in the nontumorous tissue. Therefore, the association between chronic lymphocytic thyroiditis and papillary carcinoma was confirmed. The possibility that an immunologic mechanism involved in the pathogenesis of papillary carcinoma stimulates lymphocytic infiltration in the thyroid tissue through an autoimmune mechanism is suggested.

  15. Autoimmune Pancreatitis Presenting a Short Narrowing of Main Pancreatic Duct with Subsequent Progression to Diffuse Pancreatic Enlargement over 24 Months; Natural History of Autoimmune Pancreatitis

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    Shuichiro Umemura

    2014-05-01

    Full Text Available Context Initial pancreatogram and natural history of autoimmune pancreatitis (AIP have not been clarified, and there were few recent studies concerning the association between AIP and intraductal papillary mucinous neoplasm (IPMN. Case report We report an 81-yearold man with AIP associated with IPMN. Although the initial pancreatogram was normal, a short narrowing of the main pancreatic duct (MPD appeared during a follow-up for IPMN after 6 months, which was highly suggestive of pancreatic cancer. A narrowing of the MPD extended after 15 months, and this progressed to diffuse narrowing of the MPD with an elevation in the serum IgG4 levels after 24 months. Finally, the patient was diagnosed with diffuse-type AIP, according to the Japanese diagnostic criteria 2011 and the International Consensus Diagnostic Criteria. Considering the natural history of AIP, this marked change of the MPD is indicative of this condition. Conclusion Wereport a case of AIP presenting with a short narrowing of the MPD with subsequent progression to diffuse pancreatic enlargement during a follow-up for IPMN.

  16. A case of facial lentiginous lichen planus pigmentosus associated with Hashimoto’s thyroiditis and diabetes mellitus

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    Fadime Kilinc

    2015-10-01

    Full Text Available Lichen planus pigmentosus (LPP is an autoimmune, chronic and rare variant of lichen planus of unknown etiology that progresses with pigmentation. The condition is rarely observed concurrently with autoimmune diseases. In this case report, a diabetic male patient with speckled lentiginous lesions on the face, also diagnosed with concurrent autoimmune thyroiditis is presented due to the rarity of the condition and the morphological character of the lesions.

  17. Isolated right ventricular cardiomyopathy with autoimmune hypothyroidism: a rare association in an adolescent

    Science.gov (United States)

    Yelve, Kavita; Panandikar, Gajanan Ashok; Pazare, Amar; Bajpai, Smrati

    2015-01-01

    A 13-year-old girl presented with progressive dyspnoea and palpitation, diagnosed on echocardiography as primary right ventricular cardiomyopathy with atrial fibrillation. Her thyroid profile was positive for antithyroid microsomal antibody, and antithyroid peroxidase antibodies were suggestive of autoimmune hypothyroidism. She was managed with furosemide, digoxin, acenocoumarol and thyroxine following which she showed significant improvement. This is a rare case of isolated right ventricular cardiomyopathy and its association with autoimmune hypothyroidism presenting at the age of 13. PMID:25795745

  18. Association of parvovirus B19 infection and Hashimoto's thyroiditis in children.

    Science.gov (United States)

    Lehmann, Hartwig W; Lutterbüse, Nicola; Plentz, Annelie; Akkurt, Ilker; Albers, Norbert; Hauffa, Berthold P; Hiort, Olaf; Schoenau, Eckhard; Modrow, Susanne

    2008-09-01

    Hashimoto's thyroiditis is a common autoimmune disorder of the thyroid gland. It has been linked to infections with hepatitis C, EBV, HTLV-1, and Yersinia enterocolitica. As parvovirus B19 has been associated with a wide spectrum of autoimmune diseases, we investigated the potential role of B19 infection in inducing Hashimoto's thyroiditis. Serum samples derived from 73 children and adolescents with Hashimoto's thyroiditis and from 73 age-matched controls were included in the study. The mean age of disease manifestation was 10 y 7 mo. All samples were analyzed for the presence of viral DNA and for antibodies against VP1, VP2, and NS1 proteins. VP1- and VP2-specific antibodies were present in 38 patients (52%) and 43 controls (59%; N.S.). NS1-specific antibodies were detectable in 23 patients (32%) and 19 controls (26%; N.S.). Parvovirus B19 DNA was detectable in 9 patients (12%) and 2 controls (3%; p Hashimoto's thyroiditis.

  19. IDIOPATHIC AUTOIMMUNE HEMOLYTIC ANEMIA PRESENTING AS MASSIVE SPLENOMEGALY IN AN ELDERLY MALE WHICH RESPONDED TO STEROID THERAPY

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    Deepak

    2014-07-01

    Full Text Available Autoimmune hemolytic anemia is uncommon. The estimated overall (not age-adjusted annual incidence is about 1 case per 100,000 populations; after age 60 years, the annual incidence reaches 10 per 100,000. The disorder can occur at any age, but most patients are older than 40 years. About 65% of patients with primary autoimmune hemolytic anemia are women, and almost all cases that complicate systemic lupus erythematosus occur in women. A 65 years old male presented with generalized weakness, breathlessness on exertion, swelling of lower limbs and pain abdomen of 6 months duration. He was previously admitted elsewhere on several occasions (within past 3-4 months with similar complaints, and had received multiple blood transfusions. On clinical examination, patient had pallor and bilateral pitting pedal edema. Abdominal examination revealed massive Splenomegaly (12 cm below left costal margin, moderate Hepatomegaly. Investigations revealed Hb% of 8.6 g/dl, Platelet count = 1 lakh/cmm, ESR = 120 mm, retic count -2.2 %. Peripheral smear showed evidence of hemolysis. Serum LDH was high, Serum bilirubin predominantly indirect hemoglobin= 2, S. Haptoglobin below 6.63. These findings suggested hemolysis as a cause of his anemia and splenomegaly. Further evaluation was done to find out the cause of hemolysis in this elderly male. Hb Quantification using HPLC was normal. Serum G6PD activity was normal. ANA was negative. Hams test was negative. Direct & Indirect Coomb’s tests were positive. Bone marrow examination showed erythroid hyperplasia. CT Abdomen showed hepatosplenomegaly. Upper GI endoscopy and colonoscopy were normal. Based on these findings a diagnosis of warm antibody type auto immune haemolytic anaemia (AIHA, probably of idiopathic type, was made and patient was started on steroid therapy. After 2 weeks, repeat haemoglobin was 12.8 gm%, WBC count was 7020/cumm reflecting response to steroid therapy. Severe AIHA can be a medical emergency. Red

  20. Association of functional polymorphisms in promoter regions of IL5, IL6 and IL13 genes with development and prognosis of autoimmune thyroid diseases.

    Science.gov (United States)

    Inoue, N; Watanabe, M; Morita, M; Tatusmi, K; Hidaka, Y; Akamizu, T; Iwatani, Y

    2011-03-01

    To clarify the association of genetic producibility of interleukin (IL)-5, IL-6 and IL-13, which are secreted by T helper type 2 (Th2), with the development and prognosis of autoimmune thyroid disease (AITD), we genotyped IL5-746C/T, IL6-572C/G and IL13-1112C/T polymorphisms, which are functional polymorphisms in the promoter regions of the genes regulating these cytokines. Fifty-seven patients with intractable Graves' disease (GD), 52 with GD in remission, 52 with severe Hashimoto's disease (HD), 56 with mild HD and 91 healthy controls were examined in this study. The IL13-1112T allele, which correlates with higher producibility of IL-13, was more frequent in patients with GD in remission than in those with intractable GD [P=0·009, odds ratio (OR)=3·52]. The IL5-746T allele, which may correlate with lower levels of IL-5, was more frequent in patients with GD in remission than controls (P=0·029, OR=2·00). The IL6-572G allele carriers (CG and GG genotypes), which have higher producibility of IL-6, were more frequent in AITD patients (P=0·033, OR=1·75), especially in GD in remission (P=0·031, OR=2·16) and severe HD (P=0·031, OR=2·16) than in controls. Interestingly, both allele and genotype frequencies of Th2 cytokine genes were similar between GD and HD patients. In conclusion, functional polymorphisms in the genes encoding Th2 cytokines are associated differently with the development and prognosis of AITD from each other.

  1. Thyroid in pregnancy: From physiology to screening.

    Science.gov (United States)

    Springer, Drahomira; Jiskra, Jan; Limanova, Zdenka; Zima, Tomas; Potlukova, Eliska

    2017-03-01

    -half of women with thyroid disorders escape the case-finding approach. Moreover, the universal screening has been shown to be more cost-effective. Screening for thyroid disorders in pregnancy should include assessment of both TSH and TPOAb, regardless of the screening approach. This review summarizes the current knowledge on physiology of thyroid hormones in pregnancy, causes of maternal thyroid dysfunction and its effects on pregnancy course and fetal development. We discuss the question of case-finding versus universal screening strategies and we display an overview of the analytical methods and their reference intervals in the assessment of thyroid function and thyroid autoimmunity in pregnancy. Finally, we present our results supporting the implementation of universal screening.

  2. Cytomorphological features of oncocytic variant of papillary thyroid carcinoma with lymphocytic thyroiditis

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    Nivedita Patnaik

    2016-01-01

    Full Text Available Cytological diagnosis of hurthle cell lesions of thyroid is a diagnostic dilemma. Presence of hurthle cells on fine needle aspiration (FNA leads to a wide range of differential diagnosis including benign and malignant entities. The oncocytic variant of papillary thyroid carcinoma (PTC is one entity of the vast list of differentials of which very few cases have been reported to date. We report a case of oncocytic variant of PTC in a 28-year-old female diagnosed on cytomorphology. The findings of FNA smears of the first aspirate were not sufficient for a definitive diagnosis. Repeat FNA was done to rule out the possibility of autoimmune thyroiditis/thyroid neoplasm. The repeat FNA smears showed oncocytic cells present in papillary and loosely cohesive clusters. Many of the cells displayed nuclear features of PTC and the case was finally diagnosed as PTC; oncocytic variant. Thyroidectomy specimen revealed PTC; oncocytic variant with lymphocytic thyroiditis in the surrounding tissue. Thus, in cytology practice, concurrent autoimmune thyroiditis may pose a problem in diagnosis of PTC; oncocytic variant.

  3. Autoimmune hepatitis.

    Science.gov (United States)

    Heneghan, Michael A; Yeoman, Andrew D; Verma, Sumita; Smith, Alastair D; Longhi, Maria Serena

    2013-10-26

    Autoimmune hepatitis is a disease of the hepatic parenchyma that can present in acute or chronic forms. In common with many autoimmune diseases, autoimmune hepatitis is associated with non-organ-specific antibodies in the context of hepatic autoimmunity. This dichotomy has made definition of a unifying hypothesis in the pathophysiology of the disease difficult, although data from the past 8 years have drawn attention to the role of regulatory T cells. Several triggers have been identified, and the disease arises in genetically susceptible individuals. Clinical and biochemical remission is achievable in up to 85% of cases. For the remaining patients, alternative immunosuppression strategies are an option. Liver transplantation provides an excellent outcome for patients with acute liver failure or complications of end-stage liver disease, including hepatocellular carcinoma. Variant or overlapping syndromes are worthy of consideration when unexpected disease features arise.

  4. Autoimmune hypophysitis.

    Science.gov (United States)

    Ezzat, S; Josse, R G

    1997-03-01

    Autoimmune (lymphocytic) hypophysitis has emerged as a distinct and specific clinical and pathological disease entity. Although relatively rare compared with other autoimmune endocrine diseases, nearly a hundred cases have been described. The condition is much more common in females (9:1) and appears to have a particular predilection for the pregnant and postpartum states. The anterior pituitary, and less often the neurohypophysis, appear to be the target for inflammatory autoimmune destruction. During the evolution of the disease process, pituitary hyperfunction (usually hyperprolactinemia) has been noted. This disease should now be included in the differential diagnosis of pituitary disorders, especially in females presenting with pituitary enlargement, particularly if symptoms occur in temporal relationship to pregnancy. The disease may form part of the spectrum of the polyglandular autoimmune endocrine disorders. (Trends Endocrinol Metab 1997;8:74-80). (c) 1997, Elsevier Science Inc.

  5. Affective psychosis, Hashimoto's thyroiditis, and brain perfusion abnormalities: case report

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    Loviselli Andrea

    2007-12-01

    Full Text Available Abstract Background It has recently become evident that circulating thyroid antibodies are found in excess among patients suffering from mood disorders. Moreover, a manic episode associated with Hashimoto's thyroiditis has recently been reported as the first case of bipolar disorder due to Hashimoto's encephalopathy. We report a case in which Hashimoto's thyroiditis was suspected to be involved in the deteriorating course of mood disorder and discuss potential pathogenic mechanisms linking thyroid autoimmunity with psychopathology. Case presentation A 43-year-old woman, with a history of recurrent depression since the age of 31, developed manic, psychotic, and soft neurological symptoms across the last three years in concomitance with her first diagnosis of Hashimoto's thyroiditis. The patient underwent a thorough medical and neurological workup. Circulating thyroperoxidase antibodies were highly elevated but thyroid function was adequately maintained with L-thyroxine substitution. EEG was normal and no other signs of current CNS inflammation were evidenced. However, brain magnetic resonance imaging evidenced several non-active lesions in the white matter from both hemispheres, suggestive of a non-specific past vasculitis. Brain single-photon emission computed tomography showed cortical perfusion asymmetry particularly between frontal lobes. Conclusion We hypothesize that abnormalities in cortical perfusion might represent a pathogenic link between thyroid autoimmunity and mood disorders, and that the rare cases of severe Hashimoto's encephalopathy presenting with mood disorder might be only the tip of an iceberg.

  6. Evaluation of the 2. generation radio-receptional assay for anti-TSH receptor antibodies (TRAb) in autoimmune thyroid diseases. Comparison with 1. generation and anti-thyroperoxidae antibodies (AbTPO)

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    Giovanella, L.; Ceriani, L.; Garacini, S. [University Hospital Ospedale di Circolo e Fondazione Macchi, Dept. of Nuclear Medicine, Lab. of Endocrinology and Thyroid Unit, Varese (Italy)

    2001-03-01

    The detection of autoantibodies to the TSH-receptor (TRAb) by radio-receptor assays (RRA) is widely requested in clinical practice for the diagnostic work-up of Graves' disease and its differentiation from diffuse thyroid autonomy. Additionally, TRAb measurement can be useful during antithyroid drug treatment of Graves' disease to evaluate the risk of relapse after therapy discontinuation. Nevertheless, some patients affected by Graves' disease are TRAb-negative when 1. generation assay is used. In this study the diagnostic performance of a newly developed 2. generation TRAb assay (TRAK human DYNOtest(R), BRAHMS Diagnostica GmbH, Berlin, Germany) was evaluated in 74 untreated patients affected by Graves' disease, in 53 untreated patients affected by Hashimoto's thyroiditis and in 88 patients affected by euthyroid nodular goiter. It was also compared the new TRAb assay with the 1. generation test (TRAK(R) Assay, BRAHMS Diagnostica GmbH, Berlin, Germany) and anti-thyroperoxidase assay (AbTPO DYNOtest(R), BRAHMS GmbH, Berlin). The 2. generation TRAb assay showed the better diagnostic sensitivity in Graves' disease (97%) with respect to the 1. generation assay (85%) and AbTPO assay (64%). The AbTPO assay was positive in 50 of 53 (94%) patients affected by autoimmune thyroiditis. The 1. and 2. generation TRAb assays were positive in 4 (7%) and 7 (13%) of 53 patients affected by autoimmune thyroiditis, respectively. No patients affected by nodular goiter showed positive 1. and 2. generation TRAb assay while AbTPO levels were positive in 8 of 88 patients (specificity 91%). In conclusion, the 2. generation TRAb assay is clearly more sensitive than the 1. generation test and should be used in clinical practice to minimize the incidence of TRAb-negative Graves' disease. Long term prospective studies are needed to evaluate the prognostic role of 2. generation TRAb assay in Graves' disease. The assay of AbTPO is the best marker for

  7. PREVELANCE OF ANTI-TPO ANTIBODY IN TYPE-1 DIABETES AND THYROID DYSFUNCTION IN TPO ANTIBODY POSITIVE DIABET ICS

    OpenAIRE

    Ganesan; Josephine Latha

    2012-01-01

    ABSTRACT: BACKGROUND: The appearance of TPO-Abs precedes thyroid dysfunction and increases in autoimmune diseases like type1diabetes. Thyroid peroxidase (TPO) antibodies are one of the major secondary antibodies associated wi th autoimmune thyroid disease and can be used as diagnostic marker. The prevalence of thyroid auto antibodies is increased when patients have non-thyroid autoimmune diseases such as type 1 diabetes and pernicious anemia. Thyroid dysfuncti...

