Is only thyroid peroxidase antibody enough for diagnosis of chronic lymphocytic thyroiditis? Post operative histopathological evaluation

Abstract. A case of a female, 10-year-old rhesus macaque (Macaca mulatta) with spontaneous chronic lymphocytic thyroiditis is presented. At necropsy, the thyroid gland was slightly enlarged, with up to 2 mm large, round, confluent, beige foci on the surface of both lobes. Histopathologic features resembled human Hashimoto's thyroiditis: multifocally, the interstitium was infiltrated by lymphocytes and variably sized lymphoid follicles. In the pituitary gland, there were increased numbers of large, basophilic cells throughout the adenohypophysis. Using a human electrochemiluminescence immunoassay (ECLIA), no autoantibodies against thyroglobulin, thyroid peroxidase, or thyroid-stimulating hormone receptor were detected.

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Thyroid cytotoxic antibodies in atrophic and goitrous autoimmune thyroiditis

Acta Endocrinologica ◽

10.1530/eje.0.1320069 ◽

1995 ◽

Vol 132 (1) ◽

pp. 69-74 ◽

Cited By ~ 28

Author(s):

Ulrich Bogner ◽

Laszlo Hegedüs ◽

Jens Molholm Hansen ◽

Reinhard Finke ◽

Horst Schleusener

Keyword(s):

Autoimmune Thyroiditis ◽

Confidence Limit ◽

Thyroid Volume ◽

Human Thyroid ◽

Thyroid Peroxidase ◽

Chronic Lymphocytic Thyroiditis ◽

Lymphocytic Thyroiditis ◽

Cytotoxic Antibodies ◽

Thyroid Peroxidase Antibodies ◽

Blocking Antibodies

Bogner U, Hegedüs L, Hansen JM, Finke R, Schleusener H. Thyroid cytotoxic antibodies in atrophic and goitrous autoimmune thyroiditis. Eur J Endocrinol 1995;132:69–74. ISSN 0804–4643 It is unknown whether in chronic lymphocytic thyroiditis the goitrous (Hashimoto's thyroiditis) and atrophic forms (primary myxedema) are variants of the same disease or different pathogenic entities. Conventional thyroid-related autoimmune parameters are unable to separate both diseases serologically. It is assumed that cellular and humoral cytotoxic events induce gland atrophy and thus should be detectable more often in non-goitrous than goitrous autoimmune thyroiditis. We determined antibody-dependent cell-mediated cytotoxicity in 67 patients with autoimmune thyroiditis, using a 51chromium-release assay against human thyroid cells. Thyroid volume had been measured by ultrasonography. Other thyroid-specific antibodies, like TSH binding-inhibiting antibodies, TSH function-blocking antibodies, thyroglobulin antibodies and thyroid peroxidase antibodies, were determined. Cytotoxic antibody activity was 20.5% (median, range 0–54.5%) in patients with autoimmune thyroiditis and 8.3% (median, range 0–18.4%) in controls (p < 0.0001). Analysis of cytotoxicity regarding thyroid size showed a high incidence of cytotoxic antibodies in atrophic disease (median thyroid volume 6 ml), where cytotoxic antibodies were detectable in 80% versus 39% (x2 = 9.6; p < 0.0001) in goitrous disease (median thyroid volume 36 ml). The specific lysis of 30% (median; 95% confidence limit 23.9–32.9) in non-goitrous thyroiditis patients was significantly higher than in goitrous patients (16.9%; 95% confidence limit 13.2–20.4) (p = 0.0006). Prevalence of thyroglobulin and thyroid peroxidase antibodies were equally distributed in both groups, with slightly higher levels of thyroid peroxidase antibodies in goitrous thyroiditis (p < 0.05). Both TSH binding-inhibiting and TSH function-blocking antibodies were rarely positive in either atrophic or goitrous disease. Our study shows for the first time a striking association of thyroid cytotoxic antibodies with the atrophic variant of autoimmune thyroiditis. We suggest that the occurrence of cytotoxic antibodies in the pathogenesis of chronic lymphocytic thyroiditis is the decisive event that favors the development of the atrophic rather than goitrous form of the disease. Ulrich Bogner, Thyroid Research Unit, Freie Universität Berlin, Kurfürstenstr. 126, 10785 Berlin, Germany

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RETROSTERNAL GOITRE WITH VARIED HISTOMORPHOLOGY: A CLINICOPATHOLOGICAL CASE REPORT

10.36106/ijsr/6105108 ◽

2021 ◽

pp. 75-76

Author(s):

Avinash Kumar ◽

Manjari Kishore ◽

Garima Sinha ◽

Mudit Gupta ◽

Dilip Kumar Singh

Keyword(s):

