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Biomedical subjects

U B Ericsson

Publications and source records attributed to U B Ericsson.

53 records · Page 3Linked to original sources

Endogenous antibodies to bovine lactoperoxidase in children and adolescents.

Sera from 146 children and adolescents (70 girls and 76 boys, median age 6 years; range 8 months - 18 years) were analysed for the presence of antibodies to bovine lactoperoxidase (LPO) using a solid-phase immunosorbent radioassay. LPO antibodies were present in all but one serum. The antibody titres varied from 1/5 to greater than 1/5000 (final dilutions). Most of the individuals had antibody titres between 1/50 to 1/5000. Because of the frequent occurrence of LPO antibodies in human beings, the presence of LPO antibodies in the serum must be regarded as a physiological phenomenon.

Adolescent↗

Evaluation of the usefulness of a sensitive immunoradiometric assay for thyroid stimulating hormone as a first-line thyroid function test in an unselected patient population.

A new sensitive immunoradiometric assay for serum thyroid stimulating hormone (TSH) was applied to 1627 consecutive patients from four large clinics at Malmö General Hospital, in whom a thyroid function disorder was suspected. The final diagnoses were taken from the patients' charts at a follow-up 1-2 years after the primary evaluation. If only those patients without thyroid disease were used as a reference population, the 5th percentile was 0.8 mIU/l. When this cutoff limit was applied to the unselected patient population, the TSH assay had a high sensitivity for the diagnosis of hyperthyroidism (96%), a lower specificity (64%) and a very low predictive value (10%). Therefore, in the majority of the patients (72%) the sensitive TSH assay cannot be used alone to define thyroid function.

Adolescent↗

A prospective critical evaluation of in vitro thyroid function tests.

A number of 2 325 serum samples from a population of in- and outpatients were collected during a six-month period in order to evaluate the usefulness of various thyroid function tests in the clinical laboratory routine. The samples were analysed with the following thyroid function tests: total triiodothyronine (T3) (TT3), total thyroxine (T4) (TT4), free T3 index (FT3I), free T4 index (FT4I) and thyrotropin (TSH). One to two years after the primary evaluation, a follow-up was performed and the final diagnoses were checked in the patients' records. The values of these parameters in the diagnosis of hyperthyroidism were: FT3I greater than FT4I greater than TT3 greater than TT4. The corresponding results in the diagnosis of hypothyroidism were: TSH greater than FT4I greater than FT3I = TT3. No single test could detect both hyper- and hypothyroidism effectively. The only one-step strategy for thyroid evaluation in patients without apparent clinical signs of hyper- or hypothyroidism would therefore be the combined determination of T3 and TSH. The study also showed distinct differences between the reference values of the healthy population and patients without thyroid disorders.

Adolescent↗

A high prevalence of thyroglobulin autoantibodies in adults with and without thyroid disease as measured with a sensitive solid-phase immunosorbent radioassay.

Sera from 228 patients with thyroid disease and 140 healthy subjects without clinical or biochemical evidence of thyroid disease, were tested using a sensitive solid-phase immunosorbent radioassay (RIA) and a passive hemagglutination test (TRC test) for thyroglobulin antibodies (Tg-ab). With the RIA technique, Tg-ab was found in 27% of the controls (36% of the women and 15% of the men), whereas only 0.7% of them were Tg-ab positive with the TRC test. All individuals with primary hypothyroidism were Tg-ab positive with the RIA, compared with only 56% with the TRC test. Tg-ab (RIA) were found in 43/53 (81%) of the patients with toxic diffuse goiter, and in 30-40% of the patients with toxic nodular goiter, toxic adenoma, atoxic goiter, and thyroid carcinoma, the TRC test being positive in 10-17% of these patients. The high prevalence of Tg-ab in the healthy population suggests that subclinical thyroiditis is more frequent than has been assumed from antibody measurements made with less sensitive methods, and is in agreement with the prevalences reported from autopsy studies.

Adult↗

Influence of cigarette smoking on goiter formation, thyroglobulin, and thyroid hormone levels in women.

The possible influence of cigarette smoking on goiter formation, thyroglobulin (Tg) secretion, and thyroid hormone production was assessed by estimations of the presence of palpable goiter and by RIAs of Tg, T3, rT3, T4, and TSH in sera from 441 women (48-53 yr old), representing a normal population included in a study on the prevalence of thyroid disease. Smoking habits were evaluated by a questionnaire, and the women were then classified as never smokers (n = 192), smokers (n = 169), and exsmokers (n = 80). Smokers were subdivided as moderate (1-19 cigarettes/day) and heavy (greater than or equal to 20 cigarettes/day). Palpable goiter was found in 15% of the smokers, in contrast to only 4% of the exsmokers and 9% of the never smokers. Among smokers, 37% had serum Tg values over 30 micrograms/liter (third quartile), while such values were found in only 16% of the exsmokers and 18% of the never smokers. In addition, smokers were found to have higher serum T3 and lower rT3 concentrations than never smokers; this difference was most pronounced in heavy smokers. Serum T4 was not different, while TSH was insignificantly lower in smokers than in nonsmokers. Exsmokers did not differ significantly from never smokers in any of these parameters. It seems possible that cigarette smoking may have two, calorigenically opposed, effects on thyroid hormone production; it may be goitrogenic (possibly due to inhaled thiocyanate), but it may also enhance the formation of T3 at the expense of rT3 formation.

