Biomedical subjects

J Aguayo

Publications and source records attributed to J Aguayo.

At least 19 recordsLinked to original sources

PubMed2001

Maternal lactation for preterm newborn infants.

In recent decades, neonatologists have made considerable progress in life support techniques, especially in the treatment and prevention of respiratory disorders, which has led to a higher neonatal survival rate. Research into neonatal nutrition has also produced great benefits. It has been found that one of the key points regarding the improved survival rate of infants is the necessity for nutrition that is both adequate and as natural as possible. In this respect, it is necessary to achieve a better understanding of the process, protection, support and maintenance of maternal lactation in neonatal units. Humanization of perinatal attention during delivery, respect for the rights of parents and their children, protection of the mother and child bonding process, early skin contact with the mother and greater attention to individualized care are all key factors in the reinforcement of maternal lactation and are issues that must be addressed within the field of neonatology. Research activities need to concern themselves with: (1) acquiring greater knowledge concerning the common problems and difficulties that arise with mothers and their preterm babies; (2) training healthcare professionals in these aspects, for example in the extraction and storage of milk and in improving techniques of emotional and communicational skills; (3) by means of specific programmes such as the setting up of support groups, so that the effort made to encourage the initiation of breastfeeding is justified by its continuation for as long as possible. Thus, we hope to establish standards of care based on starting, encouraging and prolonging maternal lactation, in sufficient quantity and quality, always remembering that the fundamental goal of our research is the well-being of the child and its family.

Breast↗

PubMed2000

Metastatic prostate cancer (with prostate-specific antigen of 9996) presenting as obstructive jaundice.

A 78-year-old man admitted with clinical jaundice and pelvic pain had a total bilirubin level of 6.56 mg/dL, an alkaline phosphatase level of 855 U/L, and a prostate specific antigen (PSA) level of 9996 ng/mL. A computed tomogram demonstrated marked retroperitoneal, peripancreatic, periceliac, and periaortic lymphadenopathy. A bone scan revealed increased radiolabeled technetium uptake in the pelvis, vertebral column, parietooccipital region, ribs, and appendiceal skeleton. A biopsy of one pelvic lesion revealed metastatic prostate cancer. This man's obstructive jaundice and bone pain had a dramatic response to treatment with a gonadotropin-releasing hormone analog (leupro lide) and antiandrogen (bicalutamide). All bone pair and clinical signs of jaundice disappeared in 1 week His total bilirubin decreased to 0.84 mg/dL by 2 weeks His PSA values reflected this clinical response, decreasing to 4022 ng/mL in 1 week, 2680 ng/dL after 2 weeks and 1028 ng/mL after 1 month of the above therapy.

Aged↗

PubMed2000

Patronage in the dispute over child analysis between Melanie Klein and Anna Freud--1927-1932.

The author investigates the role of patrons and advocates for Melanie Klein's clinical ideas at the British Psycho-Analytical Society against the backdrop of her theoretical and technical differences with Anna Freud from 1927 to 1932. He also outlines the development of Klein and Anna Freud's theories and techniques within the nascent discipline of child psychoanalysis. The London and Viennese patrons/advocates contributed to polarising what initially were clinical differences about how to analyse pre-latency and latency-age children and which technical processes might best facilitate successful treatment. While the author speculates that a diversity of motivations and agendas may have driven the London group's support for Klein--personal and politicised enthusiasm (Jones), genuine conviction (Riviere) and attempts at theoretical rapprochement between the London and Vienna schools (Glover)--he also argues that Freud's diagnosis with cancer in 1923 and suspicion of patricidal son-successors necessitated the choice of a female successor with unquestioning loyalty to his doctrines. From 1932, when Klein's clinical authority was established, her first group of English supporters began to splinter, as she went on to become a training analyst, mentor and patron in her own right to a succeeding generation of adherents who defended her views during the Controversial Discussions.