Case Report ◽

Degenerative Changes ◽

Chronic Lymphocytic Thyroiditis ◽

Thoracic Inlet ◽

Lymphocytic Thyroiditis ◽

Histopathological Evaluation ◽

Right Lobe ◽

The Right

The term such as retrosternal or substernal is used when a goitre extends below thoracic inlet. Retrosternal goitre is rare and accounts for 5–20% of thyroidectomy patients. Majority of the patients present with symptoms of dyspnoea as in our case. Also, patients can come with change of voice, stridor and a huge swelling. Most of the cases of retrosternal goitre can be removed with conventional collar incision, however sternotomy may be required in few cases. Our patient was euthyroid at presentation and a right hemithyroidectomy was done for her. A detailed histopathological evaluation (HPE) showed evidence of long-standing Adenomatoid goitre with extensive hyalinization, thickened capsule and secondary degenerative changes in the right lobe of thyroid and evidence of chronic lymphocytic thyroiditis in the sections examined from the portion of isthmus. The procedure was uneventful. The patient was doing well after three months of clinical follow up.

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Cytological Grading of Chronic Lymphocytic Thyroiditis and Correlation with Thyroid Profile

Annals of Pathology and Laboratory Medicine ◽

10.21276/apalm.2899 ◽

2020 ◽

Vol 7 (11) ◽

pp. A551-555

Author(s):

Netra M Sajjan ◽

B R Vani ◽

Srinivasamurthy V ◽

V Vijayakumari

Keyword(s):

Cost Effective ◽

Statistical Correlation ◽

Clinical Findings ◽

Thyroid Peroxidase ◽

Chronic Lymphocytic Thyroiditis ◽

Quick Method ◽

Lymphocytic Thyroiditis ◽

Grade 3 ◽

Thyroid Profile ◽

Tsh Levels

Background: Chronic lymphocytic thyroiditis is a thyroid specific autoimmune disease often seen in middle aged women, although rarely do occur in men, children1. This disease is characterized by antibody directed against thyroid peroxidase, called antimicrosomal antibody. The present study was undertaken to evaluate the various cytological features occurring in HT and to correlate with clinical and serological findings. Methods: The study was conducted in department of Pathology from May 2017 to August 2017. The cases diagnosed as HT by FNAC were taken up for the study. Cytomorphologic features were reviewed microscopically and graded as per Bhatia et al. Result: Fifty cases were diagnosed as lymphocytic thyroiditis. Age of the patient ranged from 7-56 years. Clinically 41 of 50 cases (82%) presented with diffuse thyroid enlargement. In our study we had 31 cases (62 %) of grade 2 thyroiditis, 15 and 4 cases each of grade 1 and grade 3 respectively. We observed increased TSH values in 100% of G3 thyroiditis and 64.5% of G2 thyroiditis. None of the Grade 1 thyroiditis had increased TSH levels. The statistical correlation between grades of thyroiditis with T3, T4 and TSH levels was found to be significant with p values < 0.05. Conclusion: FNAC is simple cost effective and quick method for diagnosing HT. Also combined evaluation of HT with clinical findings and thyroid profile promotes more accurate diagnosis and early institution of therapy and follow up. FNAC is also necessary to rule out malignant lesions like lymphoma and papillary carcinoma at preliminary cytological level.

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Chronic lymphocytic thyroiditis

Endocrine Abstracts ◽

10.1530/endoabs.70.ep509 ◽

2020 ◽

Author(s):

Mehdi Hasnaoui ◽

Mohamed Masmoudi ◽

Takwa Belaid ◽

Khalifa Mighri

Keyword(s):

Chronic Lymphocytic Thyroiditis ◽

Lymphocytic Thyroiditis

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Serum Thyroid Peroxidase Antibody Level and Incident Hypertension in Iranian Men: A Suggestion for the Role of Thyroid Autoimmunity

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666200624163035 ◽

2020 ◽

Vol 20 (10) ◽

pp. 1711-1718

Author(s):

Maryam Tohidi ◽

Aidin Baghbani-Oskouei ◽

Atieh Amouzegar ◽

Ladan Mehran ◽

Fereidoun Azizi ◽

...

