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At least 19 recordsLinked to original sources
PubMed1991

Anti-bovine thyrotropin autoantibodies in patients with Hashimoto's thyroiditis, subacute thyroiditis, and systemic lupus erythematosus.

We report four cases found to have anti-bovine thyrotropin (bTSH) antibodies, two with Hashimoto's thyroiditis and the other two, each with subacute thyroiditis and systemic lupus erythematosus (SLE). The unusually high negative titers of anti-TSH receptor antibodies (Case no. 1, -43.1%; Case no. 2, -34.9%; Case no. 3, -55.2%; Case no. 4, -59.9%) led to the incidental finding of the presence of anti-bovine (bTSH) antibodies in each patient. Case no. 1 was diagnosed to have Hashimoto's thyroiditis and was treated with L-thyroxine (L-T4). With the treatment, serum free T4 (FT4)normalized with a decline in the serum TSH concentration. The other patient diagnosed to have Hashimoto's thyroiditis (Case no. 2) remained euthyroid even without supplemental thyroid hormone therapy and the serum concentrations of FT4 and TSH stayed within the normal range. The third is a case of subacute thyroiditis (Case no. 3) with a typical clinical course of the disease. She had the anti-bTSH antibodies on her first outpatient visit. Serial examination of her sera disclosed the antibody titers to be on the same range over the 28 months after the onset of the symptoms. The fourth is a patient with SLE who had been treated with steroid (alternative day therapy of 40 mg/day prednisolone). Titers of the anti-bTSH antibodies spontaneously declined to the negative level 5 months later. None of the four cases had antibodies against human TSH alpha-subunit of bovine LH and alpha-subunit of bovine FSH.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Atypical presentation of subacute thyroiditis.

Subacute thyroiditis is extremely rare during the first decade of life. We describe a case of subacute thyroiditis in a 2 year old child whose initial clinical, sonographic, and radioisotopic features were indistinguishable from acute suppurative thyroiditis. The diagnosis was established by a raised antibody titre against adenovirus and typical increased thyroid function tests.

Child, Preschool↗
PubMed1992

[Painful lymphocytic subacute thyroiditis].

Subacute granulomatous thyroiditis (SGT) and subacute lymphocytic thyroiditis (SLT) present a similar evolution during the first year, however, posteriorly, except on rare occasions, SGT maintains normofunction while SLT may present relapse with persistent goiter or permanent hypothyroidism requiring periodic follow up. The presence of spontaneous pain and very elevated VSG have been described accompanying SGT but not SLT histologically proven to be used for differentiating these entities. Two cases with clinical criteria and cytological diagnosis of SLT consulted for spontaneous thyroid pain are presented. VSG greater than 50 mm/1st hour was suggestive of SGT. The importance of cytology for the correct management of subacute thyroiditis is emphasized.

Adult↗
PubMed1990

[Lymphocyte subpopulations and the soluble interleukin-2 receptor in Hashimoto's thyroiditis and subacute thyroiditis].

There are no univocal experimental data in literature about T cell clone alterations in the peripheral blood during Hashimoto's thyroiditis (TH), autoimmune disease, and during subacute thyroiditis (TSA), an inflammatory thyroid lesion with possibility of "self-perpetuation". The object of our research was to examine the T cell clones, soluble fraction of interleukin 2 receptor and HLA-DR modifications in patients with TH and TSA compared with healthy population. Our results show significant increase of sIL-2r in the TSA compared with normal subjects and with patients TH, where on the contrary, a constant increase of HLA-DR was observed.

Adult↗
PubMed1998

TSH receptor antibody-associated thyroid dysfunction following subacute thyroiditis.

