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Fitti, Pisa, Italy, compared results of colour-flow doppler sonography
(CFDS) in patients with Graves' disease (GD) and with Hashimoto's thyroiditis
(HT). Bloodflow was increased in 21/23 patients with untreated GD and slightly
increased in 11/14 euthyroid GD patients under methimazole treatment. In
HT patients bloodflow was reduced in 21/23 untreated euthyroid patients,
in 25/29 patients + T4 and in 2/3 untreated hypothyroid patients. It is
concluded that CFDS can make a distinction on the basis of differences
in bloodflow between GD and HT. Recently antibodies have been found in
patients with thyroid autoimmune disease that both react against thyroglobulin
(TG) and thyroperoxidase (TPO).
Feldt-Rasmussen et al., Copenhagen, Denmark and Marsseille, France, reported that those antibodies are specifically present in patients with HT, whereas they are present with much less frequency in patients with other thyroid diseases like nodular goiter, thyroid carcinoma, primary idiopathic myxedema, postpartum thyroiditis and in autoimmune disorders like penicious anemia, rheumatoid arthritis, and insulin dependent diabetes mellitus. They conclude that the presence of these antibodies can be used in discriminating patients with HT versus patients with other autoimmune thyroid disorders. (Comment: no results were reported concerning patients with Graves' disease.) Mohr-Kahaly, Mainz, Germany, performed doppler and conventional echocardiography to detect mitral valve prolapse (MVP) in 50 patients with HT and in 201 controls. MVP was detected in 36 % of the patients and 8 % of controls. No correlation was found between MVP and presence of hypothyroidism, serum thyroid autoantibodies or duration of disease. In 8% and 2 % of patients prolapse of the aortic and tricuspid valves was also present respectively. Valve abnormalities were accompanied by thickening of leaflets hypothetically the result of glycosaminoglycans accumulation. Joe et al., San Francisco, Ca, and Baltimore, MD, USA, characterized TPO antibodies, using a panel of human monoclonal IgG-class TPO autoantibodies in sera from children with Hashimoto's disease that were available on 2 or 3 occasions over 15 years. They found that the epitopic characteristics (fingerprints) were kept constant, even after 15 years. They also found that the same fingerprint was present in sera of families of 2 of these patients. It is concluded that TPO autoantibody epitope fingerprints in Hashimoto's thyroiditis and their families appear to be conserved suggesting an inherited profile. |