  8. Familial autoimmunity and polyautoimmunity in 60 Brazilian Midwest patients with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Alex Magno Coelho Horimoto

    Full Text Available ABSTRACT Introduction: Systemic sclerosis (SSc is a connective tissue disease of unknown etiology, characterized by a triad of vascular injury, autoimmunity and tissue fibrosis. It is known that a positive family history is the greatest risk factor already identified for the development of SSc in a given individual. Preliminary observation of a high prevalence of polyautoimmunity and of familial autoimmunity in SSc patients support the idea that different autoimmune phenotypes may share common susceptibility variants. Objectives: To describe the frequency of familial autoimmunity and polyautoimmunity in 60 SSc patients in the Midwest region of Brazil, as well as to report the main autoimmune diseases observed in this association of comorbidities. Methods: A cross-sectional study with recruitment of 60 consecutive patients selected at the Rheumatology Department, University Hospital, Medicine School, Federal University of Mato Grosso do Sul (FMUFMS, as well as interviews of their relatives during the period from February 2013 to March 2014. Results: A frequency of 43.3% of polyautoimmunity and of 51.7% of familial autoimmunity in SSc patients was found. Patients with the presence of polyautoimmunity and familial autoimmunity presented primarily the diffuse form of SSc, but this indicator did not reach statistical significance. The autoimmune diseases most frequently observed in polyautoimmunity patients were: Hashimoto's thyroiditis (53.8%, Sjögren's syndrome (38.5%, and inflammatory myopathy (11.5%. The main autoimmune diseases observed in SSc patients' relatives were: Hashimoto's thyroiditis (32.3%, rheumatoid arthritis (22.6%, and SLE (22.6%. The presence of more than one autoimmune disease in SSc patients did not correlate with disease severity or activity. Conclusions: From the high prevalence of coexisting autoimmune diseases found in SSc patients, we stress the importance of the concept of shared autoimmunity, in order to promote a

  9. Thyroid hormonal disturbances related to treatment of hepatitis C with interferon-alpha and ribavirin

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    Debora Lucia Seguro Danilovic

    2011-01-01

    Full Text Available OBJECTIVE: To characterize thyroid disturbances induced by interferon-alpha and ribavirin therapy in patients with chronic hepatitis C. INTRODUCTION: Interferon-alpha is used to treat chronic hepatitis C infections. This compound commonly induces both autoimmune and non-autoimmune thyroiditis. METHODS: We prospectively selected 26 patients with chronic hepatitis C infections. Clinical examinations, hormonal evaluations, and color-flow Doppler ultrasonography of the thyroid were performed before and during antiviral therapy. RESULTS: Of the patients in our study, 54% had no thyroid disorders associated with the interferon-alpha therapy but showed reduced levels of total T3 along with a decrease in serum alanine aminotransferase. Total T4 levels were also reduced at 3 and 12 months, but free T4 and thyroid stimulating hormone (TSH levels remained stable. A total of 19% of the subjects had autoimmune interferon-induced thyroiditis, which is characterized by an emerge of antithyroid antibodies or overt hypothyroidism. Additionally, 16% had non-autoimmune thyroiditis, which presents as destructive thyroiditis or subclinical hypothyroidism, and 11% remained in a state of euthyroidism despite the prior existence of antithyroidal antibodies. Thyrotoxicosis with destructive thyroiditis was diagnosed within three months of therapy, and ultrasonography of these patients revealed thyroid shrinkage and discordant change in the vascular patterns. DISCUSSION: Decreases in the total T3 and total T4 levels may be related to improvements in the hepatocellular lesions or inflammatory changes similar to those associated with nonthyroidal illnesses. The immune mechanisms and direct effects of interferon-alpha can be associated with thyroiditis. CONCLUSION: Interferon-alpha and ribavirin induce autoimmune and non-autoimmune thyroiditis and hormonal changes (such as decreased total T3 and total T4 levels, which occur despite stable free T4 and TSH levels. A thyroid

  10. Generalized Vitiligo Associated Autoimmune Diseases in Japanese Patients Their Families

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    Tomohiko Narita

    2011-01-01

    Conclusions: Among Japanese vitiligo patients, there is a subgroup with strong evidence of genetically determined susceptibility to not only vitiligo, but also to autoimmune thyroid disease and other autoimmune disorders.

  11. Transient Non-Autoimmune Hyperthyroidism of Early Pregnancy

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    Alexander M. Goldman

    2011-01-01

    Full Text Available It is characterized by chemical and sometimes clinical hyperthyroidism, without evidence of thyroid autoimmunity that resolves spontaneously by 16 weeks gestation without significant obstetrical complications.

  12. Value of FNAC in diagnosis of different types of thyroiditis and its comparison with clinical and biochemical findings.

    Science.gov (United States)

    Parveen, K; Barua, A R; Hossain, A; Zaman, J; Momen, A

    2009-07-01

    FNAC has developed tremendous improvement in the diagnosis of thyroiditis. The present study was designed to asses the usefulness of FNAC to diagnose various types of thyroiditis and to study their smear patterns. Over a period of one-year, 70 cases of thyroiditis have been evaluated on the basis of cytomorphological criteria and clinical findings of patients. The age ranged from 12-60 years. Majority of the cases were between 21 to 30 years of age with female preponderance in each group of thyroiditis. Among 70 cases, 26(37.14%) cases were Hashimoto's thyroiditis, 21(30%) cases were lymphocytic thyroiditis, seven (10%) cases as granulomatous thyroiditis and 16(22.8%) were non-specific thyroiditis. Further study was carried out in these 70 cases regarding biochemical thyroid status, ultrasonography and radionucleotide scan. Blood was drawn from all patients for estimation of antibody titer to compare with cytological diagnosis. It was found that, clinical examination and history of patients had limited value in the diagnosis of thyroiditis. Ultrasonography and thyroid scan could not reliably differentiate between patients with autoimmune thyroiditis and those with simple and nodular goiter. Biochemically hypothyroidism is more frequently evaluated with Hashimoto's diseases. On the other hand, hyperthyroidism was observed in most other types of thyroiditis. Cytologically diagnosed 78.72% cases of autoimmune thyroiditis had positive antibody titer. From the present study it is concluded that FNAC is a safe, reliable, cost effective and time saving method in the diagnosis of thyroiditis. Being a benign condition also reduce the rate of unnecessary operation, which can be treated conservatively.

  13. Autoimmune hepatitis: Single-center experience of clinical presentation, response to treatment and prognosis in Saudi Arabia

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    Fallatah Hind

    2010-01-01

    Full Text Available Background /Aim : Autoimmune hepatitis (AIH is a common cause of end-stage liver disease worldwide. It is a disease prevalent in children and adults, with female predominance and variable clinical presentations. AIH has favorable responses to steroids and immunomodulators. Diagnosis of AIH is based on clinical and laboratory criteria, as suggested by the International Autoimmune Hepatitis Group. Data on the disease pattern of AIH from the Middle East countries is scarce. Materials and Methods : In this retrospective analysis, we studied clinical and laboratory features, immunological data, radiological findings, liver biopsy findings and response to therapy in patients with AIH from the hepatology clinics of King Abdul Aziz, University Hospital, Jeddah, from 1994 to 2008. Results : We diagnosed 41 patients with AIH, and 33 were included in the analysis. The mean age was 32.3 years, with female predominance of 75.7%. De- compensated cirrhosis at presentation was found in 45.5% of the patients. Acute hepatitis was associated with significantly higher levels of the serum ALT and bilirubin (P=0.001 and P=0.03, respectively. All our patients had type 1 AIH. Treatment with prednisolone and azathioprine resulted in complete or partial remission in majority of the patients (54.8%. However, patients with advanced disease showed a poorer response to treatment (P=0.016. Six patients with poor compliance had relapse of AIH. Two patients had a flare of the disease during pregnancy, and they responded well with prednisolone. The longest follow-up was 14 years and the shortest was 2 months. Four patients died from liver disease. Conclusion : AIH patients in Saudi Arabia are likely to present with advanced disease at a young age and would have a poorer response to therapy as compared with patients in other countries worldwide.

  14. Results and summary of voting among the audience during presentation and discussion of Medullary Thyroid Carcinoma clinical guidelines prepared by American Thyroid Association.

    Science.gov (United States)

    Feldt-Rasmussen, Ulla; Soderstrom, Folke

    2013-03-14

    The one-day ETA-CRN meeting, preceding the ETA meeting in Lisbon, was planned in advance to provide a thorough assessment of the European response to the published American Thyroid Association MTC guidelines. During the meeting, following each of the European speakers, a series of questions, related to the specific aspect, were presented to the audience. The responses from the audience were collected by an AudioResponseSystem (ARS voting system). The results of the voting showed in summary that European expert opinion leaders and an audience of specialists in treatment of Medullary Carcinoma welcomes the American Guidelines on the management of MTC, but simultaneously only partially agrees with some of the statements in the guidelines.

  15. Interleukin-10 but not interleukin-18 may be associated with the immune response against well-differentiated thyroid cancer

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    Lucas Leite Cunha

    2011-01-01

    Full Text Available OBJECTIVES: The aim of this study was to investigate the role of the interleukin-18 +105A/C and interleukin-10 -1082A/G germline polymorphisms in the development and outcome of differentiated thyroid carcinoma associated or not with concurrent thyroiditis. METHODS: We studied 346 patients with differentiated thyroid carcinomas, comprising 292 papillary carcinomas and 54 follicular carcinomas, who were followed up for 12-298 months (mean 76.10 ± 68.23 months according to a standard protocol. We genotyped 200 patients and 144 control individuals for the interleukin-18 +105A/C polymorphism, and we genotyped 183 patients and 137 controls for the interleukin-10 -1082A/G polymorphism. RESULTS: Interleukin-18 polymorphisms were not associated with chronic lymphocytic thyroiditis or any clinical or pathological feature of tumor aggressiveness. However, there was an association between the presence of interleukin-10 variants and chronic lymphocytic thyroiditis. Chronic lymphocytic thyroiditis was present in 21.74% of differentiated thyroid carcinoma patients, most frequently affecting women previously diagnosed with Hashimoto's thyroiditis who had received a lower 131I cumulative dose and did not present lymph node metastases. CONCLUSIONS: We conclude that the inheritance of a G allele at the interleukin-10 -1082A/G polymorphism may favor a concurrent thyroid autoimmunity in differentiated thyroid carcinoma patients, and this autoimmunity may favor a better prognosis for these patients.

  16. Increased prevalence of thyroid dysfunction and diabetes mellitus in Indian vitiligo patients: A case-control study

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    K.V.T. Gopal

    2014-01-01

    Full Text Available Background: Though it is well-known that vitiligo is associated with other autoimmune disorders, few Indian studies have focused on the relation between vitiligo, autoimmune thyroid dysfunction and diabetes mellitus. Materials and Methods: This case-control study included 150 new cases of vitiligo and 100 age and sex-matched controls. A complete history and thorough dermatological examination was done. Serum samples from both patients and controls were collected and assayed for triiodothyronine, thyroxine, thyroid-stimulating hormone, anti-thyroid antibodies-anti-thyroid peroxidase and anti-thyroglobulin and fasting plasma glucose. Results: Thyroid hormonal profile revealed autoimmune thyroid dysfunction manifesting as hypothyroidism in 30 (20% vitiligo patients and two controls (2%. Diabetes mellitus was present in 24 (16% vitiligo patients and five controls. Seven (4.7% patients had both hypothyroidism and diabetes mellitus. Conclusion: There is a clear association between vitiligo, autoimmune hypothyroidism and diabetes mellitus. It would be very useful to screen for thyroid dysfunction and diabetes mellitus in all patients with vitiligo.

  17. The onset of systemic lupus erythematosus and thyroid dysfunction following graves’ disease - a case report and literature review

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    Zhanga Yuanyuan

    2016-01-01

    Full Text Available Introduction. Graves’ disease is a multifactorial autoimmune thyroid disease, with the presence of typical circulating autoantibodies that can activate the thyroid hormone receptors, resulting in hyperthyroidism, goiter, and ophthalmopathy. Systemic lupus erythematosus is a multi-systemic autoimmune disease that involves almost all the organs of the human body and is characterized by autoantibodies formation. Several studies have reported that autoimmune thyroid and rheumatic disorders can present an unusual relationship. Case Outline. We report a case of a middle-aged woman who presented with systemic lupus erythematosus one year after being diagnosed with Graves’ disease. Prednisone and cyclophosphamide were administered to control the development of systemic lupus erythematosus. Furthermore, a percutaneous thyroid biopsy was performed for further confirmation of Graves’ disease. Methimazole instead of propylthiouracil was added into the therapeutic scheme. A month later, the patient’s clinical manifestation and laboratory tests got significant improvement, except that new thyr o id dysfunction appeared opposite to the original one. The administration of anti-thyroid drug was discontinued. With a period of decreased administration of prednisone, the patient’s thyroid function gradually got back to normal levels without any levothyroxine replacement. Conclusion. In conclusion, the clinical use of prednisone and antithyroid drugs may result in instability of the hypothalamus-pituitary-thyroid axis, and thyroid function should be carefully monitored in such patients.

  18. Promiscuous presentation and recognition of nucleosomal autoepitopes in lupus: role of autoimmune T cell receptor alpha chain.

    Science.gov (United States)

    Shi, Y; Kaliyaperumal, A; Lu, L; Southwood, S; Sette, A; Michaels, M A; Datta, S K

    1998-02-01

    T cells specific for nucleosomal autoepitopes are selectively expanded in lupus mice and these Th cells drive autoimmune B cells to produce pathogenic antinuclear antibodies. We transfected the TCR-alpha and -beta chain genes of a representative, pathogenic autoantibody-inducing Th clone specific for the nucleosomal core histone peptide H471-94 into TCR-negative recipient cells. Although the autoimmune TCRs were originally derived from SNF1 (I-Ad/q) mice, the transfectants could recognize the nucleosomal autoepitope presented by APC-bearing I-A molecules of all haplotypes tested, as well as human DR molecules. Competition assays indicated that the autoepitopes bound to the MHC class II groove. Most remarkably, MHC-unrestricted recognition of the nucleosomal peptide epitope was conferred by the lupus TCR-alpha chain even when it paired with a TCR-beta chain of irrelevant specificity. Several other disease-relevant Th clones and splenic T cells of lupus mice had similar properties. The TCR-alpha chains of these murine lupus Th clones shared related motifs and charged residues in their CDRs, and similar motifs were apparent even in TCR-alpha chains of human lupus Th clones. The lupus TCR-alpha chains probably contact the nucleosomal peptide complexed with MHC with relatively high affinity/avidity to sustain TCR signaling, because CD4 coreceptor was not required for promiscuous recognition. Indeed, pathogenic autoantibody-inducing, CD4-negative, TCR-alphabeta+ Th cells are expanded in systemic lupus erythematosus. These results have implications regarding thymic selection and peripheral expansion of nucleosome-specific T cells in lupus. They also suggest that universally tolerogenic epitopes could be designed for therapy of lupus patients with diverse HLA alleles. We propose to designate nucleosomes and other antigens bearing universal epitopes "Pantigens" (for promiscuous antigens).

  19. A rare association of localized scleroderma type morphea, vitiligo, autoimmune hypothyroidism, pneumonitis, autoimmune thrombocytopenic purpura and central nervous system vasculitis. Case report

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    Bonilla-Abadía Fabio

    2012-12-01

    Full Text Available Abstract Background The localized scleroderma (LS known as morphea, presents a variety of clinical manifestations that can include systemic involvement. Current classification schemes divide morphea into categories based solely on cutaneous morphology, without reference to systemic disease or autoimmune phenomena. This classification is likely incomplete. Autoimmune phenomena such as vitiligo and Hashimoto thyroiditis associated with LS have been reported in some cases suggesting an autoimmune basis. To our knowledge this is the first case of a morphea forming part of a multiple autoimmune syndrome (MAS and presenting simultaneously with autoimmune thrombocytopenic purpura and central nervous system vasculitis. Case presentation We report an uncommon case of a white 53 year old female patient with LS as part of a multiple autoimmune syndrome associated with pneumonitis, autoimmune thrombocytopenic purpura and central nervous system vasculitis presenting a favorable response with thrombopoietin receptor agonists, pulses of methylprednisolone and cyclophosphamide. Conclusion Is likely that LS have an autoimmune origin and in this case becomes part of MAS, which consist on the presence of three or more well-defined autoimmune diseases in a single patient.

