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Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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Autoimmune Thyroid Diseases.

Petra Petranović Ovčariček1, Rainer Görges2, Luca Giovanella3

  • 1Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.

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Autoimmune thyroid diseases (AITDs), including Graves' disease and Hashimoto's thyroiditis, are common, particularly in women. Nuclear medicine and antibody tests aid in diagnosing these conditions and differentiating them from other thyroid disorders.

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Area of Science:

  • Endocrinology
  • Immunology
  • Nuclear Medicine

Background:

  • Autoimmune thyroid diseases (AITDs) encompass conditions like Graves' disease (GD) and Hashimoto's thyroiditis (AIT), predominantly affecting women.
  • Recent years have seen an increase in AITDs and drug-induced thyroiditis due to tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICPIs), alongside SARS-CoV-2 related thyroiditis.
  • AITDs can fluctuate between hyperthyroidism and hypothyroidism, complicating diagnosis and treatment, and thyrotoxicosis must be distinguished from true hyperthyroidism.

Purpose of the Study:

  • To review the diagnostic approaches for autoimmune thyroid diseases (AITDs).
  • To highlight the role of nuclear medicine and serological markers in differentiating thyroid disorders.
  • To discuss the evolving landscape of AITDs, including drug-induced and infection-related forms.

Main Methods:

  • Utilizing nuclear medicine techniques like radioiodine uptake (RAIU) and thyroid scintigraphy with 99mTc-pertechnetate or 123-Iodine.
  • Measuring thyroid antibodies, including thyroid peroxidase antibodies (TPO) and thyrotropin receptor antibodies (TRAb).
  • Employing thyroid ultrasound as a complementary diagnostic tool.

Main Results:

  • Nuclear medicine imaging is crucial for differential diagnosis of AITDs.
  • Thyroid antibody measurements and ultrasound provide essential complementary data.
  • Accurate diagnosis is vital due to differing therapeutic strategies for thyrotoxicosis and hyperthyroidism.

Conclusions:

  • A multi-faceted diagnostic approach combining nuclear medicine, serological tests, and ultrasound is essential for managing AITDs.
  • Distinguishing between thyrotoxicosis and hyperthyroidism is critical for appropriate patient management.
  • The increasing incidence of drug-induced and infection-related thyroiditis necessitates ongoing vigilance and diagnostic refinement.