History, 20th Century↗

PubMed2000

[Thyroid function tests in normal pregnant women (third trimester) and in pregnant women with pregnancy cholestasis or with acute hepatitis].

BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is a disease of unknown cause characterized by pruritus and biochemical cholestasis in the 3rd trimester of pregnancy. Its pathogenesis may be due to the interaction of abnormalities in the metabolism of estrogens and progesterone, while still unknown environmental factor (s) modulate the expressivity of a genetic predisposing trait. AIMS: To verify if thyroid function tests (TFT) are altered in ICP as in other hepatic diseases and whether a dietary iodine deficiency could be involved. MATERIAL AND METHODS: From 1983 to 1986, 13 normal pregnancies (3rd trimester), 26 ICP patients (with 30 pregnancies) and 4 patients with acute non-A non-B hepatitis in pregnancy, were studied. Serum T3, rT3, T4, fT4 and TSH (before and after TRH) were measured by RIA; in ICP patients, measurements were repeated in puerperium. Urinary 24 h iodine excretion was measured in normal pregnancies and in 6 ICP patients. RESULTS: In normal pregnancies, T3 (3.00 +/- 0.22 nmol/L) and rT3 (0.40 +/- 0.03 nmol/L) were higher than the values detected in non-pregnant women; other TFT were unchanged. Urinary iodine excretion was normal in all individuals tested. Patients with acute hepatitis in pregnancy or with ICP had lower T3 than normal pregnancies (1.82 +/- 0.19 nmol/L in hepatitis; 2.24 +/- 0.12 nmol/L in ICP; p < 0.01) and higher rT3 (0.80 +/- 0.25 nmol/L in hepatitis; 0.54 +/- 0.05 nmol/L in ICP; p < 0.05), while other TFT were unchanged. None of them had clinical signs of hypo or hyperthyroidism. A "euthyroid sick syndrome" was detected in 2 ICP patients and in 2 acute hepatitis in pregnancy. In puerperium of ICP patients, T3 and rT3 returned to levels in non-pregnant women. CONCLUSIONS: In ICP patients, TFT show similar trends than in more severe hepatic and non-hepatic diseases. Although thyroid binding-globulin was not measured in our patients, the pattern of TFT suggests that an impaired peripheral (hepatic?) deiodination of T4 is responsible for these changes. The influence of a dietary iodine deficiency can be ruled out.

Acute Disease↗

PubMed1997

Historicising the origins of Kleinian psychoanalysis. Klein's analytic and patronal relationships with Ferenczi, Abraham and Jones, 1914-1927.

Historical examination of Klein's clinical synthesis through three crucial analytic relationships enables the author to account for the way in which the cultural background--gender, politics and textual analysis--informs theory formation. Klein's analysis with Ferenczi led to her work with children and self-analysis. With Abraham, she arrived at ideas about the origins of neurosis, linking severely disturbed with infantile states of mind. The author argues that the role of the cultural background must be explicated since Klein's initial clinical cohort existed in a Germany ravaged by starvation and absent fathers, which figured in the distinctive significance of the mother-child relationship. Klein's play technique involving toys understood it as the exteriorisation of the child's fantasy life, leading to fresh hypotheses about the early child. By 1925, her work collided with the interests of Sigmund and Anna Freud, who were in the throes of a succession crisis. It was imperative to establish Anna as the new 'pre-eminent' Freud, leading to hasty publication and direct critique of Klein's child technique. Through the intercession of Ernest Jones, who provided her with much needed support by 1927, the first shots of the Freud-Klein controversy were fired when Klein, propelled to centre stage in the international movement, established her reputation in London.

Adult↗

PubMed1994

Development of anti-human B blood group monoclonal antibodies suitable as a blood typing reagent.