  20. Travels and travails of autoimmunity: a historical journey from discovery to rediscovery.

    Science.gov (United States)

    Mackay, Ian R

    2010-03-01

    Consideration on autoimmunity began, as did immunology itself, around year 1900, first with Ehrlich's doctrine of 'horror autotoxicus', then interpreted as 'autoimmunity cannot happen'. Yet by 1904 the antibody nature of the autohemolysin responsible for cold hemoglobinuria was described, and soon confirmed, but without generating any durable concept on autoimmunization as a cause of disease. Reasons included Ehrlich's doctrine, the particular directions that immunology was to take after the initial advances, and a greater preoccupation with bodily responses to extrinsic rather than autologous substances. So, during 1915-1945, autoimmunity underwent a long eclipse despite, during this time, some potentially telling studies relating to brain, kidney and other diseases. The 'awakening' dates from 1945 when a general theoretical concept did appear feasible. Knowledge accrued from applications of several research undertakings mostly for purposes quite unrelated to the proof of autoimmunization: the use of adjuvants; the Coombes anti-globulin reaction; the Waaler-Rose rheumatoid factor; Hargraves' LE cell; the Witebsky-Rose experimental induction of thyroiditis with autologous thyroid gland, and others. By the early 1960s resistance to the idea of autoimmunization had weakened, perhaps hastened by a monograph on autoimmune disease published in 1963, and surely by the consensus reached at a large international conference published as proceedings in 1965. This present conspectus arbitrarily concludes at year 1965, recognizing that the history of autoimmunity even now is far from over.

  1. Autoimmune Schizophrenia? Psychiatric Manifestations of Hashimoto's Encephalitis.

    Science.gov (United States)

    Haider, Ali S; Alam, Maryam; Adetutu, Ebun; Thakur, Richa; Gottlich, Caleb; DeBacker, Danielle L; Marks, Lianne

    2016-07-05

    Hashimoto's encephalitis (HE), also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), can be a debilitating manifestation of an autoimmune reaction against the thyroid that is often under-diagnosed primarily due to a lack of definitive diagnostic criteria. This is a case of a 52-year-old woman who has been diagnosed with HE after presenting with recurrent and severe psychosis in conjunction with paranoia and a thyroidopathy. Her symptoms are chronic, having first been documented as presenting 15 years prior and showing progressive exacerbation in both frequency and severity. The patient's paranoia often manifested as delusions involving family members or close friends and consequently introduced an opportunity for harm to herself and others. She showed great conviction with self-diagnoses that were proven incorrect, resulting in occasional non-compliance. Between episodes, the patient did not show evidence of symptoms. This patient struggled with several incorrect diagnoses and treatments for several years before the correct diagnosis of HE was made and displayed extreme improvement upon corticosteroid administration. This case illustrates the importance of increasing awareness of HE as well as including HE in a differential diagnosis when any patient presents with psychosis and concurrent thyroidopathy. Hashimoto's encephalitis follows putative characteristics of autoimmune diseases, exhibiting a higher incidence in women as compared to men, presenting with increased titers of autoantibodies, and showing dramatic amelioration when treated with corticosteroids.

  2. Th17细胞与自身免疫性甲状腺疾病研究进展%Research Progress in the Role of Th17 in Autoimmune Thyroid Diseases

    Institute of Scientific and Technical Information of China (English)

    周玉荣(综述); 赵超; 王加林(审校)

    2015-01-01

    辅助性T细胞17(Th17)是一种新型辅助 T细胞亚群,主要表达白细胞介素17等效应因子,已证实其在自身免疫性疾病中发挥重要的调节作用。随着研究的深入,人们发现 Th17细胞及其细胞因子亦参与了包括弥漫性毒性甲状腺肿、慢性淋巴细胞性甲状腺炎和甲状腺相关眼病在内的自身免疫性甲状腺疾病( AITD)的发病过程。该文就Th17细胞及其细胞因子在AITD发病中的作用研究进展予以综述。%The T helper cells 17(Th17) are a novel helper T cell subset,with interleukin 17(IL-17) as main expression ,have been proved to play an important regulatory role in the development of autoimmune dis-eases.Th17 cells may also contribute to the pathogenesis of autoimmune thyroid disorders(AITD) including diffuse toxic goiter disease,chronic lymphocytic thyroiditis,and thyroid-associated ophthalmopathy.Here is to make a review of the current knowledge regarding IL-17 and Th17 cells roles in the pathogenesis of AITD.

  3. Does microbiota composition affect thyroid homeostasis?

    Science.gov (United States)

    Virili, Camilla; Centanni, Marco

    2015-08-01

    The intestinal microbiota is essential for the host to ensure digestive and immunologic homeostasis. When microbiota homeostasis is impaired and dysbiosis occurs, the malfunction of epithelial barrier leads to intestinal and systemic disorders, chiefly immunologic and metabolic. The role of the intestinal tract is crucial in the metabolism of nutrients, drugs, and hormones, including exogenous and endogenous iodothyronines as well as micronutrients involved in thyroid homeostasis. However, the link between thyroid homeostasis and microbiota composition is not yet completely ascertained. A pathogenetic link with dysbiosis has been described in different autoimmune disorders but not yet fully elucidated in autoimmune thyroid disease which represents the most frequent of them. Anyway, it has been suggested that intestinal dysbiosis may trigger autoimmune thyroiditis. Furthermore, hypo- and hyper-thyroidism, often of autoimmune origin, were respectively associated to small intestinal bacterial overgrowth and to changes in microbiota composition. Whether some steps of this thyroid network may be affected by intestinal microbiota composition is briefly discussed below.

  4. Maternal Thyroid Dysfunction and Neonatal Thyroid Problems

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    Hulya Ozdemir

    2013-01-01

    Full Text Available Aim. To investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants. Methods. Women with hypothyroidism and having anti-thyroglobulin (ATG and anti-thyroid peroxidase (anti-TPO antibodies were assigned as group I, women with hypothyroidism who did not have autoantibodies were assigned as group II, and women without thyroid problems were assigned as group III. Results. Pregnant women with autoimmune hypothyroidism (group I had more preterm delivery and their babies needed more frequent neonatal intensive care unit (NICU admission. In group I, one infant was diagnosed with compensated hypothyroidism and one infant had transient hyperthyrotropinemia. Five infants (23.8% in group II had thyroid-stimulating hormone (TSH levels >20 mIU/mL. Only two of them had TSH level >7 mIU/L at the 3rd postnatal week, and all had normal free T4 (FT4. Median maternal TSH level of these five infants with TSH >20 mIU/mL was 6.6 mIU/mL. In group III, six infants (6.5% had TSH levels above >20 mIU/mL at the 1st postnatal week. Conclusion. Infants of mothers with thyroid problems are more likely to have elevated TSH and higher recall rate on neonatal thyroid screening. Women with thyroid disorders and their newborn infants should be followed closely for both obstetrical problems and for thyroid dysfunction.

  5. Insufficient documentation for clinical efficacy of selenium supplementation in chronic autoimmune thyroiditis, based on a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Winther, Kristian Hillert; Wichman, Johanna Eva Märta; Bonnema, Steen Joop;

    2017-01-01

    placebo and/or levothyroxine substitution, were eligible for inclusion. Identified outcomes were serum thyrotropin (thyroid stimulating hormone) levels in LT4-untreated patients, thyroid ultrasound and health-related quality of life. Eleven publications, covering nine controlled trials, were included...... in the systematic review. Random effects model meta-analyses were performed in weighted mean difference for thyroid stimulating hormone, ultrasound and health-related quality of life. Quality of evidence was assessed per outcome, using GRADE. Meta-analyses showed no change in thyroid stimulating hormone......, or improvements in health-related quality of life or thyroid echogenicity (ultrasound), between levothyroxine substitution-untreated patients assigned to selenium supplementation or placebo. Three trials found some improvement in wellbeing in patients receiving levothyroxine substitution, but could...

  6. Discontinuation of Smoking Increases the Risk for Developing Thyroid Peroxidase Antibodies and/or Thyroglobulin Antibodies: A Prospective Study

    NARCIS (Netherlands)

    G. Effraimidis; J.G.P. Tijssen; W.M. Wiersinga

    2009-01-01

    Context: Autoimmune thyroid disease develops in genetic susceptible subjects, provoked by environmental factors. Little is known of the environment in the early stages of autoimmunity. Objective: We evaluated environmental factors contributing to de novo occurrence of thyroid antibodies. Design: We

  7. Ultrasonography in the diagnosis of Hashimoto's thyroiditis.

    Science.gov (United States)

    Wu, Guihua; Zou, Dazhong; Cai, Haiyun; Liu, Yajun

    2016-06-01

    Hashimoto's thyroiditis is a type of autoimmune thyroid disease with an increasing prevalence in past decades. Its diagnosisis mostly based on ultrasonography. Ultrasonography is a useful and essential tool to make this diagnosis based on the characteristics of the disease. In the differential diagnosis of thyroid nodules, ultrasound-guided fine-needle biopsy is an effective method to distinguish Hashimoto's thyroiditis from other thyroid disorders. One exciting and recent advance is that non-invasive ultrasound-based methods have supplemented fine-needle aspiration to diagnose Hashimoto's thyroiditis under more complex conditions. In this review, we discuss the recent advantages of ultrasonography in the diagnosis of Hashimoto's thyroiditis.

  8. Autoimmune diseases and HIV infection

    Science.gov (United States)

    Virot, Emilie; Duclos, Antoine; Adelaide, Leopold; Miailhes, Patrick; Hot, Arnaud; Ferry, Tristan; Seve, Pascal

    2017-01-01

    Abstract To describe the clinical manifestations, treatments, prognosis, and prevalence of autoimmune diseases (ADs) in human immunodeficiency virus (HIV)-infected patients. All HIV-infected patients managed in the Infectious Diseases Department of the Lyon University Hospitals, France, between January 2003 and December 2013 and presenting an AD were retrospectively included. Thirty-six ADs were found among 5186 HIV-infected patients which represents a prevalence of 0.69% including immune thrombocytopenic purpura (n = 15), inflammatory myositis (IM) (n = 4), sarcoidosis (n = 4), Guillain–Barré syndrome (GBS) (n = 4), myasthenia gravis (n = 2), Graves’ disease (n = 2), and 1 case of each following conditions: systemic lupus erythematosus, rheumatoid arthritis, autoimmune hepatitis, Hashimoto thyroiditis and autoimmune hemolytic anemia. One patient presented 2 ADs. Thirty patients were known to be HIV-infected when they developed an AD. The AD preceded HIV infection in 2 patients. GBS and HIV infection were diagnosed simultaneously in 3 cases. At AD diagnosis, CD4 T lymphocytes count were higher than 350/mm3 in 63% of patients, between 200 and 350/mm3 in 19% and less than 200/mm3 in 19%. Twenty patients benefited from immunosuppressant treatments, with a good tolerance. ADs during HIV infection are uncommon in this large French cohort. Immune thrombocytopenic purpura, sarcoidosis, IM, and GBS appear to be more frequent than in the general population. Immunosuppressant treatments seem to be effective and well tolerated. PMID:28121924

  9. Production of interleukin (IL)-5 and IL-10 accompanies T helper cell type 1 (Th1) cytokine responses to a major thyroid self-antigen, thyroglobulin, in health and autoimmune thyroid disease

    DEFF Research Database (Denmark)

    Nielsen, C H; Hegedüs, L; Rieneck, K;

    2007-01-01

    Tumour necrosis factor (TNF)-alpha and interferon (IFN)-gamma exert detrimental effects in organ-specific autoimmune disease, while both destructive and protective roles have been demonstrated for interleukin (IL)-10, IL-4 and IL-5. We examined the production of these cytokines by peripheral bloo......-gamma, IL-5 and IL-10 responses were markedly inhibited by partial denaturation of Tg by boiling. We hypothesize that autoantibodies and complement may promote mixed Th1/Th2 cell cytokine responses by enhancing the uptake of autoantigens by antigen-presenting cells....... appeared to promote the production of IL-2 and particularly IL-5, the levels of which were reduced by neutralization of complement by heat- or zymosan treatment. The production of IFN-gamma and IL-2 of the three groups together correlated directly with the serum anti-Tg activity. Moreover, TNF-alpha, IFN...

  10. [Risk factors and pathogenesis of Hashimoto's thyroiditis].

    Science.gov (United States)

    Paknys, Gintaras; Kondrotas, Anatolijus Juozas; Kevelaitis, Egidijus

    2009-01-01

    The aim of this review is to summarize the current knowledge on Hashimoto's thyroiditis and its pathogenesis and to introduce the readers to the basic concept of autoimmune thyroid disease. Hashimoto's thyroiditis and Graves' disease are different expressions of a basically similar autoimmune process, and the clinical appearance reflects the spectrum of the immune response in a particular patient. During this response, cytotoxic autoantibodies, stimulatory autoantibodies, blocking autoantibodies, or cell-mediated autoimmunity may be observed. Persons with classic Hashimoto's thyroiditis have serum antibodies reacting with thyroglobulin and thyroid peroxidase. These antibodies (particularly antibodies against thyroid peroxidase) are complement-fixing immunoglobulins and may be cytotoxic. In addition, many patients have cell-mediated immunity directed against thyroid antigens. Cell mediated-immunity is also a feature of experimental thyroiditis induced in animals by injection of thyroid antigen with adjuvants. Hashimoto's thyroiditis is predominantly the clinical expression of cell-mediated immunity leading to destruction of thyroid cells, which in its severest form causes thyroid failure. The significance of genetic component and nongenetic risk factors (pregnancy, drugs, age, sex, infection, and irradiation) in the development of Hashimoto's thyroiditis is also reviewed. Epidemiologic studies have demonstrated that the genetic component is important in the pathogenesis of Hashimoto's thyroiditis, although the pattern of inheritance is non-Mendelian and is likely to be influenced by subtle variations in the functions of multiple genes. Nongenetic risk factors (environmental factors) are also etiologically important, because the concordance rate in monozygotic twins is below 1.

  11. Autoimmune Hemolytic Anemia.

    Science.gov (United States)

    Liebman, Howard A; Weitz, Ilene C

    2017-03-01

    Autoimmune hemolytic anemia is an acquired autoimmune disorder resulting in the production of antibodies directed against red blood cell antigens causing shortened erythrocyte survival. The disorders can present as a primary disorder (idiopathic) or secondary to other autoimmune disorders, malignancies, or infections. Treatment involves immune modulation with corticosteroids and other agents.

  12. Autoimmune sensorineural hearing loss as presenting manifestation of paediatric Behçet disease responding to adalimumab: a case report

    OpenAIRE

    Marsili, Manuela; Marzetti, Valentina; Lucantoni, Marta; Lapergola, Giuseppe; Gattorno, Marco; Chiarelli, Francesco; Breda, Luciana

    2016-01-01

    Background Autoimmune sensorineural hearing loss, also known as autoimmune inner ear disease (AIED) is a rare clinical entity characterized by progressive and bilateral sensorineural hearing loss often accompanied by vestibular symptoms. Diagnosis is essential as a consistent number of patients show a positive response to steroids alone or in association with other immunosuppressive drugs. AIED is defined as primary when the disease is limited to the ear, whereas in up to a third of cases it ...

  13. Type 1 diabetes associated autoimmunity.

    Science.gov (United States)

    Kahaly, George J; Hansen, Martin P

    2016-07-01

    Diabetes mellitus is increasing in prevalence worldwide. The economic costs are considerable given the cardiovascular complications and co-morbidities that it may entail. Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by the loss of insulin-producing pancreatic β-cells. The pathogenesis of T1D is complex and multifactorial and involves a genetic susceptibility that predisposes to abnormal immune responses in the presence of ill-defined environmental insults to the pancreatic islets. Genetic background may affect the risk for autoimmune disease and patients with T1D exhibit an increased risk of other autoimmune disorders such as autoimmune thyroid disease, Addison's disease, autoimmune gastritis, coeliac disease and vitiligo. Approximately 20%-25% of patients with T1D have thyroid antibodies, and up to 50% of such patients progress to clinical autoimmune thyroid disease. Approximately 0.5% of diabetic patients have concomitant Addison's disease and 4% have coeliac disease. The prevalence of autoimmune gastritis and pernicious anemia is 5% to 10% and 2.6% to 4%, respectively. Early detection of antibodies and latent organ-specific dysfunction is advocated to alert physicians to take appropriate action in order to prevent full-blown disease. Patients and family members should be educated to be able to recognize signs and symptoms of underlying disease.

  14. A Case of Resistance to Thyroid Hormone with Chronic Thyroiditis: Discovery of a Novel Mutation (I54V

    Directory of Open Access Journals (Sweden)

    I. Kammoun

    2011-01-01

    Full Text Available Resistance to thyroid hormone (RTH is a rare disorder characterized by variable tissue hyporesponsiveness to thyroid hormone, usually caused by mutations in the thyroid hormone receptor beta (TRβ. It has been reported that the serum of patients with RTH is free of auto-antibodies against thyroglobulin (Tg and thyroid peroxidase (TPO, except in rare cases where coincidental autoimmune thyroiditis is also present. We describe a 13-year-old girl with chronic thyroiditis and RTH. This patient had increased plasma free T3, free T4 at the upper limits with unsuppressed TSH. She had peripheral manifestations of thyroid hormone excess, hypertension and growth acceleration. Anti-TPO antibodies were positive. Sequence analysis of the TRβ gene was performed and revealed a novel mutation I54V in exon 4. The same mutation was also found in the mother and two asymptomatic sisters. The clinical presentation of our patient is not habitual in RTH because growth retardation is frequently reported in this syndrome. The association between RTH and thyroiditis complicate the management of the hypothyroidism.

