Thyroid Hormones, Their Carrier Proteins, and Thyroid Antibodies in the Pleural Effusion of Two Patients with Graves' Disease-induced Thyrotoxicosis

Abstract Thyroid hormone antibodies (THAbs)--i.e., antibodies to thyroxin (T4) and triiodothyronine (T3)--are detected rarely in human serum, where they are searched for, possibly because of a quantitatively minimal interaction between thyroid hormones (the haptens) and serum IgGs (the antibodies). The weak binding could result from these facts: (a) there are already six physiological carrier proteins for thyroid hormones; (b) THAbs usually account for a very small fraction of the total serum IgGs; (c) THAbs may have--as reported in the literature--a relatively low affinity. To ascertain whether THAbs could pass undetected in serum, we measured antibodies to T3 and T4 in both the serum and the corresponding IgG fraction of six normal persons and 45 patients with various thyroid diseases (Graves' disease, idiopathic myxedema, Hashimoto's thyroiditis, subacute thyroiditis, tumors), using radioimmunoprecipitation. The prevalence of antibodies to T4 was 0/51 in both the sera and the IgG fractions; the prevalence of antibodies to T3 was 1/51 in both materials. Because all of the sera that tested THAb negative were confirmed to be so in the THAb assay of the IgG fraction, we conclude that the prevalence of serum THAbs is not underestimated and that autoimmunization against thyroid hormones is really a rare phenomenon.

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Severe hypothyroidism associated with the degree of edema in a patient with nephrosis

Clinics and Practice ◽

10.4081/cp.2011.e78 ◽

2011 ◽

Vol 1 (3) ◽

pp. 78 ◽

Cited By ~ 2

Author(s):

Hiroyuki Kinoshita ◽

Amiko Ishii ◽

Akiko Hayakawa ◽

Mutsuko Yasuda ◽

Seiji Inoshita ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Pleural Effusion ◽

Renal Insufficiency ◽

Thyroid Hormones ◽

Third Space ◽

Carrier Proteins ◽

Free Triiodothyronine ◽

Thyroxine Binding Globulin ◽

The Third ◽

Total Triiodothyronine

We report the pleural fluid values of thyroid hormones and their carrier proteins in a patient who suffered from nephrotic syndrome with renal insufficiency and transient hypothyroidism. The pleural effusion was transudate. The concentrations of thyroxine-binding globulin (TBG), thyroxine-binding prealbumin (TBPA), and albumin (Alb) were approximately 30-50% of the plasma. The concentrations of total triiodothyronine (TT3), total tetraiodothyronine (TT4), free triiodothyronine (FT3), and free tetraiodothyronine (FT4) were approximately 30-50% of the plasma. Hypothyroidism was associated with the degree of edema. After improving systemic edema, proteinuria remained unchanged but the patient did not require levothyroxine. We speculate that the large amount of transudation of thyroid hormones with their carrier proteins from the blood vessels to the third space (edema and pleural effusion), thereby reducing thyroid hormones in the plasma, was associated with hypothyroidism.

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HETEROGENEITY OF LONG ACTING THYROID STIMULATING (LATS) – ACTIVITY, THYROGLOBULIN ANTIBODIES AND THYROID MICROSOMAL ANTIBODIES

Acta Endocrinologica ◽

10.1530/acta.0.0730483 ◽

1973 ◽

Vol 73 (3) ◽

pp. 483-488 ◽

Cited By ~ 16

Author(s):

F. Adlkofer ◽

H. Schleusener ◽

L. Uher ◽

A. Ananos ◽

C. Brammeier

Keyword(s):

Isoelectric Focusing ◽

Graves Disease ◽

Thyroid Antibodies ◽

Thyroglobulin Antibodies ◽

Ph Range ◽

Long Acting ◽

Thyroid Microsomal Antibodies

ABSTRACT Crude IgG of sera from 3 patients with Graves' disease, which contained LATS-activity and/or thyroid antibodies, was fractionated by isoelectric focusing in a pH-range between 6.0 to 10.0. LATS-activity was found in IgG-subfractions from pH 7.5 to 9.5, thyroglobulin antibodies and thyroid microsomal antibodies from pH 6.0 to 10.0. It was not possible to separate LATS-activity from the thyroid antibodies by this technique. The results indicate that LATS and the thyroid antibodies are heterogeneous and of polyclonal origin.

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EFFECT OF THE COMBINATION OF DEXAMETHASONE AND SODIUM IPODATE ON SERUM THYROID HORMONES IN GRAVES' DISEASE

Clinical Endocrinology ◽

10.1111/j.1365-2265.1983.tb00040.x ◽

1983 ◽

Vol 19 (5) ◽

pp. 619-627 ◽

Cited By ~ 13

Author(s):

E. ARTEAGA ◽

J. M. LÓPEZ ◽

J. A. RODRÍGUEZ ◽

P. MICHAUD ◽

G. LÓPEZ

Keyword(s):

Thyroid Hormones ◽

Graves Disease ◽

Sodium Ipodate ◽

Serum Thyroid Hormones

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Thyroid Stimulating Immunoglobulins: Measurement and Clinical use

Clinical Science ◽

10.1042/cs0690113 ◽

1985 ◽

Vol 69 (2) ◽

pp. 113-121 ◽

Cited By ~ 4

Author(s):

C. A. Ollis ◽

S. Tomlinson ◽

D. S. Munro

Keyword(s):