An improved procedure for the generation of high-avidity anti-human B blood group monoclonal antibodies (MAbs) was developed. One of them, termed 7A1-2, showed excellent qualities of titer, avidity, and intensity required for use as human B blood typing reagent. Hemagglutination inhibition studies with monosaccharides and oligosaccharides were carried out to determine the specificity of the MAb 7A1-2. These studies indicate that the antibody reacts with the immunodominant region of the antigen which is known to confer the serologic specificity of this blood group.

ABO Blood-Group System↗

PubMed1994

[Determination of antibody antireceptor of TSH, experience in patients with thyroid disorders and controls].

In order to measure TSH receptor antibodies (TRAb) we tried to set up a radioreceptor assay using human thyroid membranes. Due to lack of appropriate binding activity of the material obtained, we decided to use a kit which provides solubilized porcine membrane-receptors to TSH instead of human membranes, as well as calibrators that have been standardized in a receptor assay against MRC LATS std B. With these reactives we have measured TRAb in sera from 7 normal controls (C), 54 thyrotoxic patients (43 diffuse goiters [BDH], 8 multinodular goiters [BHM] and 3 Subacute Thyroiditis [TSA]), 3 patients with Hashimoto's Thyroiditis (TH) and in 6 non-hyperthyroid Graves ophthalmopathy patients. Measurement were initially performed using calibrators and the results expressed as U/L; since a very good correlation between the expression U/L and the calculated Inhibition Index (I.I.) was found (r = 0.99, n = 15, p < 0.001), results are shown using latter. In C mean +/- SD value for I.I. was 3.4 +/- 2.37%, so we decided to use, as cut off criteria for differentiating between normal and abnormal results, the figure 11%, which represents the mean +/- 3 SD. According to this, 93% of BDH had elevated TRAb activity while only slightly more than one third of MBH had elevated values, this difference being highly significant (p < 0.0001); both TSA and TH patients showed low TRAb activity while all Graves ophthalmopathy pts had elevated values, thus suggesting that they had a latent disease. We concluded that the methodology that is adequate and practical for clinical purposes.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies↗

PubMed1994

[Effect of insulin-like growth factor I on HLA-DR antigen expression in cultured human thyrocytes: a component of the autoimmune process?].

The aim of this study was to determine whether IGF-1 and INS are able to induce HLA-DR antigen expression (AgHLA-DR) in cultured human thyrocytes. Cytotoxicity assay in thyroid epithelial cells (cultured for 7 days to avoid spontaneous antigen expression) from 14 patients operated due to different thyroidal diseases, was used to assess HLA-DR expression. AgHLA-DR was reinduced adding IFN-delta, IGF-1 or INS to the culture media, alone, combined or associated with TSH or TBII. Both IGF-1 and INS induced HLA-DR expression in a similar way as IFN-delta did, and the response was enhanced with their combination, suggesting that they have different sites of action. Their association with TSH or TBII further augmented the response. To determine if IGF-1 acts via lymphocyte IFN-delta secretion, peripheral lymphocytes from 5 normal subjects were cultured with and without IGF-1 and the supernatant was used as stimulator, observing a stimulation similar to that induced by IFN-delta. This finding supports the hypothesis that IGF-1 acts stimulating a specific tyrosine kinase protein (p56 1ck) which is located in T lymphocyte receptors. According to our results we can conclude that, at least in vitro, both IGF-1 and INS play a role in the immune process, probably exerting a paracrine effect on autoimmunity, acting as perpetuating factors.

Analysis of Variance↗

PubMed1994

[Intrathyroidal lymphocytes in autoimmune thyroid diseases].