OBJECTIVE: Autoimmunity plays an important role in the development of thyrotrophin (TSH) receptor antibodies and the pathogenesis of Graves' disease and Hashimoto's thyroiditis. On the other hand, subacute thyroiditis is a self-limited inflammatory disease of presumed viral aetiology. The aim of this study was to examine whether subacute thyroiditis triggers TSH receptor antibody-associated thyroid disorders. PATIENTS: We reviewed 1,697 patients with subacute thyroiditis seen between 1985 and 1995. DESIGN AND MEASUREMENTS: We measured antibodies which inhibit the TSH binding to the TSH receptor (TBIAb), thyroid stimulating antibodies (TSAb) and antibodies that block TSH action (TBAb). Other thyroid autoantibodies were also determined. RESULTS: TBIAb became positive in 38 patients following subacute thyroiditis. Thyroid function after the development of TBIAb appeared to be influenced by the bioactivity of the antibody. Hyperthyroidism developed in the presence of TSAb, and so did hypothyroidism in the presence of TBAb, although 21 patients did not have thyroid dysfunction despite high titres of TBIAb. Fifteen out of 17 patients recovered from hyperthyroidism or hypothyroidism after the disappearance of TBIAb sometimes even without medication. TBIAb-positive patients had a high incidence of a family history of thyroid disease and positive anti-thyroid microsomal antibodies. An ophthalmopathy similar to Graves' disease was also observed in 3 patients. CONCLUSIONS: Subacute thyroiditis may trigger autoreactive B cells to produce TSH receptor antibodies, resulting in TSH receptor antibody-associated thyroid dysfunction in some patients.

Adult↗
PubMed1995

Thyroid hemiagenesis with subacute thyroiditis.

A 58-year-old woman with thyroid hemiagenesis associated with subacute thyroiditis is described. Physical examinations revealed a firm nodule with spontaneous pain and tenderness in the left thyroid lobe. A serum thyroid hormone levels were elevated and thyroid scintiscan with 99mTc pertechnetate showed an extremely low uptake, we made a diagnosis of subacute thyroiditis. A 201Tl thyroid scan demonstrated an enlarged left lobe and absence of the right lobe. Ultrasonography of the thyroid gland revealed an enlarged left lobe occupied mostly with a hypoechoic region. An incidental finding was absence of the right lobe. Two months later thyroid function returned to normal. A follow-up thyroid scintiscan revealed a normal left lobe but absent right lobe. The diagnosis of hemiagenesis was confirmed by CT scan. This appears to be the first case report of thyroid hemiagenesis associated with subacute thyroiditis.

Blood Cell Count↗
PubMed1987

Persistent thyroid autoimmunity after subacute thyroiditis.

Subacute (de Quervain's) thyroiditis (SAT) is accompanied by temporary abnormalities in thyroid function and, in a minority of patients, by transient thyroglobulin and thyroid microsome autoantibody formation. In this report we have examined the sera of patients with SAT for the presence of multiple thyroid autoantibodies using qualitative immunoblotting (Western blotting). For this purpose we used a crude thyroid extract (2,000 g supernatant) as a source of antigen, in order to identify antibodies reacting with a wide range of potential autoantibodies. Eight of the 9 patients tested had autoantibodies which reacted with between 2-18 antigenic determinants (molecular weights 177-10 kd) present in the thyroid antigen preparation. None of the sera reacted with thyroglobulin or thyroid microsomes. The majority of these autoantibodies were directed against antigens which were absent from liver membrane preparations. Furthermore there was no diminution in the levels of these autoantibodies over a period of up to 39 months after the onset of SAT. The prolonged presence of these novel thyroid autoantibodies may explain the recent findings of subtle thyroid defects, such as altered gland iodine content, long after apparent clinical resolution of SAT. The accumulated evidence for a viral aetiology in this condition suggests that these sequelae may be due to a virally-induced autoimmune response.

Adult↗
PubMed1983

T lymphocyte subsets in autoimmune thyroid diseases and subacute thyroiditis detected with monoclonal antibodies.