Thyroid Hormones ◽

Elevated Serum ◽

Serum Levels ◽

The Other ◽

Graves Disease ◽

Clinical Use ◽

Hormone Production ◽

Skin Changes ◽

Thyroid Stimulating Immunoglobulins ◽

Eye Involvement

Graves’ disease is the commonest form of hyperthyroidism in which excessive production of thyroid hormones by the hyperplastic overactive thyroid gland produces elevated serum levels of the thyroid hormones tri-iodothyronine (T3) and thyroxine (T4). Many of the manifestations of Graves’ disease, increased basal metabolic rate, increased heart rate, heat intolerance, sweating and nervousness, can be attributed to the peripheral actions of the excess thyroid hormones. The pathogenesis of many of the other dramatic features of Graves’ disease, such as the eye involvement or localized skin changes, is not fully understood, but circulating immunoglobulins with thyroid stimulating activity are almost certainly linked to excess thyroid hormone production and thereby cause the hyperthyroidism.

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A Case of Thyrotoxicosis due to Simultaneous Occurrence of Subacute Thyroiditis and Graves’ Disease

Case Reports in Endocrinology ◽

10.1155/2018/3210317 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Kazunori Kageyama ◽

Noriko Kinoshita ◽

Makoto Daimon

Keyword(s):

Thyroid Hormones ◽

Thyroid Disease ◽

Rare Case ◽

Autoimmune Thyroid Disease ◽

Subacute Thyroiditis ◽

Simultaneous Occurrence ◽

Graves Disease ◽

Inflammatory Disorder ◽

Autoimmune Thyroid ◽

Prompt Diagnosis

Subacute thyroiditis is an inflammatory disorder of the thyroid. Graves’ disease is an autoimmune thyroid disease in which thyroid hormones are overproduced. Here we present a rare case of thyrotoxicosis due to the simultaneous occurrence of both diseases. Prompt diagnosis and therapy are required to prevent complications in patients with thyrotoxicosis.

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CONTENTS OF THYROID HORMONES, CYTOKINES AND α2-MACROGLOBULIN IN BLOOD SERA AND IN CULTURE SUPERNATES OF BLOOD CELLS FROM THE GRAVES DISEASE PATIENTS

Medical Immunology (Russia) ◽

10.15789/1563-0625-2015-1-53-58 ◽

2015 ◽

Vol 17 (1) ◽

pp. 53 ◽

Cited By ~ 1

Author(s):

V. N. Zorina ◽

T. P. Maklakova ◽

T. T. Sheppel ◽

O. N. Boyko ◽

R. M. Zorina ◽

...

Keyword(s):

Thyroid Hormones ◽

Blood Cells ◽

Graves Disease ◽

Α2 Macroglobulin

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Thyrotoxicosis treatment with lithium corbanate. Cases reported

Clinical and experimental thyroidology ◽

10.14341/ket12709 ◽

2021 ◽

Vol 17 (3) ◽

pp. 22-26

Author(s):

I. A. Matsueva ◽

A. B. Dalmatova ◽

T. V. Andreychenko ◽

E. N. Grineva

Keyword(s):

Side Effects ◽

Thyroid Gland ◽

Thyroid Hormones ◽

Toxic Hepatitis ◽

Lithium Carbonate ◽

Graves Disease ◽

Allergic Reactions ◽

Low Doses ◽

Short Course ◽

Toxic Goiter

Treatment of thyrotoxicosis caused by Graves’ disease or multinodular toxic goiter, is not difficult, in most cases, since the prescription of thionamides allows to normalize the level of thyroid hormones quickly and safety. But in a number of cases this therapy might be associated with serious side effects (agranulocytosis, toxic hepatitis, cholestasis), severe allergic reactions and also individual intolerance on thionamides. In such cases lithium carbonate is used, especially in severe thyrotoxic syndrome. It is known, that lithium can accumulate in the thyroid gland at a concentration 3–4 times higher than in the plasma. Perhaps, lithium uses Na+/I- ions. It can inhibit the synthesis and secretion thyroid hormones of thyroid gland. The article presents the cases reported the use of lithium carbonate in thyrotoxicosis treatment before thyroidectomy. Administering low doses of carbonate lithium (900 mg/ per day) renders significant decrease or normalization of thyroid hormones concentration within 7–14 days, thus it let perform thyroidectomy on the patients. No side effects have been identified with such a short course of lithium carbonate treatment.

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Graves' Disease and Diabetes Mellitus

Paediatrica Indonesiana ◽

10.14238/pi32.11-12.1992.327-31 ◽

2019 ◽

Vol 32 (11-12) ◽

pp. 327-31

Author(s):

M. Suttan Assin ◽

Jusuf Rukman ◽

Jose R. L. Batubara ◽

Purnama Wati S. P.

Keyword(s):

Diabetes Mellitus ◽

Thyroid Hormones ◽

Graves Disease ◽

Hyperthyroid Patient ◽

Hyperthyroid State

Thyroid hormones play an important role in the metabolic propesses. Its disturbances will involve several organs, consequently. A 5 year old girl with Graves' diseases, after several weeks of treatment with propylthiouracil (PTV), developed thyrotoxicosis crisis and diabetes mellitus with ketoacidosis; a condition which is usually fatal. Treatment toward the hyperthyroid state overcome the diabetic stage, eventually. This report is an example of an endocrinological interaction in a hyperthyroid patient. Therefore, the diabetogenic effect of hyperthyroxinemia should not be overlooked.

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