Aiming to assess the autoimmune origin of certain thyroid diseases, we studied the phenotypic composition and the ability of intrathyroidal lymphocytes to a re-induce HLA-DR expression on autologous thyrocytes coming from patients with graves's disease, nodular goiter and papillary thyroid carcinoma. Lymphocytes coming only from graves's disease patients were capable of reinduce HLA-DR expression on autologous thyrocytes (24.1 +/- 13.6 vs 1.5 +/- 2.54% in nodular goiter and carcinoma), as interferon gamma did (17.4 +/- 8.34%). Phenotypic characterization showed a significant decrease of T-CD3 (total lymphocytes) and T-CD4 (helper) in lymphocytes coming from patients with nodular goiter and carcinoma, and a marked reduction of T-CD8 (suppressor) in lymphocytes coming from patients with graves disease. Thus the T-CD4/T-CD8 ratio varies according to the etiology of the thyroidal disease. The lack of suppressor activity would explain why cells coming only from patients with graves disease, show marked HLA-DR expression. These findings give little support to the autoimmune origin hypothesis for nodular goiter and thyroid carcinoma.

Autoimmune Diseases↗

PubMed1993

[Lack of in vitro effect of antithyroid drugs upon peroxidase antigen expression in autoimmune thyroid disease].

The aim of this study is to determine whether antithyroid drugs (ATD) act via inhibiting thyroid hormone synthesis or by interfering with the immune process which leads to autoimmune disease. Previously we had demonstrated that ATD do not affect HLA-DR and TPO antigen expressions induced by appropriate stimulus in normal thyrocytes, so we decided to study what happens when the same experiments are performed using autoimmune thyrocytes. Cultured thyroid tissue from patients operated on for Graves' Disease or Hashimoto's Thyroiditis were stimulated with TSH or TBII alone or associated with ATD; TPO antigen expression was evaluated by the Cytotoxicity Assay using human monoclonal antiTPO. When autoimmune thyrocytes were cultured and no stimulus was used or with the addition of MMI or PTU alone, very low values of TPO expression were noted (8.6 +/- 6.7, 5.0 +/- 7.1 and 4.2% +/- 2.3% respectively); if they were stimulated with TSH or TBII, a sharp rise of TPO antigen expression was detected (54.4 +/- 23.3 and 62.6 +/- 16.5%), these figures being significantly different from unstimulated cells (p < 0.001). If both stimulus were used associated with ATD, the high TPO antigen expression was unaffected. It is concluded that, at least in vitro, ATD have no effect upon induced-antigen expression in autoimmune thyrocytes. Since they do not alter antigen presentation, a primary step in the immune process, it is difficult to accept that their mechanism of action is through interference with the immune response.

Antithyroid Agents↗

PubMed1993

[Experimental evidence that endogenous TSH modulates microsomal antigen expression: clinical implications].

The purpose of this work was to study if TSH has a role in TPO antigen expression in vivo. Using the cytotoxicity assay we measured TPO expression and correlated it with TSH serum levels in 3 groups of rats: control, hypothyroid and hypothyroid supplemented with thyroxine. For comparative purposes, in the cytotoxicity assay we used rat monoclonal antiTPO or human sera with high titles for antiTPO antibodies. Hypothyroid rats showed marked elevations of TSH serum levels and TPO antigen expression in their thyrocytes when compared to the control and supplemented group. A positive correlation between TPO antigen and TSH levels was observed (r = 0.69, p < 0.001). There was an excellent correlation between TPO results using rat monoclonal or human sera antibodies (r = 0.94 p < 0.0001). It is concluded that TSH modulates TPO antigen expression. These data are of clinical relevance considering that TSH modulates the expression of other antigens that can maintain the immune response and perpetuate the immune disease in patients with Graves disease treated with antithyroid drugs. Thus, the avoidance of TSH hypersecretion with administration of thyroxine could be useful to treat these patients.

Analysis of Variance↗

PubMed1993

[Importance of gamma-interferon and DR expression in autoimmune thyroid disease].