Keyword(s):

Total Population ◽

Thyroid Autoimmunity ◽

Elevated Serum ◽

Thyroid Peroxidase ◽

Incident Hypertension ◽

Natural Logarithm ◽

Hazard Ratios ◽

Thyroid Peroxidase Antibody ◽

Unit Increase

Background: Dysfunction of the thyroid gland has profound effects on the cardiovascular system. Objective: We aimed to explore the relation of serum thyroid peroxidase antibody (TPO-Ab), as a marker of thyroid autoimmunity with incident hypertension among a euthyroid population. Methods: A total of 3681 participants (1647 men) entered the study. Multivariate Cox proportional hazard models were conducted to estimate the association between TPO-Ab and incident hypertension. Results: The mean age (standard deviation) of the participants was 37.5 (12.8) years. During a median follow-up of 12.2 years, 511 men and 519 women developed hypertension. The multivariable hazard ratios (HRs) and related 95% confidence intervals (CIs) of 1-unit increase in natural logarithm (ln) of TPO-Ab for incident hypertension were 1.09 (1.00-1.19), 1.03 (0.97-1.10), and 1.05 (1.00-1.11) for men, women, and total population, respectively. Moreover, considering the TPO-Ab status as a categorical variable (i.e. TPO-Ab positive or TPO-Ab negative), the multivariate-adjusted HRs (95% CIs) of TPO-Ab positivity for incident hypertension, were 1.33 (0.95-1.85), 1.12 (0.86-1.45) and 1.19 (0.97- 1.46) for men, women, and total population, respectively. Conclusion: Elevated serum TPO-Ab level can contribute to the development of hypertension among euthyroid men during a long follow-up; suggesting a role for thyroid autoimmunity.

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Expression of Thyroid Peroxidase Antibody, Thyroglobulin Antibody, and Thyrotropin Receptor Antibody in Breast Cancer and Their Associations with Clinical Characteristics of Breast Cancer

Indian Journal of Surgery ◽

10.1007/s12262-021-02887-y ◽

2021 ◽

Author(s):

Xiaoyi Liu ◽

Zhengju Fu ◽

Hongmei Xu ◽

Kui Che ◽

Jingwei Chi ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Characteristics ◽

Thyroid Peroxidase ◽

Thyrotropin Receptor ◽

Receptor Antibody ◽

Thyroid Peroxidase Antibody ◽

Thyroglobulin Antibody ◽

Thyrotropin Receptor Antibody

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Role of the Specialized Pro-resolving Mediator Resolvin D1 in Hashimotoʼs Thyroiditis

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/a-1345-0173 ◽

2021 ◽

Author(s):

Jing Song ◽

Rongxin Sun ◽

Yuanyuan Zhang ◽

Ying Fu ◽

Dong Zhao

Keyword(s):

Thyroid Autoimmunity ◽

Thyroid Stimulating Hormone ◽

Inflammatory Factors ◽

Thyroid Peroxidase ◽

Sensitivity Index ◽

Resolvin D1 ◽

Thyroid Peroxidase Antibody ◽

Thyroglobulin Antibody ◽

Inflammation Resolution

Abstract Objective Resolvins are produced by the catabolism of polyunsaturated fatty acids (PUFAs) and play vital roles in inflammation resolution. Resolvins have been associated with autoimmune disorders. This study aimed to measure the level of Resolvin D1 (RVD1) in the serum of Hashimoto's thyroiditis (HT) patients and healthy controls (HCs) and to further analyse its correlation with thyroid autoantibodies and inflammatory factors. Methods Sixty-three participants were recruited, namely, 30 untreated HT patients and 33 sex- and age-matched HCs. Serum RVD1 and inflammatory chemokine (MCP-1 and IP-10) levels were measured by ELISA according to the manufacturer’s protocol. Serum total T3 (TT3), TT4, free T3 (FT3), FT4, thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and thyroid-stimulating hormone (TSH) levels were measured using an electrochemiluminescence immunoassay. Thyroid homeostasis parameters, including the thyroid secretory capacity (SPINA-GT), the total deiodinase activity (SPINA-GD), Jostel’s TSH index (TSHI) and the thyrotroph thyroid hormone sensitivity index (TTSI), were calculated. Results Serum RVD1 levels in HT patients (134.76, 85.35–201.36 pg/mL) were significantly lower than those in HCs (187.64, 131.01–326.85 pg/mL) (P=0.004). As the TPOAb level increased, the RVD1 level showed a decreasing trend (P for trend=0.002). Both multinomial and ordinal logistics analyses revealed that serum RVD1 levels were negatively correlated with TPOAb levels in the adjusted models. Moreover, RVD1 showed a negative correlation with the inflammatory chemokine IP-1 0 (r=–0.276, P=0.034), TSHI (r=–0.269, P=0.036) and TTSI (r=–0.277, P=0.031). Conclusions Thyroid autoimmunity may be associated with low levels of RVD1. Decreased RVD1 levels indicate impaired resolution of inflammation in HT patients.

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