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Thyroid autoimmunity and thyroid autonomy.

P Vitti1, S Mariotti, C Marcocci

  • 1Istituto di Endocrinologia, University of Pisa, Italy.

Acta Medica Austriaca
|January 1, 1990
PubMed
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Autoimmune factors are key in Graves' disease, but their role in thyroid autonomy is debated. This study investigates Thyroid Stimulating Antibodies (TSAb) and Thyroid Growth Stimulating Antibodies (TGAb) in goiter development.

Area of Science:

  • Endocrinology
  • Immunology
  • Thyroidology

Background:

  • Autoimmune factors cause Graves' disease but their role in thyroid autonomy is unclear.
  • Increased thyroid antibodies are seen in iodine-deficient areas with higher thyroid autonomy.
  • Thyroid autoimmune phenomena may be a consequence, not cause, of goiter.

Purpose of the Study:

  • To investigate the pathogenetic relevance of Thyroid Stimulating Antibodies (TSAb) and Thyroid Growth Stimulating Antibodies (TGAb) in thyroid autonomy and goiter.
  • To clarify the relationship between TSAb and TGAb in Graves' disease and nontoxic goiter.

Main Methods:

  • Analysis of TSAb and TGAb in patients with nodular autonomous goiter, multinodular nontoxic goiter, and Graves' disease.
  • Detection of anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies.

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Main Results:

  • TSAb were detected in few multinodular nontoxic goiter cases, always with anti-Tg and anti-TPO antibodies, suggesting a variant of Graves' disease.
  • TGAb were detected in Graves' disease and nontoxic goiter.
  • Data suggest TGAb and TSAb may be sufficient pathogenetic agents for Graves' disease.

Conclusions:

  • The pathogenetic relevance of TSAb in nodular autonomous goiter requires further confirmation.
  • TGAb may play a role in both goiter and hyperthyroidism in Graves' disease.
  • The role of TGAb in euthyroid goitrous conditions remains uncertain.