The purpose of this paper is to study some of the mechanisms by which antigen presentation, one of the first steps in the immune process, is modulated. Three different experiments are performed: a) Using thyroid tissue from patients operated on for Graves' Disease, spontaneous HLA-DR and TPO antigen expressions were measured through the Cytotoxicity Assay; these findings were correlated with the presence of antiTPO in the sera of these patients. It was found that only patients whose thyroid tissue spontaneously expressed both antigens had circulating antiTPO in their sera, thus demonstrating that dual expression is basic for antibody production. b) Blood samples from other Graves' patients were obtained; peripheral lymphocytes were isolated and cultured in complete media for 5 days, then supernatant was separated and IFN-g concentration was measured by a sandwich type RIA; the same procedure was done in 12 normal controls in order to compare the results. It was found that lymphocytes from Graves' patients secreted significantly more IFN-g than normal controls (20.9 +/- 13.54 U/ml vs 3.7 +/- 3.22 U/ml respectively, p < 0.001) confirming that they were sensitized, so this determination could be used as a marker of immune process, if other infectious conditions are excluded; also it was found that IFN-g hypersecretion persists once hyperthyroidism has been treated, pointing out that the immune abnormality is still present.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigen Presentation↗

PubMed1993

[Thyroid profile in normal pregnancy].

The aim of this study was to update the thyroid hormone profile in normal pregnant women with adequate iodine nutrition, to analyze the physiological changes that occur during pregnancy and to know the role that TBG and bHCG exert on these changes. One hundred six pregnant women without goiter, former thyroid diseases or positive antimicrosomal antibodies were studied. Fifty three of them were prospectively followed during the gestational period. Thirty age matched non pregnant women were studied as a control group. Serum T3t, T4t, T41, conventional and IRMA TSH, rT3, TBG, bHCG, antimicrosomal antibodies and urinary iodine content were measured. Median urinary iodine content was 18.9 ug/ml in pregnant women, discarding iodine deficiency, the main observed changes occurred between weeks 6 and 14 with significant elevations of T3t, T4t, T41, rT3, TBG and bHCG and TSH decrease. There was a positive correlation between TBG and T3t and T4t indicating a causal relationship. There was a negative correlation between T41 and TSH and between TSH and bHCG and a positive correlation between T41 and bHCG, suggesting a thyroid stimulator effect of bHCG which would raise T41 and thus inhibit TSH secretion.

Adolescent↗

PubMed1991

Rapid preoperative preparation in hyperthyroidism.

OBJECTIVE: We have evaluated an alternative method of preparation of hyperthyroid patients for surgery, using betamethasone, iopanoic acid and propranolol. DESIGN: Betamethasone (0.5 mg every 6 hours), iopanoic acid (500 mg every 6 hours) and propranolol (40 mg every 8 hours) were given orally for 5 days; thyroidectomy was performed on the 6th day. We analysed patient acceptability, clinical and hormonal effects, ease of surgery and final outcome. PATIENTS: Thirteen females and 1 male, aged 16-59 years, ten with diffuse goitre and four with nodular goitre were submitted to subtotal thyroidectomy because antithyroid drugs had failed to control thyrotoxicosis or because hyperthyroidism coexisted with other conditions (pregnancy, hypertensive disease). MEASUREMENTS: Daily clinical assessments were made together with T3, T4 and rT3 serum concentrations before and while on drug treatment, during the surgical procedure and post-operatively. RESULTS: Daily assessment showed progressive clinical improvement so that on day 5 the patients were considered clinically euthyroid. Serum levels of T3 (mean +/- SD) showed significant decrease (by 38.2 +/- 24.9%, P less than 0.01) as early as 24 hours after medication was started, reaching almost euthyroid levels on day 3; on the day of operation T3 had diminished by 64.5 +/- 16.6% (P less than 0.0001). Serum T4 concentration showed a slight but significant decrement only from day 4 on and never reached euthyroid levels. Serum rT3 values exhibited a brisk increment at 24 hours (+333 +/- 194%, P less than 0.0001) and remained elevated between 8 and 10 nmol/l until medication was stopped. Drug tolerance was considered as excellent since no serious side-effects were noted, even in pregnant patients. There were no anaesthetic incidents or postoperative complications and patients were discharged 48-72 hours after operation. The final outcome has been satisfactory and pregnant patients continued their pregnancies without incident, bearing normal children. CONCLUSIONS: Pharmacological combination of betamethasone, iopanoic acid and propranolol has proved to be safe and effective and is of low cost. Provided there is adequate supervision of the patients, it may be used in patients requiring urgent thyroidectomy or in those who for reasons of non-compliance need a short preoperative regime.