  15. Thyroid Hemiagenesis Associated with Hyperthyroidism

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    Gunay Gurleyik

    2015-01-01

    Full Text Available Thyroid hemiagenesis (TH, very rare congenital anomaly, is generally asymptomatic. We report two cases of TH with hyperthyroidism. Case One. The patient presented with signs and symptoms of thyrotoxicosis. Physical examination revealed asymmetric nodular goitre at right lobe. Biochemical analysis revealed the diagnosis of hyperthyroidism. Ultrasound showed multinodular hypertrophy in the right lobe and absence of the left lobe. Nuclear scan, confirming absence of the left lobe, showed hot nodules in the right one. The diagnosis was toxic multinodular goitre. Case Two. The thyroid was not palpable in this patient presented with signs and symptoms of thyrotoxicosis. Biochemical analysis revealed the diagnosis of autoimmune thyrotoxicosis. Ultrasound showed mild diffuse hyperplasia of the right lobe and agenesis of the left lobe. Nuclear scan, confirming absence of the left lobe, showed increasing diffuse uptake of radiotracer in the right one. The diagnosis was Graves’ disease in this patient. After antithyroid medication, the patients were surgically treated with total excision of the thyroid tissue. TH is sometimes associated with disorders of the thyroid. Hyperthyroidism makes TH cases symptomatic. During evaluation of patients, ultrasound and nuclear scan usually report agenesis of one lobe and establish the diagnosis of TH. The surgical treatment is total removal of hyperactive tissue and total excision of the remaining lobe.

  16. Hashimoto's Thyroiditis and Medullary Carcinoma of Thyroid.

    Science.gov (United States)

    Dasgupta, S; Chakrabarti, S; Mandal, P K; Das, S

    2014-01-01

    Hashimoto's thyroiditis (HT) has been found to be associated with lymphoma, papillary carcinoma and Hürthle cell neoplasms of thyroid. In contrast, there are only a few reports of co-existence of HT with medullary carcinoma of thyroid. An overall prevalence of medullary carcinoma of only 0.35% has been reported in HT patients. Such a rare combination is being presented here. A 33 year old female presented with history of goiter for one year. Fine needle aspiration cytology (FNAC) of the swelling revealed cytological features suggestive of medullary carcinoma of thyroid. Histopathological examination of total thyroidectomy specimen revealed Hashimoto's thyroiditis along with medullary carcinoma of thyroid. Although Hashimoto's thyroiditis can uncommonly co-exist with thyroid neoplasm, its association with medullary carcinoma is extremely rare and hence being presented.

  17. [Polyglandular autoimmune syndromes : An overview].

    Science.gov (United States)

    Komminoth, P

    2016-05-01

    Polyglandular autoimmune syndromes (PGAS), also known as autoimmune polyendocrinopathy syndromes (APS), are a heterogeneous group of rare, genetically caused diseases of the immune system which lead to inflammatory damage of various endocrine glands resulting in malfunctions. In addition, autoimmune diseases of non-endocrine organs may also be found. Early diagnosis of PGAS is often overlooked because of heterogeneous symptoms and the progressive occurrence of the individual diseases. The two most important forms of PGAS are the juvenile and adult types. The juvenile type (PGAS type 1) is caused by mutations in the autoimmune regulator (AIRE) gene on chromosome 21, exhibits geographic variations in incidence and is defined by the combination of mucocutaneous candidiasis, Addison's disease and hypoparathyroidism. In addition, autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) syndrome and other autoimmune diseases can also occur. The adult form of PGAS (PGAS type 2) is a multigenetic disorder associated with some HLA haplotypes, is more common than the juvenile type, shows female predominance and exhibits the combination of type 1 diabetes, autoimmune thyroid disease, Addison's disease and other autoimmune disorders. The histological alterations in affected organs of PGAS patients are similar to findings in sporadically occurring autoimmune diseases of these organs but there are no pathognomic fine tissue findings. If patients exhibit autoimmune changes in two different endocrine glands or if there are indications of several autoimmune disorders from the patient history, it is important to consider PGAS and inform the clinicians of this suspicion.

  18. Autoimmune Cholangitis: A Variant Syndrome of Autoimmune Hepatitis

    OpenAIRE

    Brij Sharma; Sujeet Raina; Rajesh Sharma

    2014-01-01

    Autoimmune cholangitis (AIC) or autoimmune cholangiopathy is a chronic inflammation of liver and a variant syndrome of autoimmune hepatitis (AIH). We present a case of an adult female who had biochemical features of cholestasis and transaminasemia but aminotransferases were not in the hepatitis range and had histological evidence of bile duct injury which was subsequently diagnosed as autoimmune cholangitis.

  19. A case control study on psychiatric disorders in Hashimoto disease and euthyroid goitre: not only depressive but also anxiety disorders are associated with thyroid autoimmunity

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    Carbone Fiora

    2005-11-01

    Full Text Available Abstract Objective To evaluate the association between mood and anxiety disorders in Hashimoto disease and Euthyroid Goitre in a case control study. Methods Cases included 19 subjects with Hashimoto disease in euthyroid phase, 19 subjects with euthyroid goitre, 2 control groups each of 76 subjects matched (4/1 according to age and sex drawn from the data base of a community based sample. Psychiatric diagnoses were formulated using the International Composite Diagnostic Interview Simplified, according to DSM-IV criteria. All subjects underwent a complete thyroid evaluation including physical examination, thyroid echography and measure of serum free T4 (FT4, free T3 (FT3, thyroid-stimulating hormone (TSH and anti-thyroid peroxidase autoantibodies (anti-TPO. Results: Subjects with Hashimoto disease showed higher frequencies of lifetime Depressive Episode (OR = 6.6, C.L. 95% 1.2–25.7, Generalized Anxiety Disorders (OR = 4,9 Cl 95% 1.5–25.4 and Social Phobia (OR = 20.0, CL 95% 2.3–153.3 whilst no differences were found between subjects with goitre and controls. Conclusion The study seems to confirm that risk for depressive disorders in subjects with thyroiditis is independent of the thyroid function detected by routine tests and indicates that not only mood but also anxiety disorders may be associated with Hashimoto disease.

  20. Recurrent pregnancy loss in patients with thyroid dysfunction

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    Debanjali Sarkar

    2012-01-01

    Full Text Available Purpose of the Review: Thyroid disturbances are common in women during their reproductive years. Thyroid dysfunction interferes with human reproductive physiology, reduces the likelihood of pregnancy and adversely affects pregnancy outcome, thus becoming relevant in the algorithm of reproductive dysfunction. This review highlights the "gap" in knowledge regarding the contribution of thyroid dysfunction in reproduction. Literature Reviewed: Following implantation, the maintenance of the pregnancy is dependent on a multitude of endocrinological events that will eventually aid in the successful growth and development of the fetus. It is estimated that approximately 8-12% of all pregnancy losses are the result of endocrine factors. Autoimmune thyroid disease is present in around 4% of young females and up to 15% are at risk because they are thyroid antibody-positive. There is a strong relationship between thyroid immunity on one hand and infertility, miscarriage, and thyroid disturbances in pregnancy and postpartum, on the other hand. Even minimal hypothyroidism can increase rates of miscarriage and fetal death and may also have adverse effects on later cognitive development of the offspring. Hyperthyroidism during pregnancy may also have adverse consequences. Summary: Pregnant women with subclinical hypothyroidism or thyroid antibodies have an increased risk of complications, especially pre-eclampsia, perinatal mortality, and miscarriage. Universal screening for thyroid hormone abnormalities is not routinely recommended at present, but thyroid function must be examined in female with fetal loss or menstrual disturbances. Practitioners providing health care for women should be alert to thyroid disorders as an underlying etiology for recurrent pregnancy loss.

  1. HASIMOTO’S THYROIDITIS A REVIEW

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    Ramya Ranganathan

    2015-10-01

    Full Text Available Hashimoto thyroditis is an organ specific autoim-mune disorder. Initially described Hakaru Hash-imotoa century ago is now the most common cause of hypothyroidism in iodine sufficient are-as of the world. But still the pathogenesis is not fully understood. With higher incidence among female population HT develops as a result of in-teraction between the genetic factors and envi-ronmental factors in susceptible individuals. HT is associated with other autoimmune disorders. Now many variants of HT have been identified: classical form, fibrous variant, IgG4 variant, juve-nile form, hashitoxicosis and silent thyroiditis (sporadic or postpartum. All variants of HT are characterized by lympho-cytic infiltration, destruction and atropy of thyroid gland ultimately thyroid failure though each entity has specific other features. Clinically HT can also present as euthyroid or even hyperthyroid state with or without goiter. Diagnosis is based on the clinical features, demonstration of antibodies against thyroid antigen, sonography and cytological findings. Treatment is mainly supplementing Levothyroixin for correction of hypothyroidism. Surgery is reserved for patients with large goiter causing mechanical compression of cervical structures, painful HT and suspicion of malignancy.

  2. Thyroiditis: an integrated approach.

    Science.gov (United States)

    Sweeney, Lori B; Stewart, Christopher; Gaitonde, David Y

    2014-09-15

    Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment with levothyroxine ameliorates the hypothyroidism and may reduce goiter size. Postpartum thyroiditis is transient or persistent thyroid dysfunction that occurs within one year of childbirth, miscarriage, or medical abortion. Release of preformed thyroid hormone into the bloodstream may result in hyperthyroidism. This may be followed by transient or permanent hypothyroidism as a result of depletion of thyroid hormone stores and destruction of thyroid hormone-producing cells. Patients should be monitored for changes in thyroid function. Beta blockers can treat symptoms in the initial hyperthyroid phase; in the subsequent hypothyroid phase, levothyroxine should be considered in women with a serum thyroid-stimulating hormone level greater than 10 mIU per L, or in women with a thyroid-stimulating hormone level of 4 to 10 mIU per L who are symptomatic or desire fertility. Subacute thyroiditis is a transient thyrotoxic state characterized by anterior neck pain, suppressed thyroid-stimulating hormone, and low radioactive iodine uptake on thyroid scanning. Many cases of subacute thyroiditis follow an upper respiratory viral illness, which is thought to trigger an inflammatory destruction of thyroid follicles. In most cases, the thyroid gland spontaneously resumes normal thyroid hormone production after several months. Treatment with high-dose acetylsalicylic acid or nonsteroidal anti-inflammatory drugs is directed toward relief of thyroid pain.

  3. Lymphocytic thyroiditis: a correlation of cytological grades with clinical, biochemical and ultrasound findings

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    P. Uma

    2013-08-01

    Full Text Available Background: Hashimoto’s thyroiditis sometimes referred to as goitrous thyroiditis is a synonym of chronic lymphocytic thyroiditis or autoimmune thyroiditis. Chronic lymphocytic thyroiditis (Hashimoto’s thyroiditis is one of the most common cause of goiter and hypothyroidism, it is found most commonly in middle aged and young female, but can also occur in other age groups, including children. Chronic lymphocytic thyroiditis can be graded based on cytomorphology. In this study an attempt has been made to correlate the grades with clinical findings, biochemical levels and ultrasonography findings. Methods: This is a prospective study conducted on 309 patients in the Department of Pathology, Andhra Medical College, Visakhapatnam. The various parameters like patient’s clinical presentation, biochemical levels and thyroid ultrasound were studied. Fine needle aspiration of thyroid gland and grading of thyroiditis was done on smears. The grades were correlated with above parameters and the correlation indices were evaluated statistically. Chi-square tests were used for statistical correlation and p value of <0.05 was considered significant. Results: Most of the patients were females (297, 96.11% who commonly presented with a diffuse goiter (263, 85.11%. Asymptomatic cases (193, 62.46% and elevated TSH (194, 62.78% were common. Most of the cases had grade I/II disease (299, 96.76% by cytology. Conclusion: FNAC is a simple, safe and cost effective procedure and is a sensitive and specific diagnostic tool in diagnosing chronic lymphocytic thyroiditis. Cytological grading of chronic lymphocytic thyroiditis helps in assessing the severity of the disease and can predict the thyroid functional status. A combined approach of cytological grading of chronic lymphocytic thyroiditis along with ultrasonography and biochemical levels can detect subclinical hypothyroid states and provide a guide to therapy. [Int J Res Med Sci 2013; 1(4.000: 523-531

  4. [Acute renal failure in the course of Hashimoto's thyroiditis].

    Science.gov (United States)

    Papalia, Teresa; Greco, Rosita; Mollica, Francesco; Mancuso, Domenico; Bonofiglio, Renzo

    2010-01-01

    Hashimoto's thyroiditis is the commonest form of autoimmune thyroiditis in the world. It occurs most frequently in women (female/male ratio, 6:1) in the age group between 30 and 60 years. Here we report the case of a 38-year-old Caucasian man who presented with a few days' history of upper limb paresthesias, widespread joint and muscle pain, and headaches. Laboratory findings showed increased CPK, myoglobin and plasma creatinine levels with acute renal failure. Low free T3 and T4 values associated with a high TSH value, the presence of antithyroid globulin and peroxidase autoantibodies pointed to a diagnosis of hypothyroidism with Hashimoto's thyroiditis. Treatment with levothyroxine was initiated and within 2 months normalization of renal function, myoglobin, CPK and thyroid hormone levels was observed.

  5. Thyroid dysfunction and pregnancy outcomes

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    Sima Nazarpour

    2015-07-01

    Full Text Available Background: Pregnancy has a huge impact on the thyroid function in both healthy women and those that have thyroid dysfunction. The prevalence of thyroid dysfunction in pregnant women is relatively high. Objective: The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction including hyperthyroidism, hypothyroidism and thyroid autoimmune positivity on pregnancy outcomes. Materials and Methods: In this review, Medline, Embase and the Cochrane Library were searched with appropriate keywords for relevant English manuscript. We used a variety of studies, including randomized clinical trials, cohort (prospective and retrospective, case-control and case reports. Those studies on thyroid disorders among non-pregnant women and articles without adequate quality were excluded. Results: Overt hyperthyroidism and hypothyroidism has several adverse effects on pregnancy outcomes. Overt hyperthyroidism was associated with miscarriage, stillbirth, preterm delivery, intrauterine growth retardation, low birth weight, preeclampsia and fetal thyroid dysfunction. Overt hypothyroidism was associated with abortion, anemia, pregnancy-induced hypertension, preeclampsia, placental abruption, postpartum hemorrhage, premature birth, low birth weight, intrauterine fetal death, increased neonatal respiratory distress and infant neuro developmental dysfunction. However the adverse effect of subclinical hypothyroidism, and thyroid antibody positivity on pregnancy outcomes was not clear. While some studies demonstrated higher chance of placental abruption, preterm birth, miscarriage, gestational hypertension, fetal distress, severe preeclampsia and neonatal distress and diabetes in pregnant women with subclinical hypothyroidism or thyroid autoimmunity; the other ones have not reported these adverse effects. Conclusion: While the impacts of overt thyroid dysfunction on feto-maternal morbidities have been clearly

  6. Lymphocytic Thyroiditis Presenting as a Focal Uptake on 18F-Fluorodeoxyglucose Positron Emission Tomography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Tae Seok; Kim, Eun Kyung; Lee, Sarah; Moon, Hee Jung; Kwak, Jin Young [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    Diffuse increased uptake on 18F-Fluorodeoxyglucose Positron Emission Tomography (18F FDG PET) is a well-known finding of the lymphocytic thyroiditis. Nevertheless, a pathologic confirmation is needed in cases of a focal 18F FDG uptake in the thyroid gland. This article reports a rare case of a focal 18F FDG uptake lesion by PET, which was revealed pathologically to be lymphocytic thyroiditis

  7. 甲状腺过氧化物酶抗体在自身免疫性甲状腺疾病诊治中的价值及存在问题%The value and controversy of thyroid peroxidase antibody in the diagnosis and treatment of autoimmune thyroid disease

    Institute of Scientific and Technical Information of China (English)

    范慧; 王广

    2015-01-01

    Thyroid peroxidase antibody (TPOAb) play an important role in the diagnosis of autoimmune thyroid disease.Chemiluminescence immunoassay (CLIA) is a new method been strongly recommended in recent years.The definition of positive value of TPOAb is inconsistent.The definition of TPOAb positive value is important for exploring the development of autoimmune thyroid disease.TPOAb is significantly increased in Hashimoto's disease and the titer is associated with the degree of infiltration and destruction of thyroid follicular.It is essential to monitor TPOAb in postpartum thyroiditis and early pregnancy.The positive of TPOAb is closely related to the adverse pregnancy outcomes caused by various risk factors.Graves disease combined with Hashimoto's must to be considered.%甲状腺过氧化物酶抗体(TPOAb)在自身免疫性甲状腺疾病(AITD)的诊断中起着不可替代的作用,化学发光免疫分析(CLIA)是近年来大力推广的检测TPOAb的新方法,目前TPOAb正常参考值和医学决定水平数值的界定不一致,确定TPOAb正常参考区间和医学决定水平以及探讨抗体阳性人群的AITD发生发展的规律具有重要意义.桥本甲状腺炎患者的TPOAb显著升高,且TPOAb的浓度与淋巴细胞的浸润程度和甲状腺滤泡破坏程度相关.TPOAb是监测产后甲状腺炎的重要的检测项目,且应于妊娠早期测定.TPOAb阳性与多种原因所致不良妊娠结局有关.当甲亢合并明显升高的TPOAb时要考虑Graves病合并桥本甲状腺炎.

