[Preclinical hypothyroidism].
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Biomedical subjects
Publications and source records attributed to L Baschieri.
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200 workers of the pay-toll stations of a Tuscan motorway were examined for PbB, FEP and urinary delta-ALA. The mean value of PbB was 37 +/- mcg/100 ml R.B.C., but in 39 subjects (19.4%) it was over 50 mcg/100 ml R.B.C. FEP showed a mean value of 23.3 +/- 8.9 mcg/100 ml and in 8 subjects (4.4%) it exceeded 40 mcg/100 ml. Urinary delta-ALA was always in the normal range. There was a light difference in the mean value of PbB in comparison with a group of 50 normal subjects; no difference was found in FEP levels. The distribution of PbB and FEP values was also studied in workers and in non exposed subjects.
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Six asthmatic subjects exposed to enzymatic detergents derived from B. Licheniformis were examined by means of a specific Bronchial Provocative Test (sBPT) with solutions of the enzyme. All subjects, except for one, were positive to prick tests with solutions of the "crude" enzyme and with Alcalase, and showed high levels of specific IgE by RAST. The sBPT with solutions of the enzyme, administered by means of a Bird Mark 7 nebulyzer in IPPB with measurement of the delivered dose, showed a positive response in all 6 subjects. No positive result was obtained in 5 normal subjects and in 5 non exposed asthmatic patients, even at much higher doses of the delivered enzyme. The occupational-type sBPT showed only two positive results out of the 6 examined. A good relationship was observed between bronchial hyperresponsiveness and provocative dose of the enzyme. Therefore, the sBPT with solutions of the enzyme is proved to be highly sensitive and specific in confirming the diagnosis of occupational asthma due to proteolytic enzymes.
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The effects of lithium carbonate on thyroid was evaluated in 40 consecutive psychiatric patients on long-term treatment with this drug. Five patients had clinical and/or biochemical hypothyroidism. Twenty four (60%) subjects showed goiter of different size, including very large glands. A very high prevalence of goiter (87%) was observed in the 15 patients coming from a moderate endemic area. A lower incidence of goiter (44%) was found in subjects coming from non endemic areas. Goiter was associated with significantly elevated serum thyroglobulin concentration similar to that reported in endemic or sporadic nontoxic goiter. None of 25 psychiatric patients not receiving lithium therapy was hypothyroid and only three (12.5%) of them showed a small size goiter. These data indicate a very high prevalence of thyroid enlargement in patients on lithium therapy and suggest the opportunity to institute a prophylactic thyroid hormone treatment at least in subjects coming from endemic areas.
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C cells of the thyroid probably exert a paracrine control on follicular cells through secretion of peptides such as calcitonin and somatostatin. The aim of the present study was to investigate the expression of different peptides produced by C cells in rat thyroid and in the different morphological and pathological conditions of the human thyroid. Therefore we employed the immunohistochemical double-staining method using anti-calcitonin and anti-somatostatin antibodies. The results of this study show the presence of C cells containing calcitonin and C cells containing somatostatin exclusively in the rat and the human thyroid. This distinction with prevalence of one peptide on the other is maintained in the different morphological and pathological conditions of the human thyroid.
Concentration of C cells in the thyroid of rats treated with Mercaptoimidazole or Levo-thyroxine. The aim of the present study was to elucidate the possible functional relationship between follicular and parafollicular cells of the thyroid gland; therefore we have investigated the behaviour of calcitonin producing cells and serum calcitonin concentration in rats both in resting and hyperstimulation conditions of follicular cells. Our results showed that with regard to follicular mass the concentration of the C cells was reduced in the two groups of rats treated compared to control rats. C cell concentration decrease was associated with reduced serum calcitonin concentration. In conclusion C cell activity is independent of TSH and thyroid hormones circulating levels.
OBJECTIVE: To study the involvement of antibodies in the extrathyroidal manifestations of autoimmune Graves' disease, we determined the presence of IgG, IgA and IgM antibodies and C3c in connective tissue samples from patients with Graves' disease and pretibial myxedema (PTM) or thyroid associated ophthalmopathy (TAO). METHODS: Connective orbital tissue samples were obtained from 12 patients undergoing orbital decompression for TAO, and skin samples from lesions on the pretibial area were obtained in 7 patients with PTM. Sections from each tissue sample were stained with fluorescin-isothiocianate conjugated anti-human IgG, IgA, IgM and C3c and were examined by a fluorescence optical instrument. Other serial sections from each sample were incubated with human IgG solutions (concentration 6 mg/ml or 20 mg/ml), human albumin (40 mg/ml), PBS, myoglobin (40 mg/ml), or IgA (20 mg/ml), and were then processed by a standard direct immunofluorescence staining procedure. RESULTS: Among the samples from TAO patients 8/12 (67%) were positive for IgG deposition, 4/9 (44%) were positive for IgA, 1/9 (11%) was positive for IgM and 4/9 (44%) were positive for C3c deposition. Orbital connective samples from 3 non-TAO patients were all negative. Among samples from PTM patients 4/7 (57%) were positive for IgG deposition, 3/ 4 (75%) were positive for IgA, 0/4 was positive for IgM and 3/7 (43%) were positive for C3c deposition. Skin samples from 5 control patients undergoing skin biopsy for non-autoimmune diseases were all negative. Incubation with human IgG (20 mg/ml) resulted in the complete disappearance of IgG and C3c deposition in all positive patients. No significant variation in IgG fluorescent staining after incubation with either 6 mg/ml of IgG solution, human albumin, PBS, myoglobin or IgA was observed. CONCLUSION: The results of our study suggest that different classes of antibodies, mainly IgG and IgA, may be implicated in the disease process in autoimmune TAO and PTM. Activation of the complement cascade, via the classic or the alternative pathway, could take place in about 40% of these patients. IVIG in vitro may solubilize, by a specific mechanism, IgG and complement immune complex deposition in the extrathyroidal manifestations of autoimmune Grave's disease.