Adolescent↗

PubMed1991

[Spontaneous expression of class II (HLA-DR) molecules in thyroid pathology].

The spontaneous expression of Class II molecules (HLA-DR) was studied in cultured thyrocytes obtained from patients with Graves Disease (n = 7), Hashimoto's Thyroiditis (n = 5), euthyroid nodular goiter, (n = 12), papillary carcinoma (n = 5), and laryngeal carcinoma (3 normal thyroid glands). If nodular goiters and papillary carcinoma are of autoimmune origin, as Graves Disease and Hashimoto's Thyroiditis, they should spontaneously express HLA-DR antigen on their cell surface as this has been considered one of the initial steps of autoimmunity. The study was performed using the cytotoxicity assay. Immediately after the thyroid glands were obtained, thyrocytes were labelled with 51-Cr and incubated overnight; the cells were destroyed by adding monoclonal antiHLA-DR antibody and rabbit complement. The cytotoxicity index (CI% + SD) which reflects 51-Cr release from lyzed cells was used to measure antigen expression. While Graves Disease's and Hashimoto's Disease's thyrocytes expressed HLA-DR in high proportion, normal thyrocytes and thyroid cells from other diseases did so in minimal proportion (28.12 +/- 10.71 vs 2.26 +/- 2.32, p < 0.001). These findings strongly suggest that nodular goiters and papillary carcinoma are not of autoimmune origin since they are unable to express HLA-DR on their cell surface. It is postulated that HLA-DR expression is the result of the influence of T lymphocytes previously sensitized to thyroid antigens.

Autoimmune Diseases↗

PubMed1989

Nontoxic nodular goiter and papillary thyroid carcinoma are not associated with peripheral blood lymphocyte sensitization to thyroid cells.

We tested the claim that uni- and multinodular goiter (UNG and MNG) and papillary carcinoma (PC) of the thyroid are autoimmune thyroid diseases (AITD) similar to Graves' disease (GD) and Hashimoto's thyroiditis (HT). The expression of HLA-DR on cultured thyroid epithelial cells (thyrocytes) from UNG, MNG, and PC after coculture with autologous peripheral blood mononuclear cells (PBMC) was compared with that on GD and HT cells. The thyrocytes also were cultured with interferon-gamma (IFN gamma) alone. A cytotoxicity assay involving 51Cr-labeled thyrocytes, anti-HLA-DR, and complement was used to determine HLA-DR expression. Stimulation of thyrocytes with 200 U/mL IFN gamma induced HLA-DR (expressed as a cytotoxicity index) equally well on all thyrocytes [AITD (n = 6): IFN gamma, 23.8 +/- 7.7 (+/- SD); unstimulated, 3.6 +/- 2.0; UNG (n = 6), MNG (n = 9), and PC (n = 5): IFN gamma, 22.5 +/- 4.7; unstimulated, 4.0 +/- 3.0]. When cocultured with autologous PBMC, the values were: AITD, 24.9 +/- 10.1; UNG, MNG, and PC, 3.8 +/- 3.7 (P less than 0.001). The supernatants from the AITD cocultures had higher IFN gamma concentrations (by RIA) than those from the other cocultures. We conclude that in UNG, MNG, and PC, the peripheral blood helper T-lymphocytes are not sensitized to thyrocyte membrane antigen(s); consequently, little if any IFN gamma is produced in cocultures, and hence, there is no increase in thyrocyte HLA-DR expression, unlike the situation in AITD (GD and HT). Thus, UNG, MNG, and PC are not primarily autoimmune in nature, as defined by a lack of sensitization of the PBMC of such patients to thyroid antigen(s).