  8. Sclerosing lymphocytic lobulitis manifesting as suspicious microcalcifications with Hashimoto's thyroiditis in a young woman.

    Science.gov (United States)

    Park, Sung Hee; Choi, Seung Joon; Jung, Hyun Kyung

    2013-01-01

    Sclerosing lymphocytic lobulitis (SLL) is a rare inflammatory disorder, which is also known as fibrous mastopathy and lymphocytic mastitis. It is commonly associated with autoimmune disorders, particularly type 1 diabetes and thyroiditis. We report the case of a 28-year-old woman diagnosed as SLL with Hashimoto's thyroiditis, but without diabetes. She presented suspicious microcalcifications without palpable mass in routine mammograms in both breasts. She had been diagnosed as Hashimoto's thyroiditis several years before and had been followed up in endo-clinics.

  9. Mathematical model describing the thyroids-pituitary axis with distributed time delays in hormone transportation

    Science.gov (United States)

    Neamţu, Mihaela; Stoian, Dana; Navolan, Dan Bogdan

    2014-12-01

    In the present paper we provide a mathematical model that describe the hypothalamus-pituitary-thyroid axis in autoimmune (Hashimoto's) thyroiditis. Since there is a spatial separation between thyroid and pituitary gland in the body, time is needed for transportation of thyrotropin and thyroxine between the glands. Thus, the distributed time delays are considered as both weak and Dirac kernels. The delayed model is analyzed regarding the stability and bifurcation behavior. The last part contains some numerical simulations to illustrate the effectiveness of our results and conclusions.

  10. Hashimoto's thyroiditis following Graves' disease.

    Science.gov (United States)

    Umar, Husaini; Muallima, Nur; Adam, John M F; Sanusi, Harsinen

    2010-01-01

    Both Graves' disease and chronic thyroiditis (Hashimoto's thyroiditis) are autoimmune diseases of thyroid gland. Graves' disease is caused by stimulation of TSH receptor located on the thyroid gland by an antibody, which is known as TSH receptor antibody (TRAb). Furthermore, this may lead to hyperplasia and hyperfunction of the thyroid gland. On the contrary, the cause of Hashimoto's thyroiditis is thought due to a TSH stimulation-blocking antibody (TSBAb) which blocks the action of TSH hormone and subsequently brings damage and atrophy to thyroid gland. Approximately 15-20% of patients with Graves' disease had been reported to have spontaneous hypothyroidism resulting from the chronic thyroiditis (Hashimoto's disease). Pathogenesis for chronic thyroiditis following anti-thyroid drug treatment in patients with Graves' disease remains unclear. It has been estimated that chronic thyroiditis or Hashimoto's disease, which occurs following the Graves' disease episode is due to extended immune response in Graves' disease. It includes the immune response to endogenous thyroid antigens, i.e. thyroid peroxidase and thyroglobulin, which may enhance lymphocyte infiltration and finally causes Hashimoto's thyroiditis. We report four cases of chronic thyroiditis (Hashimoto's disease) in patients who have been previously diagnosed with Graves' hyperthyroidism. In three cases, Hashimoto's thyroiditis occurs in 7 to 25 years after the treatment of Grave's disease; while the other case has it only after few months of Grave's disease treatment. The diagnosis of Hashimoto's disease (chronic thyroiditis) was based on clinical manifestation, high TSHs level, positive thyroid peroxidase antibody and thyroglobulin antibody, and supported by positive results of fine needle aspiration biopsy. Moreover, the result of histopathological test has also confirmed the diagnosis in two cases. All cases have been successfully treated by levothyroxine treatment.

  11. Multiple endocrinopathies (growth hormone deficiency, autoimmune hypothyroidism and diabetes mellitus in Kearns-Sayre syndrome

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    A. Berio

    2013-06-01

    Full Text Available Kearns-Sayre syndrome is characterized by onset before 20 years, chronic progressive external opthalmoplegia, pigmentary retinal degeneration, and ataxia (and/or hearth block, and/or high protein content in the cerebrospinal fluid in the presence of mtDNA rearrangements. Multiple endocrine dysfunction associated with this syndrome was rarely reported. In this paper, the Authors report on a female patient with Kearns-Sayre syndrome with large heteroplasmic mtDNA deletion, absence of cytochrome c oxidase in many muscle fibers, partial GH deficiency, hypothyroidism and subsequently insulin dependent diabetes mellitus (IDDM. Anti-thyroid peroxidase and antithyreoglobulin antibodies were present in high titer in serum while anti-islet cell antibodies were absent. The patient developed thyroiditis with Hashimoto encephalopathy. The presence of GH deficiency, autoimmune thyroiditis with hypothyroidism and IDDM distinguishes this case from others and confirms the association of Kearns-Sayre syndrome with multiple endocrine dysfunction. Hashimoto encephalopathy and anti-thyroideal antibodies suggest that in this patient, predisposed by a genetic factor (a mitochondrial deletion anti-thyroideal antibodies may have contributed to the hypothyroidism and, by interfering with cerebral mitochondrial function, may have caused the encephalopathy. GH deficiency and IDDM can be attributed to oxidative phosphorylation deficiency but the autoimmunity may also have played a role in the production of glandular insufficiencies. It seems important to search for endocrine autoimmunity in every case of KSS.

  12. Thyroid cancer in childhood

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    Gorlin, J.B.; Sallan, S.E. (Children' s Hospital, Boston, MA (USA))

    1990-09-01

    The incidence, clinical presentation, and types of thyroid cancers presenting in childhood are reviewed. The role of antecedent radiation in papillary and follicular thyroid cancers and genetics of medullary thyroid carcinoma are discussed. Unique aspects of therapy and prognosis for the pediatric patient with thyroid carcinoma are addressed as well as a diagnostic approach to the child who presents with a neck mass.59 references.

  13. Rare association of chronic lymphocytic thyroiditis with dermatomyositis.

    Science.gov (United States)

    Charalabopoulos, Konstantinos; Mittari, Evanthia; Peschos, Dimitrios; Golias, Christos; Charalabopoulos, Alexander; Tsanou, Eleni; Batistatou, Anna

    2006-05-01

    Autoimmune thyroid disease (AITD) has been associated with other autoimmune diseases such as chronic urticaria, insulin-dependent diabetes mellitus, Sjøgren's syndrome, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, psoriasis, ankylosing spondylitis, and dermatomyositis (DM). AITD is a common disorder affecting primarily women, and both genetic and environmental factors are included in its pathogenesis. DM is considered an autoimmune disease of the muscles and skin. Although AITD is the most common cause of hypothyroidism, to the best of our knowledge, only three cases of DM and AITD in the same patient have been reported in the last 40 years. We consider that both are developed from the same autoimmune background. Herein, we present a case of a 30-year-old man with a 4-year history of AITD who was diagnosed as suffering as well from DM.

  14. Late Diagnosed Type II Autoimmune Polyglandular Failure Syndrome: A Case Report

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    Mehtap Evran

    2014-03-01

    Full Text Available Autoimmune polyglandular syndrome (APS type II is the term descibing a group of diseases with two or more concurrent endocrine disorders. It is more prevalent in female gender. The most common pathologies include primary adrenal insufficiency (Addison’s disease, autoimmune thyroid diseases (Graves’ disease, Hashimoto’s thyroiditis, type 1 diabetes mellitus (DM and primary hypogonadism. Replacement of deficient hormone is the basis of treatment. The present paper discussed autoimmune polyglandular syndrome based on the symptoms in a 25-year-old female patient who was followed in the intensive care unit because of impaired consciousness considered to have resulted from potential drug/substance addiction. Antidepressant therapy was recommended for the patient and she was diagnosed with APS on further evaluation. Turk Jem 2014; 1: 13-16

  15. Lymphocytic thyroiditis: a correlation of cytological grades with clinical, biochemical and ultrasound findings

    OpenAIRE

    P. Uma; B. V. S. Kartheek; S. Himaja; J. Chandra Lekha; A. Kasi Babu; A. Bhagya Lakshmi

    2013-01-01

    Background: Hashimoto’s thyroiditis sometimes referred to as goitrous thyroiditis is a synonym of chronic lymphocytic thyroiditis or autoimmune thyroiditis. Chronic lymphocytic thyroiditis (Hashimoto’s thyroiditis) is one of the most common cause of goiter and hypothyroidism, it is found most commonly in middle aged and young female, but can also occur in other age groups, including children. Chronic lymphocytic thyroiditis can be graded based on cytomorphology. In this study an att...

  16. Prevalence of chronic autoimmune thyroiditis in the urban area neighboring a petrochemical complex and a control area in Sao Paulo, Brazil Prevalência de tireoidite de Hashimoto na população vicinal ao Pólo Petroquímico de Capuava (área Polo e área controle (São Bernardo Campo na região metropolitana da grande São Paulo, Brasil

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    Rosalinda Y. A. Camargo

    2006-08-01

    was present from 1998 through 2005 may be related to a higher prevalence of chronic autoimmune thyroiditis in both areas that were studied. There was no apparent or documented relationship of chronic autoimmune thyroiditis prevalence to the proximity to the petrochemical complex.OBJETIVO: Analisar a prevalência populacional de tireoidite crônica autoimune (tireoidite de Hashimoto na área vicinal ao Polo Petroquímico de Capuava comparativamente a área controle em São Bernardo Campo. CASUÍSTICA E MÉTODOS: Em ambas as áreas urbanas foram incluídos, aleatoriamente, indivíduos adultos que, de forma voluntária, concordaram em participar do estudo, estratificado por idade (20 a > 70 anos e sexo (mulheres 80%, homens 20%. Na área Polo foram incluídos 409 indivíduos e na área controle (São Bernardo Campo 420 pessoas (sem diferenças significativas quanto a idade e sexo. Na área Polo 15,6% apresentava sinais ecográficos e de positividade para anticorpos anti TPO, confirmando tireoidite crônica autoimune (TCA comparativamente a 19,5% na área controle (p > 0,05, NS. A presença de hipotiroidismo foi confirmada em 4,9% da população na área Polo e 8,3% na área controle (São Bernardo Campo (p = 0,046, significativo. No conjunto 6,63% dos pacientes com TCA apresentavam hipofunção tireóidea. A excreção urinária de iodo ultrapassou 300 mcg Iodo/L de urina em 58,5% de ambas populações. O sal coletado nas casas dos examinados apresentava concentração normal de iodo (35,5 + 6,6 mg I/Kg de sal. CONCLUSÕES: A maior prevalência de tireoidite crônica autoimune em ambas as áreas é, provavelmente, decorrente da elevada ingestão nutricional de iodo durante o quinqüênio que precedeu esta pesquisa (1998-2004. A suposta conexão epidemiológica de maior prevalência epidemiológica de TCA com vicinidade com o Polo Petroquímico de Capuava é improvável.

  17. 促甲状腺激素β剪接变体在自身免疫性甲状腺炎小鼠甲状腺中的表达%Expression of thyroid stimulating hormone β splice variant in thyroid of mouse with autoimmune thyroiditis

    Institute of Scientific and Technical Information of China (English)

    袁继红; 周晓丽; 史亚男; 郑楠; 刘欣; 李兰英

    2014-01-01

    下降(nmol/L:67.75±11.91比45.50±3.85,t=3.55,P<0.05);TG+ HI组FT4和TSHβ剪接变体表达升高(pmol/L:54.07±3.67比139.46±30.00;×10-3:4.11±0.32比5.33±1.47;t值分别为-5.65、-5.95,P均<0.05).结论 Tg诱发了BALB/c小鼠自身免疫性甲状腺炎症反应,小鼠甲状腺中TSHβ剪接变体的表达明显升高,高碘可以加重Tg的这种反应,TSHβ剪接变体参与了自身免疫性甲状腺炎的病理过程.%Objective To investigate the expression of marrow-derived thyroid stimulating hormone β (TSHβ) splice variant in thyroid of mouse with autoimmune thyroiditis induced by thyroglobulin(Tg) immunization,and to analyze whether TSHβ splice variant participated in the pathological process of autoimmune thyroiditis.Methods Using random number table,forty-eight mice(24 females and 24 males) of 7 to 8 weeks old with body mass 20 to 25 g were randomly divided into 4 groups(12 females and 12 males in each group) based on body weight and gender.The control group:fed with deionized water; the Tg-treated group(TG):fed with deionized water,and immunized subcutaneously with 0.1 mg Tg at 8 weeks old,boost immunized twice at 11 and 15 weeks old,respectively; the high iodine-treated group (HI):fed with deionized water containing 0.05% sodium iodide (NaI); the Tg combined with HI group (TG + HI):fed with deionized water containing 0.05% NaI,and immunized the same way as the TG group did.Peripheral blood was collected after 8 weeks treatment,which was used for determination of total tetraiodothyronine (TT4),free tetraiothyronine (FT4),total triiodothyronine (TT3) and free triiodothyronine (FT3) with chemiluminescence immunoassay (CIA); thyroid glands were collected to examine the expression of TSHβ splice variant with SYBR Green fluorescent quantitative real-time PCR,and frozen sections were HE stained for observation of histopathological changes of thyroid cells under light microscopy.Results Under naked eyes,the thyroid gland enlarged

  18. Association of High Vitamin D Status with Low Circulating Thyroid-Stimulating Hormone Independent of Thyroid Hormone Levels in Middle-Aged and Elderly Males

    Directory of Open Access Journals (Sweden)

    Qingqing Zhang

    2014-01-01

    Full Text Available Background. A recent study has reported that high circulating 25-hydroxyvitamin D [25(OHD] is associated with low circulating thyroid-stimulating hormone (TSH levels, but only in younger individuals. The goal of the present study was to explore the relationship between vitamin D status and circulating TSH levels with thyroid autoimmunity and thyroid hormone levels taken into consideration in a population-based health survey of middle-aged and elderly individuals. Methods. A total of 1,424 Chinese adults, aged 41–78 years, were enrolled in this cross-sectional study. Serum levels of 25(OHD, TSH, thyroid hormones, and thyroid autoantibodies were measured. Results. The prevalence of vitamin D insufficiency was 94.29% in males and 97.22% in females, and the prevalence of vitamin D deficiency was 55.61% in males and 69.64% in females. Vitamin D status was not associated with positive thyroid autoantibodies after controlling for age, gender, body mass index, and smoking status. Higher 25(OHD levels were associated with lower TSH levels after controlling for age, FT4 and FT3 levels, thyroid volume, the presence of thyroid nodule(s, and smoking status in males. Conclusion. High vitamin D status in middle-aged and elderly males was associated with low circulating TSH levels independent of thyroid hormone levels.

  19. Resistant thyrotoxicosis: A case of sarcoidosis of thyroid

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    Uday Yanamandra

    2013-01-01

    Full Text Available Autoimmune endocrinopathies and, less commonly, thyroid autoimmune disease have been reported in patients with sarcoidosis. Similarities exist in the pathogenesis of these two conditions. Concomitant sarcoidosis in the thyroid gland in patients with Graves′ disease may contribute to the resistance to antithyroid drugs and radioiodine therapy. We present the clinical, laboratory, imaging, and pathologic findings of a patient with Graves′ disease who was unresponsive to medical management. This 37-year-old man presented with thyrotoxicosis. Thyroid hormone assays and 99m Technitium findings were consistent with Graves′ disease. He was also found to have hilar lymphadenopathy. Patient failed to achieve remission with high doses of antithyroid drugs and 2 sessions of radioiodine ablative therapy.Histopathology of lymph nodesdisclosed noncaseating granulomas, consistent with sarcoidosis. Patient′s thyrotoxicosis subsided only following steroid administration. The histopathology of the thyroid gland on aspiration and the subsidence of symptoms with steroids reiterate the possibility of thyroid sarcoidosis. This diagnosis needs biopsy for confirmation, which our patient didn′t consent for.

