Immunologic studies in two patients with persistent lymphocytic thyroiditis, thyrotoxicosis, and low radioactive iodine uptake

Journal Article · Wed Aug 01 04:00:00 EDT 1984 · Am. J. Med.; (United States)

DOI:https://doi.org/10.1016/0002-9343(84)90719-8· OSTI ID:6741156

Elliot, I; Gupta, M; Hostetter, A; Sheeler, L; Skillern, P; Tubbs, R

Two patients with persistent lymphocytic thyroiditis and thyrotoxicosis were studied. Both patients presented with severe hyperthyroidism of nine months' duration and had nontender, small thyroid glands. Uptake of radioactive iodine (131I) was consistently low. Serum thyroxine and triiodothyronine levels remained elevated without remission until thyroidectomy. The serum thyroglobulin level was normal, but testing for microsomal antibody gave weakly positive results in one case. Thyroglobulin and thyroid stimulatory antibodies were not found. The ratio of helper to suppressor T cells was elevated in one case. Neither patient showed response to propranolol, prednisone, or iodine. Light microscopic and immunohistologic studies showed severe lymphocytic thyroiditis with formation of secondary lymphoid follicles. Lymphocytes were predominately T cells (OKT11-positive), primarily helper/inducer T cells (OKT4-positive). Hyperplastic nodules contained high immunoreactive thyroglobulin and thyroxine levels. Aberrant thymus was seen within the thyroid. These studies suggest the possibility of intrathyroidal stimulation and hydrolysis of thyroglobulin within thyroid cells and also support the hypothesis that T and B cell immunoregulatory defects are important in the pathogenesis of this disease.

• Research Organization: Department of Endocrinology, Cleveland Clinic Foundation, Ohio
• OSTI ID: 6741156
• Journal Information: Am. J. Med.; (United States), Journal Name: Am. J. Med.; (United States) Vol. 77:2; ISSN AJMEA
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
AMINO ACIDS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BLOOD CHEMISTRY
BLOOD SERUM
BODY
CARBOXYLIC ACIDS
DAYS LIVING RADIOISOTOPES
DISEASES
ENDOCRINE DISEASES
ENDOCRINE GLANDS
GLANDS
GLOBULINS
HORMONES
HYPERTHYROIDISM
IMMUNOLOGY
INTERMEDIATE MASS NUCLEI
IODINE 131
IODINE ISOTOPES
ISOTOPES
MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC IODINE COMPOUNDS
ORGANS
PATHOGENESIS
PATIENTS
PEPTIDE HORMONES
PROTEINS
RADIOISOTOPES
SURGERY
THYROGLOBULIN
THYROID
THYROID HORMONES
THYROIDECTOMY
THYROIDITIS
THYROXINE
TRIIODOTHYRONINE
UPTAKE