Body Weight↗

Purification and storage of thyroglobulin. Two important factors influencing the radioimmunoassay for thyroglobulin.

The effect upon the assay of the quality of the thyroglobulin (Tg) used as standard and tracer was evaluated by comparison of two preparations, one purified with protease inhibitors added (Tg-PI) and the other without (Tg-O). Tg-PI proved more stable than Tg-O. After freezing in phosphate-buffered saline almost all 125I-Tg-O was found to have dissociated into 12 S Tg, while only about half the 125I-Tg-PI had done so. Storage in glycerol, 500 g/l, at -20 degrees C or freezing in goat serum improved the quality of the 125I-Tg markedly, but Tg-PI still remained more stable than Tg-O. In addition, the two antisera tested gave different results in the radioimmunoassay with Tg-PI and Tg-O. With one antiserum a gradual loss of Tg immunoreactivity occurred parallel to the dissociation of Tg, while no such effect was noted with the other antiserum. This difference is believed to depend on varying proportions of conformational antibodies in the antisera, the binding sites for the conformational antibodies being distorted by the dissociation of the Tg molecule, while the binding sites for the sequential antibodies remain intact.

Chromatography, Gel↗

A new sensitive immunosorbent radioassay for the detection of circulating antibodies to polypeptide hormones and proteins.

A solid-phase immunosorbent radioassay for the detection of circulating antibodies to protein hormones is described. The assay is based on the binding of the homologous 125I-labelled antigen to the antibodies which are then bound to anti-IgG antibodies covalently coupled to Sepharose. It can easily be applied as a complement to any radioimmunoassay for the detection of circulating antibodies to the ligand measured. The assay system avoids falsely elevated values due to interference of high serum concentrations of the antigen. The assay was applied to measure antibodies to FSH, LH, TSH, GH, prolactin, insulin and thyroglobulin (Tg). Among patients with chronic thyroiditis Tg antibodies were found in 100% of the sera. In diffuse toxic goitre 73% of the patients had detectable Tg antibodies. Insulin antibodies were present in 82% of the sera from patients with insulin treated diabetes. No antibodies were found against the other protein hormones tested.

Adolescent↗

Interference of endogenous lactoperoxidase antibodies in a solid-phase immunosorbent radioassay for antibodies to protein hormones.

Interference of endogenous antibodies to lactoperoxidase (EC 1.11.1.7) has been demonstrated in a solid-phase immunosorbent radioassay for the detection of antibodies to protein hormones. On enzymic iodination with lactoperoxidase, a little of the 125I is incorporated in the enzyme itself by self-iodination. Because the 125I-labeled lactoperoxidase was not removed from the tracer by chromatography on Sephadex G-50, G-100, and G-200 columns, endogenous antibodies to the enzyme, which were present in 25 of 28 sera from apparently healthy individuals, were detected in conjunction with the measurement of antibodies to growth hormone (somatotropin), prolactin, and thyroglobulin, thus causing false-positive results. Contaminating radioactive lactoperoxidase can be removed by adsorption chromatography on cellulose or by liquid chromatography, and can be avoided by performing the iodination with immobilized lactoperoxidase or with Chloramine-T.

Animals↗

Serum thyroglobulin in differentiated thyroid carcinoma.

Serum thyroglobulin (S-Tg) concentrations were measured in 262 patients with differentiated thyroid carcinoma. Analysis of S-Tg with respect to histology showed that the follicular variety of carcinoma had the highest S-Tg values preoperatively and postoperatively when metastases were found. The S-Tg levels during thyroxine treatment accurately predicted the results of 131-I total body scan in all but two cases. In another patient both S-Tg and total body iodine scan were negative at the time when metastases were discovered at X-ray examination. All but two patients with negative scan had S-Tg less than 10 micrograms/l, whereas patients with metastases had values between 11 and greater than 5000 micrograms/l. In patients with residual thyroid bed uptake the S-Tg range was from less than 2 to 84 micrograms/l. The authors conclude that determination of the S-Tg level can replace total body iodine scan in most patients who have undergone ablative therapy for differentiated thyroid carcinoma.