  20. Prevalence of subclinical thyroid disorders in type 2 diabetes mellitus

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    Satvic C Manjunath

    2013-10-01

    Full Text Available Background: Subclinical thyroid disorders usually do not produce symptoms of thyroid disease until they turn into over thyroid disease. Thyroid disease is more common in people with diabetes mellitus than in the general population and it is important to detect thyroid disorder before its clinical manifestation. Subclinical hypothyroidism (SCH can produce dyslipidemia, obesity thus resulting increased predisposition to coronary artery disease. Subclinical hyperthyroidism can aggravate hyperglycemia and impair blood sugar control. Objectives: Our objective is to determine the prevalence of subclinical thyroid disorders in patients with type 2 diabetes mellitus (T2DM and to analyze the clinical and metabolic profile of patients with this dual endocrine disorder. Methods and Results: One hundred consecutive type 2 diabetic patients without clinical manifestations of thyroid disorders were screened for SCH and subclinical hyperthyroidism using serum free T 3 , free T 4 and thyroid stimulating hormone (TSH levels. Individuals of subclinical thyroid disease were further screened for thyroperoxidase (TPO antibodies. SCH was detected in 13% of type 2 diabetic patients and none had subclinical hyperthyroidism in our study. SCH was common among females with type 2 diabetes (84.6%. Elevated TPO antibody levels were present in 84.6% SCH patients. Diabetic retinopathy among SCH patients showed significant association with higher serum TSH levels. Left ventricular diastolic dysfunction was present in 30.8% of SCH patients. Conclusion: SCH is common among type 2 diabetic patients, especially in females. It is most commonly secondary to autoimmune thyroid disease. Microvascular complications are commonly observed in this group of patients with dual endocrinal disorder and treating physician should be aware of the impact and should routinely screen SCH to prevent complications.

  1. Anti-thyroid peroxidase antibodies: Its effect on thyroid gland and breast tissue

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    Sabitha Kandi

    2012-01-01

    Full Text Available Thyroid peroxidase (TPO is a key enzyme in the synthesis of thyroid hormone. TPO is involved in thyroid hormone synthesis (organification and coupling reactions. TPO is a major antigen corresponding to thyroid-microsomal autoantibodies. Anti-TPO auto antibodies are very important to diagnose autoimmune thyroid diseases and also in estimating its clinical course. Autoimmune thyroid disease is detected mostly by measuring circulating antibodies to thyroglobulin which is uncommon measurement of antibodies to TPO that gives reliable information about autoimmune thyroid disease. Eighty percent of Grave′s disease patients have high levels of antiTPO antibodies. About 4% of subclinical hypothyroid patients with positive TPO antibodies develop clinical hypothyroidism. There is always a controversy on the relationship between breast cancer and thyroid disorders. As these tissues, i.e., breast and thyroid, originate embryologically from the same type of cells, hypothyroid/hyperthyroid females are more prone to develop benign or malignant breast tumors. The studies on breast cancer patients indicate increased thyroid disorders in breast cancer patients, most commonly Hashimoto′s thyroiditis accounts to increased thyroid disorders in these patients. This is independent of hormonal receptor status of the patient. These findings suggest the usefulness of screening for thyroid disease in any patient with breast cancer.

  2. Hashimoto thyroiditis associated with ataxia telangiectasia.

    Science.gov (United States)

    Patiroglu, Turkan; Gungor, Hatice Eke; Unal, Ekrem; Kurtoglu, Selim; Yikilmaz, Ali; Patiroglu, Tahir

    2012-01-01

    Ataxia telangiectasia is a rare genetic disease characterized by neurological manifestations, infections, and cancers. In addition to these cardinal features, different autoimmune diseases can be seen in patients with ataxia telangiectasia. Although there were reports of positive autoimmune thyroid antibodies associated with ataxia telangiectasia, to our knowledge, we report the first cases of nodular Hashimoto thyroiditis in two patients with ataxia telangiectasia in the English medical literature. These cases illustrate that despite the rarity of nodular Hashimoto thyroiditis associated with ataxia telangiectasia, physicians should be aware of this possibility. Furthermore, thyroid examination of patient with ataxia telangiectasia is recommended for early diagnosis.

  3. 自身免疫性甲状腺疾病患者唾液腺功能研究%Salivary gland function in patients with autoimmune thyroid disease

    Institute of Scientific and Technical Information of China (English)

    张丽霞; 陈金燕; 亓丽丽; 任妍; 苏君梅

    2012-01-01

    Objective To investigate the salivary gland function changes in patients with autoimmune thyroid disease. Methods Thirty five patients with Graves' disease (7 males and 28 females,aged 49.62 ± 11.10y), 15 patients with Hashimoto thyroiditis (5 males and 10 females,aged 45.67 ± 9.85 y )and 35 age- and sex-matched healthy subjects were included in the study. All subjects underwent routine thyroid scintigraphy imaging and salivery gland dynamic imaging. Time - activity curve of bilateral parotids and bilateral submandibulars were obtained by outlining regions of interest (ROI) of these glands,excreting technetium rate (ex%) and excreting technetium time (Tex) of each gland were calculated. Results The excreting technetium function of major salivary glands decreased significantly in Graves' disease patients(P<0.05). The excreting technetium function in major salivary glands of Hashimoto thyroiditis decreased significantly(P<0.05). The time of excreting technetium of major salivary gland was not longer than that of normal controls. The major salivary gland function was not correlated with thyroid technetium uptake rate at 30min in Graves' disease patients (r= -0.1768,-0.2753,-0.2596,-0.1747; P= 0.3331,0.1299,0.1514,0.3388). Conclusion With salivary gland dynamic imaging during routine thyroid scintigraphy, thyroid function parameters and salivary gland function indicators can be obtained simultaneously.%目的 通过在自身免疫性甲状腺疾病患者甲状腺显像过程中加入唾液腺显像,旨在探讨自身免疫性甲状腺疾病患者唾液腺功能的改变,以便指导临床在治疗此类疾病过程中同时关注患者唾液腺功能.方法 选取35 例Graves 病患者,15 例桥本甲状腺炎和同期同年龄唾液腺功能正常者35例.Graves 病及桥本甲状腺炎患者在甲状腺显像同时进行唾液腺显像.在甲状腺显像注射显像剂后常规等待的30min 行唾液腺动态显像,通过勾画ROI,获得

  4. Clinical implications of a new TSH-receptor-antibody-assay (DYNOtest {sup trademark} TRAKhuman) in autoimmune thyroid diseases; Klinische Implikationen eines neuen TSH-Rezeptor-Antikoerper-Assays (DYNOtest {sup trademark} TRAKhuman) bei autoimmunen Schilddruesenerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Meller, J.; Schreivogel, I.; Becker, W. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin; Bergmann, A.; Morgenthaler, N. [B.R.A.H.M.S Diagnostica, Berlin (Germany); Huefner, M. [Goettingen Univ. (Germany). Abt. Innere Medizin

    2000-07-01

    Aim: Conventional radioreceptor-antibody-assays (RAAs) fail in the detection of TSH-receptor antibodies (TRAKs) in 10-30% of patients with Graves' disease (GD). The aim of this study was the evaluation of the diagnostic and clinical impact of a new RRA (DYNOtest {sup trademark} TRAKhuman) which uses the human recombinant TSH-Receptor in the diagnosis of autoimmune thyroid disease. Methods: Sera from 142 consecutive patients (GD: n=50, autoimmune thyroiditis/AIT: n=92) and from 55 controls (31 patients without any thyroid disease and 14 with euthyroid goiter) were evaluated both with the DYNOtest {sup trademark} TRAKhuman-assay and a conventional RRA (TRAK-Assay {sup trademark}). Thyroid in vitro parameters and thyroid sonography were performed in all patients. Results: The DYNOtest {sup trademark} TRAK-assay was significantly superior to the conventional RRA in the diagnosis of GD (p<0,00012), especially in those who were treated by thionamides (p<0,003) and in the diagnosis of TRAK-positive patients with AIT (p<0,003). The majority of TRAK-positive AIT-patients suffered from hypothyroidism. One false positive result in patients with euthyroid goiter was found in the TRAK-Assay {sup trademark} as well as in the DYNOtest {sup trademark} TRAKhuman-Assay. Therefore the specifity of the DYNOtest {sup trademark} TRAKhuman was not inferior compared with the conventional assay. Conclusion: The DYNOtest {sup trademark} TRAK-assay is superior in the diagnostic work up of Graves' disease compared with a conventional TRAK-assay and offers an equal specifity. (orig.) [German] Ziel: Bei konventionellen Radiorezeptor-Antikoerper-Assays (RRAs) misslingt der Nachweis von TSH-Rezeptor Antikoerpern (TRAKS) bei 10-30% der immunogenen Hyperthyreosen (IH). Ziel der Studie war es, den diagnostischen und klinischen Stellenwertes eines neuen RRA (DYNOtest {sup trademark} TRAKhuman) bei autoimmunen Schilddruesenerkrankungen zu evaluieren. Methoden: Serumproben von 142

  5. Graves' Disease that Developed Shortly after Surgery for Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Hea Min Yu

    2013-09-01

    Full Text Available Graves' disease is an autoimmune disorder that may present with various clinical manifestations of hyperthyroidism. Patients with Graves' disease have a greater number of thyroid nodules and a higher incidence of thyroid cancer compared with patients with normal thyroid activity. However, cases in which patients are diagnosed with recurrence of Graves' disease shortly after partial thyroidectomy for thyroid cancer are very rare. Here we report a case of hyperthyroid Graves' disease that occurred after partial thyroidectomy for papillary thyroid cancer. In this case, the patient developed hyperthyroidism 9 months after right hemithyroidectomy, and antithyroglobulin autoantibody and thyroid stimulating hormone receptor stimulating autoantibody were positive. Therefore, we diagnosed Graves' disease on the basis of the laboratory test results and thyroid ultrasonography findings. The patient was treated with and maintained on antithyroid drugs. The mechanism of the recurrence of Graves' disease in this patient is still unclear. The mechanism may have been the improper response of the immune system after partial thyroidectomy. To precisely determine the mechanisms in Graves' disease after partial thyroidectomy, further studies based on a greater number of cases are needed.

  6. Thyroid storm

    Science.gov (United States)

    Thyrotoxic storm; Hyperthyroid storm; Accelerated hyperthyroidism; Thyroid crisis; Thyrotoxicosis - thyroid storm ... thyroid storm can be caused by treatment of hyperthyroidism with radioiodine therapy.

  7. Necrobiosis lipoidica associated with Hashimoto’s thyroiditis and positive detection of ANA and ASMA autoantibodies

    Science.gov (United States)

    Borgia, Francesco; Russo, Giuseppina T; Villari, Provvidenza; Guarneri, Fabrizio; Cucinotta, Domenico; Cannavò, Serafinella P

    2015-01-01

    Key Clinical Message Necrobiosis lipoidica (NL) is a rare idiopathic cutaneous condition exceptionally associated with autoimmune thyroiditis. We describe the first case of NL, Hashimoto’s thyroiditis and positive detection of autoantibodies. Appropriate screening for NL in patients with autoimmune thyroiditis may clarify its real incidence and the existence of a common pathogenetic pathway. PMID:26273437

  8. Necrobiosis lipoidica associated with Hashimoto's thyroiditis and positive detection of ANA and ASMA autoantibodies.

    Science.gov (United States)

    Borgia, Francesco; Russo, Giuseppina T; Villari, Provvidenza; Guarneri, Fabrizio; Cucinotta, Domenico; Cannavò, Serafinella P

    2015-07-01

    Necrobiosis lipoidica (NL) is a rare idiopathic cutaneous condition exceptionally associated with autoimmune thyroiditis. We describe the first case of NL, Hashimoto's thyroiditis and positive detection of autoantibodies. Appropriate screening for NL in patients with autoimmune thyroiditis may clarify its real incidence and the existence of a common pathogenetic pathway.

  9. 成人晚发性自身免疫糖尿病与自身免疫性甲状腺疾病的相关性研究%Correlation study of autoimmune thyroid disease and latent autoimmune diabetes in adults

    Institute of Scientific and Technical Information of China (English)

    黄秉文; 方咏红; 卢颖瑜; 郭春花; 王运林

    2015-01-01

    目的 探讨成人晚发性自身免疫糖尿病(LADA)与自身免疫性甲状腺疾病(AITD)的关系,并分析LADA患者发生AITD的危险因素.方法 对80例LADA患者、80例2型糖尿病(T2DM)患者和80例健康对照者进行游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)、血清超敏促甲状腺素(uTSH)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)检测.糖尿病患者还进行谷氨酸脱羧酶抗体(GADA)、胰岛素自身抗体(IAA)、胰岛细胞抗体(ICA)检测.采用放免法检测TPO-Ab、TG-Ab、FT3、FT4,直接化学发光法检测uTSH,放射配体法检测GADA、IAA、ICA.随访2年后对以上指标进行复查.结果 (1) LADA患者的基线TG-Ab及TPO-Ab阳性率分别为18.8%、21.3%,均高于T2DM患者的8.8%、13.8%和健康对照者的10.0%、12.5%,差异均有统计学意义(P0.05).(3)高滴度GADA的LADA患者与低滴度的LADA患者比较,随访前后TG-Ab阳性率均较高(25.0%vs 15.4%和32.1%vs 15.4%,P均0.05).(4) Logistic回归分析显示,女性、高滴度GADA、入组时甲状腺自身抗体(TPO-Ab、TG-Ab)阳性是LADA患者未来发生甲状腺功能异常的危险因素.结论 LADA患者,尤其是高滴度GADA者,发生甲状腺自身免疫紊乱的风险高于T2DM及健康对照者;女性、高滴度GADA、甲状腺自身抗体阳性是LADA患者将来发生甲状腺功能异常的危险因素;由于LADA有并发甲状腺功能异常的风险,推荐在LADA患者中常规筛查甲状腺自身抗体.%Objective To investigate the relationship between latent autoimmune diabetes in adults (LA-DA) and autoimmune thyroid disease (AITD), and to analyze the risk factors for AITD in patients with LADA. Methods Eighty patients of LADA, 80 patients of type 2 diabetes mellitus (T2DM), and 80 healthy subjects were recruited. Physical examination was performed and sera were sampled for the measurement of thyroid peroxidase anti-body (TPO-Ab), thyroglobulin antibody (TG-Ab), glutamic acid

  10. Prevalence of Growth Hormone Deficiency in Hashimoto's Thyroiditis

    NARCIS (Netherlands)

    S.A. Eskes; E. Endert; E. Fliers; W.M. Wiersinga

    2010-01-01

    Context: Autoimmune hypophysitis can result in GH deficiency (GHD) and is associated with other autoimmune endocrine diseases like Hashimoto's thyroiditis. Recent studies suggest a high prevalence (5%) of GHD in Hashimoto's thyroiditis. Objective: Our objective was to establish the prevalence of GHD

  11. Burkitt lymphoma presenting as a mass in the thyroid gland: a clinicopathologic study of 7 cases and review of the literature.

    Science.gov (United States)

    Quesada, Andrés E; Liu, Huifei; Miranda, Roberto N; Golardi, Natalia; Billah, Shahreen; Medeiros, L Jeffrey; Jaso, Jesse Manuel

    2016-10-01

    Burkitt lymphoma presenting in the thyroid gland is rare, and only a few cases have been reported. We retrospectively reviewed 7 patients diagnosed with Burkitt lymphoma of the thyroid gland between 2000 and 2015. There were 4 men and 3 women with a median age of 41 years (range, 19-49 years). All patients presented with a rapidly growing neck mass associated with upper airway compression in 5 (71%) patients. Two patients presented with localized (stage I/II) and 5 patients with disseminated (stage III/IV) disease. All cases showed morphologic and immunophenotypic features of Burkitt lymphoma with MYC rearrangement in all 5 cases tested. One case showed evidence of concurrent Hashimoto thyroiditis. Six of 7 patients were treated primarily with rituximab, hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone. One patient was treated primarily with dose-adjusted rituximab, etoposide, prednisolone, vincristine, and cyclophosphamide. At the end of the study period, 5 patients were alive: 4 in complete remission and 1 with persistent disease. Two patients died with persistent disease (median follow-up, 25 months; range, 12-361 months). We conclude that Burkitt lymphoma of the thyroid gland shows clinicopathologic features similar to sporadic Burkitt lymphoma at other anatomic sites, but patients present at an older median age. The clinical course is aggressive with a high frequency of disseminated disease at diagnosis; however, a subset of patients responds well to aggressive chemotherapy.

  12. Thyroid Tests

    Science.gov (United States)

    ... calories and how fast your heart beats. Thyroid tests check how well your thyroid is working. They ... thyroid diseases such as hyperthyroidism and hypothyroidism. Thyroid tests include blood tests and imaging tests. Blood tests ...