Peripheral T lymphocyte subsets were analysed with monoclonal antibodies, by highly standardized fluorescence-activated cell sorter analysis instead of manual counting by the indirect immunofluorescence method, in autoimmune thyroid diseases and subacute thyroiditis. Total lymphocyte counts were increased in patients with thyrotoxic Graves' disease and subacute thyroiditis. The percentage of total T (Leu 1) cells was significantly lower in patients with thyrotoxic Graves' disease and Hashimoto's disease with destructive thyrotoxicosis than in normal subjects. No significant changes were observed in the percentages of suppressor-cytotoxic T (Leu 2a) cells or helper-inducer T (Leu 3a) cells or in the Leu 3a-Leu 2a ratio in different groups of patients. There were no correlations between the percentages of E rosette-forming cells and Leu 1 cells and between the percentages of T gamma cells and Leu 2a cells in normal subjects and patients. The peak position of fluorescence intensity of Leu 2a cells showed a significant sex difference even in normal controls. The most important finding was a significant decrease in the peak position of Leu 2a cells in patients with thyrotoxic Graves' disease and with hypothyroid or thyrotoxic Hashimoto's disease. These findings indicate the significant association of qualitative, but not quantitative, abnormality of suppressor-cytotoxic T (Leu 2a) cells with thyroid dysfunction in autoimmune thyroid diseases.

Adult↗
PubMed1977

Thyroid echography of subacute thyroiditis.

Ultrasound was used to study 10 patients with subacute thyroiditis. With gray-scale technique, a "washed-out" appearance was seen during the active phase of the active phase of the illness. Clinical migration of the inflammation was accompanied by migration of the sonographic abnormality. Ultrasound can be especially helpful in the diagnosis of unilateral subacute thyroiditis and the differentiation of true cysts from hemorrhagic degeneration of goiter.

Humans↗
PubMed1988

Carcinomatous involvement of the thyroid presenting as subacute thyroiditis.

Carcinomatous involvement of the thyroid is a most unusual cause of hyperthyroidism and thyroiditis, with only a few cases reported in the literature. The authors present a 35-year-old woman with signs, symptoms, and laboratory findings of hyperthyroidism, and subacute thyroiditis that was due to extensive replacement of the thyroid gland by adenocarcinoma (shown by fine needle aspiration). After chemotherapy with vincristine and cisplatin, the swelling of the thyroid resolved, thyroidal uptake of radioactive iodine increased, and mild hypothyroidism developed. Despite the improvement in her thyroid status, she died from progressive malignancy. This case illustrates the value of fine needle aspiration cytology where doubt exists in the diagnosis of thyroid disorders.

Adenocarcinoma↗
PubMedDate not supplied

[Proceedings: Pituitary thyroid axis in subacute thyroiditis (author's transl)].

We studied 10 patients with subacute thyroiditis. All had an increase in free thyroxine index, PBI, T4 and PBI/T4 ratio, an absence of thyroidal radioiodine uptake and no increase in plasma TSH after TRH injection. Exogenous TSH increased the uptake in 6/9 patients. The three patients who did not respond to TSH had higher PBI/T4 ratio than others. After treatment for one month there was either a normalization of laboratory tests either a subnormal thyroid function associated with an absence of response to TRH. All tests became normal two months later.

Humans↗
PubMed1976

Lymphocyte transformation in response to human thyroid extract in patients with subacute thyroiditis.