Adolescent↗

Prediction of malignancy in the solitary thyroid nodule by physical examination, thyroid scan, fine-needle biopsy and serum thyroglobulin. A prospective study of 100 surgically treated patients.

A prospective study was made of 100 consecutive patients selected for surgical treatment of a clinically solitary thyroid nodule. Anamnestic data and findings at physical examination, thyroid scan, fine-needle aspiration biopsy and measurement of serum thyroglobulin were correlated with the postoperative histologic diagnoses. The histologic findings were malignant in 18 cases and benign in 82. Familial occurrence of benign goiter was reported more frequently by patients with benign than by those with malignant histology (46 and 11%). Of the 11 nodules that were hard at palpation, 7 were malignant. All 12 scintigraphically "hot" nodules were benign, but 13 of 59 "solitary, cold" nodules were malignant. The cytologic specimens were reviewed and reclassified. The needle aspirate was insufficient for cytologic diagnosis in 11 cases. Papillary carcinoma was cytologically recognized in four cases. Of 36 lesions cytologically reported to be neoplasm of unspecified type, 12 were histologically shown to be malignant, 20 were follicular adenomas and 4 were colloid goiter. Benign lesion was the cytologic diagnosis in 47 cases. One diagnosis was false negative, but the cancer lay beneath the index nodule. The thyroglobulin level was significantly higher in patients with thyroid cancer than in those with benign disorders, but the test's predictive value was low. Thyroglobulin levels more than tenfold the upper limit of normal were found only in three patients with thyroid cancer and two with thyrotoxicosis. Although all of the mentioned investigative data were helpful in the management of solitary thyroid nodule, fine-needle biopsy was the best single method. When cytologic examination shows malignancy or unspecified neoplasm, surgery is indicated. For most patients with cytologically benign lesions, careful follow-up will suffice.

Adult↗

The prevalence of thyroid disorders in a middle-aged female population, with special reference to the solitary thyroid nodule.

A survey of thyroid disease was conducted in 477 middle-aged women selected at random in an urban area where goiter is not endemic. The overall occurrence of thyroid disease was estimated to be 16.2%. Previously known disease was reported by 6.7% of those surveyed, and an additional 9.5% were diagnosed in the present study. The prevalence of all goiter was 11.3%, and of a palpable solitary nodule, 6.5%. Women with goiter were examined by thyroid scintigraphy and fine-needle aspiration cytology. The results of these examinations combined with the conventional clinical examination were considered a sufficient basis for benign diagnosis in all cases except one, a woman with a solitary nodule who was surgically treated because the cytologic report indicated follicular neoplasm; histopathology, however, revealed colloid goiter. The accumulated incidence of hyperthyroidism was 2.3% and of hypothyroidism 0.8%. It is concluded that goiter is a common disorder among women living in non-endemic areas, and that most goiter, including palpable solitary nodules, can be classified after evaluation as multinodular goiter.

Age Factors↗

A compound follicular-parafollicular cell carcinoma of the thyroid: a new tumor entity?

An unusual thyroid carcinoma is described, showing structural, histochemical and radioimmunologic features of both a follicular and a parafollicular cell carcinoma. Radioimmunoassay revealed high levels of thyroglobulin in the patient's serum and in extracts from metastatic tumor tissue. Immunoreactive thyroglobulin was demonstrated histochemically in tumor cells. On scanning, pulmonary metastases showed uptake of 131I. Somatostatin and neurotensin immunoreactivity was also revealed histochemically in the tumor and a large proportion of the neoplastic cells were argyrophil. Serum calcitonin level was normal and no immunoreactive calcitonin was found in tumor tissue by radioimmunoassay or histochemically. Light microscopy showed cribriform patterns suggestive of follicular carcinoma as well as solid areas reminiscent of medullary carcinoma. Electron microscopy revealed two types of tumor cells. One type had electron dense granules resembling secretory granules characteristic of polypeptide hormone and/or monoamine producing endocrine cells. The other type had no such granules but showed a prominent vesicular rough endoplasmic reticulum similar to that seen in neoplastic follicular cells. The results suggest two alternative possibilities regarding the histogenesis of the tumor. One would be a mixed neoplasm, resulting from a coincidental malignant change in both follicular and parafollicular thyroid cells. The other, more likely alternative would be that the tumor cells are derived from a common stem cell with the potentiality of differentiating into both follicular and parafollicular adult cells. The finding that both thyroglobulin and somatostatin or neurotensin immunoreactivity occurred together in some tumor cells supports the latter possibility and suggests that at least some follicular and parafollicular cells may have a common precursor origin.

Adenocarcinoma↗

Decreased radioiodine uptake values without increase in urinary iodine excretion.