  13. 实验性自身免疫性甲状腺炎大鼠甲状腺中CD4+T淋巴细胞浸润的研究%A study of CD4+T lymphocyte infiltration level in the thyroid of experimental autoimmune thyroiditis rat

    Institute of Scientific and Technical Information of China (English)

    崔丝露; 刘守军; 于钧

    2014-01-01

    Objective To establish a experimental autoimmune thyroiditis(EAT) rat model and to observe pathological change levels of CD4 + T lymphocyte infiltration in thyroid tissues under different iodine nutrient conditions.Methods One hundred and thirty-five four weeks old female Lewis rats(body weight about 80 g) were divided into control(NC),model(TG),high iodine-Ⅰ (HⅠ),high iodine and model-Ⅰ (HⅠ + TG),high iodine-Ⅱ (H Ⅱ),high iodine and model-Ⅱ (H Ⅱ + TG) groups according to body weight by random number table.There were 20 rats in NC,HⅠ and H Ⅱ groups,and 25 rats in TG,H Ⅰ + TG and H Ⅱ + TG groups.The rats of HⅠ and HⅠ + TG groups drank deionized water containing iodine 25.7 mg/L; rats of HⅡl and H Ⅱ + TG groups drank deionized water containing iodine 423.3 mg/L; rats of NC and TG groups drank distilled water.Rats of TG,HⅠ + TG and H Ⅱ + TG groups were immunized with 0.1 ml thyroglobulin(Tg,8.0 g/L) in incomplete Freunds adjuvant (IFA),once two weeks for three times.Urine samples were collected after immunization for 8 weeks; after immunization for 15 weeks,rats were killed,blood samples and thyroid tissues were taken.Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry; pathological changes in thyroid tissue were observed by Hematoxylin-Eosin (HE) method ; immunohistochemical method was used to identify the infiltration of inflammatory cells in thyroid tissue.Results The difference of rat thyroid relative quality between groups was statistically significant (F =44.428,P < 0.05).Compared with NC group (0.085 25 mg/g),thyroid relative qualities were increased in experimental groups (TG,HⅠ,HⅠ + TG,H Ⅱ,H Ⅱ + TG groups:0.095 22,0.092 85,0.097 48,0.096 55,0.095 33 mg/g,all P < 0.05).The difference of urinary iodine between groups was statistically significant(x2 =106.4,P< 0.05).Compared with NC group(456.45 μg/L),urinary iodine levels in TG,HⅠ,HⅠ +TG,HⅡ,HⅡ + TG groups(800.08,18 633.20,13 869

  14. Diagnosis and classification of autoimmune gastritis.

    Science.gov (United States)

    Toh, Ban-Hock

    2014-01-01

    Autoimmune gastritis is a silent and highly prevalent disease that only becomes clinically manifested with progression to corpus atrophy and development of iron deficient or B12-deficient (pernicious) anaemia. Autoimmune gastritis is associated with autoimmune thyroiditis and type 1 diabetes mellitus. Corpus atrophy may be complicated by gastric carcinoids and gastric cancer. Laboratory diagnosis of autoimmune gastritis rests on serum biomarkers of antibody to parietal cell H/K ATPase and intrinsic factor and corpus atrophy on serum biomarkers of gastrin and pepsinogen levels. Subjects with asymptomatic parietal cell antibody should be regularly assessed for serum biomarkers for progression to corpus atrophy, development of iron and B12 deficiency anaemia and for associated autoimmune thyroiditis and type 1 diabetes mellitus.

  15. Chronic autoimmune urticaria : Where we stand ?

    Directory of Open Access Journals (Sweden)

    Goh C

    2009-01-01

    Full Text Available It is well-recognized that 30-40% of chronic idiopathic urticaria is autoimmune in nature. Chronic autoimmune urticaria is caused by anti-FcåRI and less frequently, by anti-IgE autoantibodies that lead to mast cell and basophil activation, thereby giving rise to the release of histamine and other proinflammatory mediators. Activation of the classical complement pathway and formation of C5a are important in dermal mast cell activation. C5a is also a neutrophil and eosinophil chemoattractant. Chronic autoimmune urticaria has been found to be associated with autoimmune thyroid disease. The autologous serum skin test is used as a screening test for chronic autoimmune urticaria and has a sensitivity and specificity of about 70 and 80%, respectively. The current gold standard diagnostic test is the basophil histamine release assay. The treatment of chronic autoimmune urticaria, as in chronic idiopathic urticaria, is with H1 antihistamines. Oral corticosteroids may be used during acute flares. Refractory cases have been shown to respond to cyclosporine and other immunomodulators. The prevalence of chronic autoimmune urticaria in Singapore is similar to that reported in Western countries at about 42%. The presence of thyroid autoimmunity appears to be higher than reported, with 22.5% of patients with chronic idiopathic urticaria here, exhibiting presence of thyroid autoantibodies.

  16. Graves’ thyrotoxicosis following Hashimoto’s thyroiditis

    Directory of Open Access Journals (Sweden)

    Troisi A

    2013-03-01

    Full Text Available A Troisi,1 P Novati,1 L Sali,1 M Colzani,1 G Monti,1 C Cardillo,3 M Tesauro21Division of Internal Medicine, Saronno Hospital, Italy; 2Department of Internal Medicine, Tor Vergata Clinical Center, University of Rome, Rome, Italy; 3Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, ItalyAbstract: Autoimmune thyroid disease traditionally includes chronic thyroiditis, autoimmune hyperthyroidism (Graves’ disease, and primary nongoitrous myxedema, and these diseases have a common syndrome-sharing pathophysiology. Here we report a rare case of simultaneous occurrence of thyrotoxicosis linked to Graves’ disease and chronic hypothyroidism due to Hashimoto’s thyroiditis.Keywords: Hashimoto’s thyroiditis, Graves’ disease, autoimmune thyroid disorders

  17. X Chromosome inactivation pattern is not associated with interindividual variations in thyroid volume: a study of euthyroid danish female twins

    DEFF Research Database (Denmark)

    Brix, Thomas Heiberg; Hansen, Pia Skov; Bennedbak, Finn Noe

    2009-01-01

    Ahigher frequency of skewed X chromosome inactivation (XCI) is found in patients with autoimmune thyroid disease (AITD) than in controls. Although goitre is often present in AITD, a recent study failed to show an association between XCI and clinically overt nontoxic goitre. However, the etiology...... of overt goitre is complex, and the mechanisms influencing thyroid volume may involve fewer factors than the mechanisms underlying overt goitre. In order to examine the impact of XCI on thyroid volume in euthyroid females, we studied whether within cohort (n = 138) and within twin pair (n = 69) differences...

  18. A patient presenting with spinal cord compression who had two distinct follicular cell type thyroid carcinomas.

    Science.gov (United States)

    Koca, E; Sokmensuer, C; Yildiz, B O; Engin, H; Bozkurt, M F; Aras, T; Barista, I; Gurlek, A

    2004-06-01

    A 61-yr-old woman presented with complaints of weakness and pain in her legs. A magnetic resonance imaging showed a 3 x 5.6 x 7.8 cm mass lesion destructing the T1 and T2 vertebral bodies and compressing the spinal cord. The mass was excised surgically. It was follicular carcinoma metastasis of the cervicodorsal region. Then, she underwent a total thyroidectomy. Pathological examination showed two different types of carcinomas in two different focuses; follicular carcinoma in the left lobe and follicular variant papillary carcinoma in the isthmic lobe. After the operation she was given 100 mCi 131I. This is the first report of a patient who had both metastatic follicular carcinoma and follicular variant papillary carcinoma together.

  19. Autoimmune disease classification by inverse association with SNP alleles.

    Directory of Open Access Journals (Sweden)

    Marina Sirota

    2009-12-01

    Full Text Available With multiple genome-wide association studies (GWAS performed across autoimmune diseases, there is a great opportunity to study the homogeneity of genetic architectures across autoimmune disease. Previous approaches have been limited in the scope of their analysis and have failed to properly incorporate the direction of allele-specific disease associations for SNPs. In this work, we refine the notion of a genetic variation profile for a given disease to capture strength of association with multiple SNPs in an allele-specific fashion. We apply this method to compare genetic variation profiles of six autoimmune diseases: multiple sclerosis (MS, ankylosing spondylitis (AS, autoimmune thyroid disease (ATD, rheumatoid arthritis (RA, Crohn's disease (CD, and type 1 diabetes (T1D, as well as five non-autoimmune diseases. We quantify pair-wise relationships between these diseases and find two broad clusters of autoimmune disease where SNPs that make an individual susceptible to one class of autoimmune disease also protect from diseases in the other autoimmune class. We find that RA and AS form one such class, and MS and ATD another. We identify specific SNPs and genes with opposite risk profiles for these two classes. We furthermore explore individual SNPs that play an important role in defining similarities and differences between disease pairs. We present a novel, systematic, cross-platform approach to identify allele-specific relationships between disease pairs based on genetic variation as well as the individual SNPs which drive the relationships. While recognizing similarities between diseases might lead to identifying novel treatment options, detecting differences between diseases previously thought to be similar may point to key novel disease-specific genes and pathways.

  20. Thyroid swellings

    Institute of Scientific and Technical Information of China (English)

    Rebecca Hatton; Madhukar Patel; Devasenan Devendra

    2009-01-01

    @@ A 48 year old post-menopausal woman presents with a smooth midline sweHing in her neck,which has been present for more than 10 years.On examination.you find that it is consistent with an enlarged thyroid gland.

  1. Thyroid diseases and pregnancy

    Directory of Open Access Journals (Sweden)

    Marco Grandi

    2013-05-01

    Full Text Available BACKGROUND Thyroid diseases and diabetes mellitus are the most common endocrine diseases during pregnancy. Internal Medicine doctors could be involved in the management of pregnant women affected by thyroid diseases, in particular if an Endocrine Unit lacks in the hospital; it is mandatory that they have the skills to cope with these diseases. METHODS In this work authors describe the most common thyroid abnormalities that can occur during pregnancy: hypothyroidism (clinical and subclinical, hyperthyroidism (clinical and sub-clinical, autoimmune thyroiditis (in particular the so called post-partum thyroiditis, nodular diseases and cancer. They discuss moreover the peculiar pathophysiologic mechanisms by which these diseases appear, the diagnostic tools and the therapies, according to their own experience and the more recent international guidelines. RESULTS AND CONCLUSIONS It is important to evaluate thyroid function tests before and during pregnancy, at 16th and 28th gestational week; it is mandatory to cure also the “sub-clinical” hypothyroidism during pregnancy, when TSH level are higher than 5 μIU/mL; the optimal dose of levo-thyroxine during pregnancy is, average, 30-50% higher than that used before pregnancy; it is not correct to treat mild or sub-clinical hyperthyroidism; propylthyouracil is the best drug to treat hyperthyroidism during pregnancy; the post-partum thyroiditis is generally transient, so that a careful monitoring of thyroid function is advisable, in particular after 9-12 months of therapy; thyroid cancer, if discovered during pregnancy, generally has no negative effects on the outcome of the pregnancy; it would be better to treat surgically thyroid cancer during the last trimester of the pregnancy.

  2. Report of a case of papillary thyroid carcinoma in association with Hashimoto's thyroiditis

    Directory of Open Access Journals (Sweden)

    Chukwudi Onyeaghana Okani

    2015-01-01

    Full Text Available Hashimoto thyroiditis (HT is an autoimmune disease, known to be the most common cause of hypothyroidism in nonendemic goitrous areas. It is usually characterized by symmetric, painless, and diffused but sometimes localized swelling of the thyroid gland with features of hypothyroidism. Papillary thyroid carcinoma (PTC, on the other hand, is the most common yet less aggressive form of thyroid cancer, especially in iodine-deficient areas. The coexistence of the two diseases is possible but not common. This case study reports a 50-year-old female with a 10-year history of a huge goiter, which was essentially symptom-free until about 3 months prior to presentation when the patient started complaining of neck pain, dysphagia, productive cough, and cold intolerance. Physical examination revealed focal cystic and tender area in the multinodular swelling and associated cervical lymphadenopathy on the left side of the neck. The serum thyroid stimulating hormone was high, sub-normal T3, and the T4 was low. The fine needle aspiration cytology yielded 10 ml of aspirate of pus admixed with altered blood which on microscopy showed a few suspicious follicular epithelial cells with open nuclei admixed with mainly neutrophil polymorphs, siderophages, and foam cells in a hemorrhagic background. The patient had an incision biopsy that showed areas displaying PTC and HT.

  3. Primary Non-Hodgkin’s Lymphoma of the thyroid with lymphocytic thyroiditis

    OpenAIRE

    Raviprakash, C. S.; Joseph, Cherian; Xavier, Saju; Raj, Girish

    2005-01-01

    Primary Lymphoma of the thyroid is one of the very rare entities accounting to less than 2% of thyroid malignancies. We present a case of primary Non-Hodgkin’s Lymphoma of the thyroid with lymphocytic thyroiditis in a 60 year old woman. The patient presented with a rapidly growing nodular mass in the thyroid. The histological and immune marker features of the tumour were consistent with Primary Non-Hodgkin’s Lymphoma of the thyroid with associated thyroiditis.

  4. Non-tumor-Associated Anti-N-Methyl-D-Aspartate (NMDA) Receptor Encephalitis in Chinese Girls With Positive Anti-thyroid Antibodies.

    Science.gov (United States)

    Guan, Wenjuan; Fu, Zhenqiang; Zhang, Hui; Jing, Lijun; Lu, Jingjing; Zhang, Jing; Lu, Hong; Teng, Junfang; Jia, Yanjie

    2015-10-01

    Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is a new category of autoimmune encephalitis associated with anti-NMDA receptor antibodies. The disease was first described in 2007, and it predominantly affects young women with or without ovarian teratomas. Most patients typically present with seizures, a decreased consciousness level, dyskinesia, autonomic dysfunction, and psychiatric symptoms. The presence of anti-thyroid antibodies in non-tumor-associated anti-NMDA receptor encephalitis was first described in 2010. Additionally, anti-thyroid antibodies were found in teratoma-associated anti-NMDA receptor encephalitis. We report the cases of 3 Chinese girls with non-tumor-associated anti-NMDA receptor encephalitis with positive anti-thyroid antibodies. We followed up the details of their titers and suggest that anti-thyroid antibodies were an indicator of autoimmune predisposition in the development of non-tumor-associated anti-NMDA receptor encephalitis.

  5. A population study of the association between thyroid autoantibodies in serum and abnormalities in thyroid function and structure

    DEFF Research Database (Denmark)

    Pedersen, I.B.; Laurberg, P.; Knudsen, N.;

    2005-01-01

    autoantibodies in serum and abnormalities in thyroid function and structure, and to study the thyroid volume in subjects with subclinical autoimmune hypothyroidism. Design A population study including 4649 randomly selected subjects. Measurements Blood tests were used to analyse for thyroid peroxidase...

  6. Autoimmune thyroid disease and CD4~+ CD25~+ regulatory T cell%自身免疫性甲状腺疾病和CD4~+CD25~+调节性T细胞

    Institute of Scientific and Technical Information of China (English)

    侍晓云; 赵勇

    2010-01-01

    自身免疫性甲状腺疾病(AITD)的发生及发展与CD4~+CD25~+调节性T细胞(Treg细胞)的数量和功能密切相关.动物实验证明Treg细胞可抑制AITD的发生.如果清除动物体内的该类细胞,可导致AITD发病或使原有的甲状腺疾病加重,Treg细胞通过抑制效应性T细胞的激活而发挥对AITD的影响作用.无论是胸腺还是外周,不同诱导体系来源的Treg细胞均对AITD有影响作用.%The occurance and development of autoimmune thyroid disease (AITD)is related with changes of quantities and function of CD4~+CD25~+ regulatory T(Treg) cells. Different studies indicated that Treg cells can inhibit the development of AITD. Depletion of Treg cells can improve the incidence of AITD or increase the severity of AITD. Treg cells play roles in inhibiting activation of effector T cell. No matter Treg cells or CD4~+ CD25~+ regulatory T cells generated in the periphery can influence the development of AITD.

  7. [Autoimmune hemolytic anemia in children].

    Science.gov (United States)

    Becheur, M; Bouslama, B; Slama, H; Toumi, N E H

    2015-01-01

    Autoimmune hemolytic anemia is a rare condition in children which differs from the adult form. It is defined by immune-mediated destruction of red blood cells caused by autoantibodies. Characteristics of the autoantibodies are responsible for the various clinical entities. Classifications of autoimmune hemolytic anemia include warm autoimmune hemolytic anemia, cold autoimmune hemolytic anemia, and paroxysmal cold hemoglobinuria. For each classification, this review discusses the epidemiology, etiology, clinical presentation, laboratory evaluation, and treatment options.

  8. Ethical issues in the management of thyroid disease.

    Science.gov (United States)

    Rosenthal, M Sara

    2014-06-01

    The focus of this article is on clinical ethics issues in the thyroid disease context. Clinical ethics is a subspecialty of bioethics that deals with bedside ethical dilemmas that specifically involve the provider-patient relationship. Such issues include consent and capacity; weighing therapeutic benefits against risks and side-effects; innovative therapies; end of life care; unintended versus intentional harms to patients or patient populations; and healthcare access. This article will review core ethical principles for practice, as well as the moral and legal requirements of informed consent. It will then discuss the range of unique and universal ethical issues and considerations that present in the management of autoimmune thyroid disease and thyroid cancer.