Antigens, Surface↗

PubMed1989

Lack of effect of methimazole on thyrocyte cell-surface antigen expression.

The nature of the immunosuppressive effect of antithyroid drugs has been a subject of controversy. It has been claimed that these agents exert a direct effect on the immune system, although we and others have suggested that the drugs affect the thyroid cells primarily with consequent reduced thyrocyte-immunocyte signalling. This may occur from reduced thyroid hormone production and/or reduced antigen presentation by the thyrocytes to local T lymphocytes. Using a cytotoxicity assay system, with chromium-51 labelling, monoclonal antibodies against thyroperoxidase (TPO) and HLA-DR, and complement, we have measured the expression of TPO and HLA-DR on cultured normal human thyroid cells; we have also measured thyroglobulin (Tg) release by radioimmunoassay into the medium of the cultured cells. The thyroid cells were stimulated with TSH or thyrotropin binding inhibitory immunoglobulin (TBII) for 48 hours before measuring for TPO induction, and with interferon gamma (IFN-gamma) (with or without TSH or TBII) for thyrocyte HLA-DR expression. A dosage of 1.6 milliunits per ml of TSH resulted in a significant increase in TPO expression on thyrocytes when compared with control unstimulated thyroid cells (p less than 0.001). The concentrations of Tg released into the medium with TSH or TBII were also significantly higher than those of the control thyrocytes. IFN-gamma at 200 units per ml induced HLA-DR expression, but did not induce thyrocyte TPO expression, or Tg release. Addition of the antithyroid drug, methimazole (MMI), at different concentrations, in addition to the other stimulators, IFN-gamma, TSH, or TBII, did not result in any inhibition of TPO, Tg release, or HLA-DR expression on the thyroid cells. It would thus appear that the pathways for stimulation for the expression of TPO and HLA-DR appear to be different. Finally, MMI does not cause its immunosuppressive effect by any reduction of thyroid antigen expression or release.

Antigens, Surface↗

PubMed1989

[Thyroid microsomal autoantibodies in thyroid disease: their value as an antigenic marker].

An autoimmune disease can be the cause of thyroid disfunction. Determination of autoantibodies titers is the best way of demonstrating its existence. We studied 172 thyroid patients (146 females, 26 males) with ages ranging from 15 to 81 years. Thyroid microsomal autoantibodies (TMA) were detected by a modified agglutination test (SERA-TEK kit, Ames Div); a dilution greater than or equal to 1/1600 was considered as diagnostic of autoimmune disease. Patients were classified according to morphological and functional status in 3 groups: GI = non toxic goiter, n = 98 (71 diffuse, 20 multi and 7 uninodular); GII = toxic goiter, n = 62 (52 diffuse, 4 multi, 2 uninodular and 4 subacute thyroiditis); G III = hypothyroidism, n = 12 (5 primary hypothyroidism and 7 chronic thyroiditis). A control group of 30 normal individuals, ages ranging from 19 to 85 years was also studied. Diagnostic titers of TMA were found in 30.8% of group I, 88.5% of group II, 91.6% of group III and only in 6.6% of controls. The high incidence of positive TMA in toxic diffuse goiter (96.1%) as well as in hypothyroid patients was expected since these are typical examples of thyroid autoimmune disease. In the non toxic goiter group, positive TMA were present in 50% of multinodular, 28% of uninodular and 25% of diffuse goiters and the incidence of positive TMA varied according to age, being higher over the age of 40 years and lower under the age of 20 years. We postulate that this unexpected high incidence of positive TMA in non toxic goiter is due to amelioration of chronic iodine deficiency inducing the expression of latent autoimmune disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