A total of 12842 radioiodine uptake measurements (RIU), performed for diagnostic purposes at Malmö General Hospital 1955-75, have been reviewed. In agreement with the general trend in Europe and the USA, there was a significant decrease in uptake during this period. The 24-hour RIU (mean +/- S.D.) was 51 +/- 18% in 1955, 41 +/- 17% in 1965 and 37 +/- 18% in 1975. The 3- and 48-hour uptake values, as well as the protein-bound radioiodine, fell in a parallel fashion. The fall can not be explained by an increased dietary supply of iodine, because the mean urinary excretion did not show any consistent change from 1965 to 1975, apart from a falling trend from 1967 to 1971. The cause of the decrease in thyroid iodine uptake is not elucidated by this study.

Diet↗

Glucose tolerance, plasma insulin and C-peptide during chloroquine treatment of rheumatoid arthritis.

Since and adverse effect of chloroquine (Cq) on the specific functions of the pancreatic beta-cell has been recently documented in animals, it was of interest to study if a similar effect could be demonstrated during Cq treatment in homo. The effect of Cq on glucose tolerance and insulin secretion was studied in 10 patients with rheumatoid arthritis (RA) over a 3-month period. Fasting plasma levels of glucose, insulin, C-peptide and glucosylated haemoglobin (HbA1c) were checked before starting treatment, after 3 months' Cq treatment and 3 months after withdrawal of treatment. At the same intervals oral glucose tolerance tests (OGTT) were performed. No significant change in any of these parameters was found during treatment with Cq. In patients with a normal OGTT, Cq inhibition of insulin synthesis and/or secretion cannot be demonstrated, as measured by a decreased plasma insulin an C-peptide response to oral glucose load.

Adult↗

Thyroglobulin and thyroid hormones in patients on long-term treatment with phenytoin, carbamazepine, and valproic acid.

Serum concentrations of total triiodothyronine (T3) and thyroxine (T4) as well as serum thyroid-stimulating hormone (TSH) and thyroglobulin (Tg) were measured in 24 patients with epilepsy taking anticonvulsants (either phenytoin, carbamazepine, or valproic acid as single treatment) and in a control group of 28 patients with scoliosis but without thyroid disease. The T4 as well as the TSH concentrations were depressed in patients on phenytoin or carbamazepine treatment. The T3 concentration was increased in the patients on carbamazepine or valproic acid treatment, whereas the Tg levels were unaffected by all three drugs. Thus, a slight depression of the TSH concentration within the normal range does not influence the Tg release. The lack of change in the Tg concentration also speaks against a direct effect of the antiepileptic drugs on the thyroid gland.

Carbamazepine↗

The value of neonatal serum thyroglobulin determinations in the follow-up of patients with congenital hypothyroidism.

Serum thyroglobulin was determined in 68 newborn infants with positive screening tests for congenital hypothyroidism. In 38 infants the diagnosis was confirmed (patients), but the remaining 30 were euthyroid at follow-up (controls). The mean thyroglobulin concentration at the age of 2 weeks did not differ significantly between the patients and the controls (179 vs. 125 micrograms/l). Thyroid scintigraphy was performed in 15 patients. All seven with thyroid aplasia, based on 99mTc pertechnetate scintigraphy, had measurable thyroglobulin (greater than 2 micrograms/l) and thyroid hormones in their serum. This indicates that total absence of thyroid tissue is very rare in Swedish patients with congenital hypothyroidism. Scintigraphy based on 99mTc does not permit detection of small amounts of thyroid tissue. The neonatal concentrations of thyroglobulin did not correlate with the results of Griffiths test at 3 years and are therefore not useful for prognosis of psychomotor development. We conclude that neonatal measurement of thyroglobulin is of limited value in the follow-up of patients with congenital hypothyroidism.

Bone Development↗

Autoimmune thyroiditis and primary Sjögren's syndrome: clinical and laboratory evidence of the coexistence of the two diseases.

The prevalence of primary Sjögren's syndrome (primary SS) among patients with autoimmune thyroiditis (AT), and that of AT among patients with primary SS were studied prospectively. Of 63 patients with AT, one had precipitating antibodies against SS-A/Ro antigen together with objectively verified primary SS, and none had precipitating anti-SS-B/La antibodies; in contrast 17/63 (27%) had above normal values of anti-SS-B/La antibodies, as tested with ELISA. Of 19 AT patients tested objectively for xerostomia and keratoconjunctivitis sicca, six (32%) had keratoconjunctivitis sicca together with xerostomia and four (21%) had autoimmune sialadenitis. The prevalence of AT in patients with primary SS (n = 28) was 18%; of the 28 patients, 64% had an enlarged or abnormal thyroid gland on palpation and four of them (14%) had cytology verified AT. Ten (36%) had anti-thyroglobulin and/or antimicrosomal autoantibodies. Based upon the present investigation we conclude that the prevalence of primary SS is ten times higher among patients with AT, and that of AT is nine times higher among patients with primary SS, compared with the general population.

Adult↗