  9. Thyroid emergencies.

    Science.gov (United States)

    Klubo-Gwiezdzinska, Joanna; Wartofsky, Leonard

    2012-03-01

    This review presents current knowledge about the thyroid emergencies known as myxedema coma and thyrotoxic storm. Understanding the pathogenesis of these conditions, appropriate recognition of the clinical signs and symptoms, and their prompt and accurate diagnosis and treatment are crucial in optimizing survival.

  10. TG-Ab、TPO-Ab定量检测在自身免疫性甲状腺疾病诊断中的作用%The major role of quantitative detection of TG-Ab and TPO-Ab in helping diagnosis in autoimmune thyroid diseases

    Institute of Scientific and Technical Information of China (English)

    张保珍

    2015-01-01

    Obiective To investigate the role of the serum anti thyroglobulin antibody (TG-Ab) and anti thyroid peroxidase antibody (TPO-Ab) in diagnosis of different kinds of autoimmune thyroid diseases. Methods The levels of TG-Ab and TPO-Ab were tested in different kinds of autoimmune thyroid diseases by using electrochemical luminescence methods and then we compared the levels of TG-Ab and TPO-Ab among different groups. Conclusion Different autoimmune thyroid diseases showed different levels of TG-Ab and TPO-Ab significantly. It suggests that quantitative detection of TG-Ab and TPO-Ab can help diagnosis and differential diagnosis.%目的:探讨定量检测血清抗甲状腺球蛋白抗体(TG-Ab)和抗甲状腺过氧化物酶抗体(TPO-Ab)在自身免疫性甲状腺疾病诊断中的作用。方法用电化学发光方法检测不同甲状腺疾病患者血清抗甲状腺球蛋白抗体(TG-Ab)、抗甲状腺过氧化物酶抗体(TPO-Ab)水平,比较不同甲状腺疾病患者及正常对照组之间TG-Ab、TPO-Ab水平的差异。结果血清TG-Ab、TPO-Ab在不同甲状腺自身免疫性疾病中水平不一。结论 TG-Ab、TPO-Ab定量检测可帮助甲状腺自身免疫性疾病的诊断及鉴别诊断。

  11. Primary mediastinal large B-cell lymphoma arising from thyroid in a renal recipient with Hashimoto's thyroiditis.

    Science.gov (United States)

    Wu, Fang; Qu, Lu; Li, Dai-Qiang; Hu, Chun-Hong

    2015-01-01

    Primary mediastinal large B-cell lymphoma is a subtype of diffuse large B-cell lymphoma, arising in the mediastinum from putative thymic B-cell origin with distinctive clinical and genetic features. Generally, primary mediastinal large B-cell lymphoma is believed as only deriving in the mediastinum. The current study presents a rare case of primary mediastinal large B-cell lymphoma which arising from thyroid in a renal recipient with Hashimoto's thyroiditis. Moreover, we devoted a discussion to the relationship among primary mediastinal large B-cell lymphoma, immunomodulatory therapy and autoimmune diseases. The immunologic derangement induced by long-term immunomodulatory therapy and Hashimoto's thyroiditis may be the possible cause for the ectopic lymphoma.

  12. A meta-analysis of selenium in the treatment of autoimmune thyroid diseases%硒治疗自身免疫性甲状腺疾病的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    房方; 卫红艳; 王坤玲; 朱梅

    2016-01-01

    目的 评价元素硒治疗自身免疫性甲状腺疾病(AITD)的有效性和安全性.方法 通过5个数据库(MEDLINE,Cochrane Central Register of Controlled Trials,中国期刊全文数据库,中国生物医学文献数据库和维普数据库)检索所有研究元素硒治疗AITD的随机对照试验(RCT).由两名研究者独立筛选文献、提取数据和进行结果的统计分析.将结果数据形式一致的同类临床试验的结果进行荟萃分析,对不能荟萃分析的数据进行描述性分析.共纳入30项RCT,涉及2 963例AITD患者.结果 (1)与对照组相比,硒治疗组桥本甲状腺炎患者甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb)水平明显下降[标准化均数差(SMD)=-1.35,95% CI:-1.93~-0.67,P <0.000 01和SMD=-0.92,95% CI:-1.53~-0.31,P<0.01].(2)硒治疗组与对照组相比,Graves病患者促甲状腺激素受体抗体(TRAb)水平降低(均数差=-2.5,95% CI:-2.99~-2.01,P<0.000 01).(3)元素硒可以降低Graves病患者血清游离T3(FT3)和游离T4(FT4)水平(均数差=-1.57,95% CI:-2.56~-0.58,P<0.001和均数差=-3.74,95% CI:-5.65~-1.82,P=0.000 01),但对桥本甲状腺炎患者FT3、FT4和促甲状腺激素的作用不明显(P均>0.05).结论 对AITD患者使用200 μg∥d的元素硒治疗3~12个月,能够有效降低抗甲状腺自身抗体(TPOAb,TgAb和TRAb)的水平,并具有较好的安全性.%Objective To assess the effectiveness and safety of selenium in the treatment of autoimmune thyroid diseases (AITD).Methods Five databases (MEDLINE,Cochrane Central Register of Controlled Trials,CBM,CNKI and VIP) were searched for all randomized controlled trial (RCT) which investigating the effectiveness of selenium in the treatment of AITD.Two authors independently selected studies,extracted data and analyzed the results.Meta-analyses were performed when more than one study with sufficient similarity provided data on an outcome.Thirty RCTs were included involving

  13. Subacute lymphocytic thyroiditis after lobectomy in a patient with papillary thyroid carcinoma: a case report

    OpenAIRE

    Choi Young Sik; Han You Jin; Yeo Go Eun; Kwon Su Kyoung; Kim Bu Kyung; Park Yo-Han; Kim Sung Won; Chun Bong Kwon; Kong Eun Hee; Kim Jeong Hoon

    2013-01-01

    Abstract Introduction Subacute lymphocytic thyroiditis is anautoimmune thyroid disease presenting with transient thyrotoxicosis as well as transient hypothyroidism. Several factors have been thought to be the initiating event in subacute lymphocytic thyroiditis. However, subacute lymphocytic thyroiditis that develops after thyroid lobectomy has not yet been reported in the literature. We report a case of subacute lymphocytic thyroiditis after lobectomy in a patient with papillary thyroid carc...

  14. Present Status of Diagnosis and Surgical Treatment in Papillary Thyroid Carcinoma%甲状腺乳头状癌外科诊治现状

    Institute of Scientific and Technical Information of China (English)

    嵇庆海

    2001-01-01

    The article described the diagnostic and therapeutic methods of papillary thyroid carcinoma at present, and put forward their own opinions.%文章主要叙述了目前甲状腺乳头状癌的各种诊断方法和治疗措施,并对此提出了相应的看法与认识。

  15. [Autoimmune pancreatitis].

    Science.gov (United States)

    Beyer, G; Menzel, J; Krüger, P-C; Ribback, S; Lerch, M M; Mayerle, J

    2013-11-01

    Autoimmune pancreatitis is a relatively rare form of chronic pancreatitis which is characterized by a lymphoplasmatic infiltrate with a storiform fibrosis and often goes along with painless jaundice and discrete discomfort of the upper abdomen. Clinically we distinguish between two subtypes, which differ in terms of their histology, clinical picture and prognosis. Type 1 autoimmune pancreatitis is the pancreatic manifestation of the IgG4-associated syndrome which also involves other organs. About one third of the patients can only be diagnosed after either histological prove or a successful steroid trail. Type 2 is IgG4-negative with the histological picture of an idiopathic duct centric pancreatitis and is to higher degree associated with inflammatory bowel disease. A definitive diagnosis can only be made using biopsy. Usually both forms show response to steroid treatment, but in type 1 up to 50 % of the patients might develop a relapse. The biggest challenge and most important differential diagnosis remains the discrimination of AIP from pancreatic cancer, because also AIP can cause mass of the pancreatic head, lymphadenopathy and ductal obstruction. This article summarizes recent advances on epidemiology, clinical presentation, diagnostic strategy, therapy and differential diagnosis in this relatively unknown disease.

  16. Correlation between polycystic ovary syndrome and autoimmune thyroiditis%多囊卵巢综合征与自身免疫性甲状腺炎的相关性研究

    Institute of Scientific and Technical Information of China (English)

    成海英; 高天旸; 靖涛; 卢艳湘; 刘红艳; 傅晓英; 梁营秋; 全燕

    2015-01-01

    Objective To explore the occurrence of autoimmune thyroiditis(AIT)in polycystic ovary syndrome(PCOS)patients and their clinical significance.Methods From October 201 1 to October 2012,a total of 1 1 6 patients with PCOS were recruited in the study in the Second People′s Hospital of Guangdong Province as PCOS group(n=1 1 6).Meanwhile 309 age-matched infertile women without PCOS were chosen as control group(n=309).The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the Second People′s Hospital of Guangdong Province.Informed consent was obtained from each participants.There were no significant differences in general condition menstrual cycle and etc.between two groups(P > 0.05 ).The levels of sex hormones,serum thyroid hormones and thyroid autoantibodies were detected by chemiluminescence immunoassay at the third day of menstrual period.Results ① The levels of luteinizing hormone (LH)and testosterone in the patients with PCOS were significantly higher than those of control group (P 0.05).The levels of thyroid peroxidase antibody (TGAb),thyroglobulin antibody (TPOAb)and the proportion of abnormal TGAb,TPOAb (>60 U/mL)in PCOS group were obviously higher than those of control group,and the differences were significant (P 0.05)。采用化学发光免疫法检测两组患者月经第3天的性激素水平、血清甲状腺激素和甲状腺自身抗体水平变化。结果①PCOS 组患者月经第3天黄体生成素(LH)、睾酮水平显著高于对照组,并且差异有统计学意义(P 0.05)。PCOS 组患者甲状腺过氧化物酶抗体(TGAb)、甲状腺球蛋白抗体(TPOAb)水平及 TGAb >60 U/mL、TPOAb >60 U/mL患者比例均显著高于对照组,并且差异均有统计学意义(P <0.05)。③ PCOS 组体质量指数(BMI)和甲状腺超声结果异常患者比例显著高于对照组,且差异有统计学意义(P <0.05)。结论PCOS与 AIT 的发病密切相关。

  17. Production of interleukin (IL)-5 and IL-10 accompanies T helper cell type 1 (Th1) cytokine responses to a major thyroid self-antigen, thyroglobulin, in health and autoimmune thyroid disease

    DEFF Research Database (Denmark)

    Nielsen, Claus H; Hegedüs, L; Rieneck, Klaus

    2007-01-01

    Tumour necrosis factor (TNF)-alpha and interferon (IFN)-gamma exert detrimental effects in organ-specific autoimmune disease, while both destructive and protective roles have been demonstrated for interleukin (IL)-10, IL-4 and IL-5. We examined the production of these cytokines by peripheral blood....... Release of IFN-gamma, IL-4 and, notably, IL-5 ensued. Both patient groups exhibited increased TNF-alpha, IL-2, IFN-gamma and IL-10 responses, and PBMC from HT patients secreted lower amounts of IL-5 than male, but not female, controls. Enhanced TNF-alpha production by HT cells also occurred...... in the presence of pooled normal sera, indicating a dependency on intrinsic cellular factors. Conversely, higher production of TNF-alpha and IL-5 occurred in the presence of autologous sera than in the presence of pooled normal sera in both patient groups, indicating a dependency on serum constituents. Complement...

  18. Autoimmune epilepsy.

    Science.gov (United States)

    Greco, Antonio; Rizzo, Maria Ida; De Virgilio, Armando; Conte, Michela; Gallo, Andrea; Attanasio, Giuseppe; Ruoppolo, Giovanni; de Vincentiis, Marco

    2016-03-01

    Despite the fact that epilepsy is the third most common chronic brain disorder, relatively little is known about the processes leading to the generation of seizures. Accumulating data support an autoimmune basis in patients with antiepileptic drug-resistant seizures. Besides, recent studies show that epilepsy and autoimmune disease frequently co-occur. Autoimmune epilepsy is increasingly recognized in the spectrum of neurological disorders characterized by detection of neural autoantibodies in serum or spinal fluid and responsiveness to immunotherapy. An autoimmune cause is suspected based on frequent or medically intractable seizures and the presence of at least one neural antibody, inflammatory changes indicated in serum or spinal fluid or on MRI, or a personal or family history of autoimmunity. It is essential that an autoimmune etiology be considered in the initial differential diagnosis of new onset epilepsy, because early immunotherapy assures an optimal outcome for the patient.

  19. Thyroid dysfunction and thyroid antibodies in Iranian patients with vitiligo

    Directory of Open Access Journals (Sweden)

    Moradi Sedighe

    2008-01-01

    Full Text Available Vitiligo is a common skin disorder, and the pathogenesis is unknown. An increased prevalence of autoimmune thyroid diseases has been described in these patients. The aim of this study is to assess the prevalence of thyroid dysfunction and hypoparathyroidism in patients with vitiligo. Materials and Methods: One hundred and nine patients (38 males and 71 females with vitiligo were enrolled. Thyroid physical examination was carried out. Thyroid function tests, thyroid antibodies, calcium and phosphorus were assessed. The collected data were analysed by SPSS version 11. Results: Thyromegaly was found in 30.1% of patients. Hypothyroidism was found in 16 (15.7% out of 109 cases. Two of them had clinical and 14 had subclinical hypothyroidism. One patient had Grave′s disease. Antibody positivity was the most common disorder (anti-TPO and anti-tg were positive in 36.7 and 32.1%, respectively. No patient had hypoparathyroidism. Conclusion: According to our study, thyroid dysfunction, particulary hypothyroidism and thyroid antibodies increase in patients with vitiligo. We recommend thyroid antibodies assessment and thyroid function evaluation in these patients.

  20. [Autoimmune hepatitis].

    Science.gov (United States)

    Ostojić, Rajko

    2003-01-01

    Autoimmune hepatitis is an unresolving, hepatocellular inflammation of unknown cause that is characterized by the presence of periportal hepatitis on histologic examination, tissue autoantibodies in serum, and hypergammaglobulinemia. By international consensus, the designation autoimmune hepatitis has replaced alternative terms for the condition. Three types of autoimmune hepatitis have been proposed based on immunoserologic findings. Type 1 autoimmune hepatitis is characterized by the presence of antinuclear antibodies (ANA) or smooth muscle antibodies (SMA) (or both) in serum. Seventy percent of patients with type 1 of autoimmune hepatitis are women. This type is the most common form and accounts for at least 80% of cases. Type 2 is characterized by the presence of antibodies to liver-kidney microsome type 1 (anti-LKM1) in serum. Patients with this type of autoimmune hepatitis are predominantly children. Type 3 autoimmune hepatitis is characterized by the presence of antibodies to soluble liver antigen (anti-SLA) in serum. There are no individual features that are pathognomonic of autoimmune hepatitis, and its diagnosis requires the confident exclusion of other conditions. The large majority of patients show satisfactory response to corticosteroid (usually prednisone or prednisolone) therapy. For the past 30 years it has been customary to add azathioprine as a "steroid sparing" agent to allow lower doses of steroids to be used and remission, once achieved, can be sustained in many patients with azathioprine alone after steroid withdrawal. Patients with autoimmune hepatitis who have decompensated during or after corticosteroid therapy are candidates for liver transplantation.

  1. Anetoderma: Is It a Sign of Autoimmunity?

    Directory of Open Access Journals (Sweden)

    Hessa Al Buainain

    2009-12-01

    Full Text Available Anetoderma is a rare elastolytic disorder characterized by circumscribed areas of flaccid skin due to the loss of elastic tissue in the dermis. Primary anetoderma is frequently observed in patients with autoimmune diseases or abnormalities especially with antiphospholipid antibodies with or without antiphospholipid syndrome. In this case report we discuss a patient with primary anetoderma with positive antithyroid peroxidase antibodies, which is consistent with autoimmune thyroiditis.

  2. Hashimoto′s encephalopathy and motor neuron disease: A common autoimmune pathogenesis?

    Directory of Open Access Journals (Sweden)

    Harzheim Michael

    2006-01-01

    Full Text Available Hashimoto′s encephalopathy is a rare complication of autoimmune thyroiditis not associated with thyroidal function decline. We report a 50-year-old man presenting with lower motor neuron symptoms evolving over 3 years and changes in behavior associated with attentive and cognitive impairment occurring in the last few months. Memory deficits, emotional instability, marked dysarthria, mild symmetric weakness of the lower extremities, and fasciculations were the most striking clinical features. EEG was diffusely slow, cranial MRI revealed multiple subcortical white matter lesions, CSF protein was slightly elevated, electromyographic recordings showed acute and chronic denervation, and extremely high TPO antibody titers were found in the serum. Hashimoto′s encephalopathy and lower motor neuron disease were d