Seven patients with subacute thyroiditis were studied for evidence of cell-mediated immunity (CMI) to human thyroid extract, as judged from lymphocyte transformation responses, measured by the increase in labeled thymidine uptake in vitro. Significant transformation was observed in lymphocytes from five of the seven patients with active subacute thyroiditis, and in the lymphocytes from only three of 15 patients with Graves disease (x2, P EQUALS 0.036). Repeated studies of lymphocyte transformation were done in four of the patients with subacute thyroiditis, three of whom initially showed abnormal responses. By eight weeks after initial studies, when all patients were in clinical remission without treatment, transformation responses were within the normal range. Thyroid antibodies were absent or present in low titer (is less than 1:100) in sera of patients with subacute thyroiditis, and became undetectable by eight weeks in those patients initially positive. In contrast, significant titers of antithyroid antibodies were frequently present in patients with Graves' disease. The present studies have shown the occurence of CMI to thyroid antigens during the active phase of subacute thyroiditis. The abnormality was transient, however, since it disappeared when the disease had resolved. These findings strongly suggest that the release of thyroid antigen leading tothe development of a cell-mediated immune responses is not in itself sufficient to initiate chronic immunological disease of the thyroid. If, as some have suggested, Hashimoto's disease or Graves' disease are characterized by a permanent disorder of CMI, then in these diseases either the antigenic stimulus is persistent or there exists an intrinsic disorder of immune surveillance.

Acute Disease↗
PubMed1992

Painful subacute thyroiditis (de Quervain's thyroiditis).

Painful subacute thyroiditis (de Quervain's thyroiditis) usually occurs in association with systemic viral illnesses. This disorder may be manifested in various clinical forms. Primary care physicians must be aware of the clinical features of this disorder to make the correct diagnosis and treat appropriately. Three cases are reported to illustrate the different clinical manifestations of this disorder.

Adult↗
PubMed1991

Follicular thyroid carcinoma masquerading as subacute thyroiditis. Diagnosis using ultrasonography and radionuclide thyroid angiography.

The rare presentation of a follicular thyroid carcinoma mimicking the clinical and radionuclide features of subacute thyroiditis is described. Granulomatous thyroiditis was initially suspected on the clinical basis of acute onset of a hard, tender right lobe thyroid enlargement with associated systemic symptoms, modest elevation of thyroid hormone levels and suppressed thyroid RAIU. Fine needle aspiration cytology specimens were unsatisfactory for characterization. Three weeks later the thyroid RAIU was normal. The thyroid enlargement persisted, now being clearly visualized as a hypofunctional nodule on scintiscan. Repeat fine needle aspiration cytology was suggestive of acinar proliferation with hyperfunction. Ultrasonography revealed a solid nodule with a peripheral sonolucent halo. Radionuclide angiography showed intense arterial flow of Tc-99m pertechnetate through the right lobe thyroid enlargement suggestive of malignant thyroid pathology. Surgical excision and histopathological examination revealed a follicular carcinoma involving the right lobe. The possibility of carcinomatous involvement should be considered in those patients where initially tender thyroid nodularity persists longer than expected for a benign inflammatory disease, careful follow-up and relevant investigations being necessary to confirm the diagnosis.

Adenocarcinoma↗
PubMed1998

Failure in detection of Epstein-Barr virus and cytomegalovirus in specimen obtained by fine needle aspiration biopsy of thyroid in patients with subacute thyroiditis.

To study the possible role of viral infection in the etiology of subacute thyroiditis (SAT), we measured serum virus-specific antibodies to measles, rubella, mumps, type I herpes, chicken pox, human parvovirus B19 and cytomegalovirus (CMV) in 10 patients with SAT during the course of illness. In spite of the presence of IgG to each virus in more than 70% of patients, no significant changes in the IgG titers were observed except those to measles, rubella, chicken pox or CMV in only 10% of patients, respectively. Then we examined the presence of virus DNA in specimens of 9 patients with SAT obtained by fine-needle aspiration biopsy (FNAB) of the thyroid. DNA was amplified to detect that of Epstein-Barr virus and CMV by polymerase chain reaction. However, none of them were detected in all the specimens. Whereas previous studies suggest the involvement of viral infection in the pathogenesis of SAT, we failed to demonstrate significant changes in serum antiviral antibody titers or to detect viral DNA in the specimens obtained by FNAB of the thyroid. Thus further studies are clearly required to establish the definite role of viral infection in the pathogenesis of SAT.

Antibodies, Viral↗