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Category: Immunology
Endocrinopathies: Chronic Thyroiditis, Addison Disease, Pernicious Anemia, Graves’ Disease, Diabetes, and Hypophysitis, Page 1 of 2
< Previous page | Next page > /docserver/preview/fulltext/10.1128/9781555818722/9781555818715_CH98-1.gif /docserver/preview/fulltext/10.1128/9781555818722/9781555818715_CH98-2.gifAbstract:
Chronic lymphocytic thyroiditis (CLT), also known as Hashimoto thyroiditis, is an autoimmune disease characterized by lymphocytic infiltration of the thyroid gland, with the concomitant production of autoantibodies to thyroid antigens, primarily thyroglobulin and/or thyroperoxidase (TPO), formerly known as microsomal antigen (1). Although few epidemiological data are available, the prevalence of CLT is estimated to be 1 in 1,000 people, with an incidence of 0.2 to 2% and a female-to-male ratio of about 18:1 (1). Clinical signs and symptoms manifest slowly and may involve many systems of the body (1). Accumulations of hydrophilic mucoproteins with edema, a condition called myxedema, affects skin and connective tissue and can affect the appearance of the individual. Lethargy may ensue, with a loss of mental acuity. Systems commonly affected are the gastrointestinal tract, the hemopoietic system, the endocrine system, and the urogenital system (1). Enlargement of the thyroid gland due to lymphocyte invasion, called goiter, is a frequent manifestation, although there is an atrophic variation. Demonstration of autoantibodies to the thyroid antigens aids in the diagnosis of CLT, distinguishing it from other causes of hypothyroidism.
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Indirect IF for antibodies to adrenal cortex using an unfixed, air-dried section of monkey adrenal cortex. All layers of the adrenal cortex are stained. Magnification, ×32.
Indirect IF for antibodies to adrenal cortex using an unfixed, air-dried section of monkey adrenal cortex. All layers of the adrenal cortex are stained. Magnification, ×32.
Same as Fig. 1 but at a higher magnification. Only the cytoplasm of the adrenal cells is attained. Magnification, ×80.
Same as Fig. 1 but at a higher magnification. Only the cytoplasm of the adrenal cells is attained. Magnification, ×80.
Indirect IF for antibodies to parietal cells using an unfixed, air-dried section of rodent stomach mucosa. The cytoplasm of only the parietal cells is stained. Magnification, ×100.
Indirect IF for antibodies to parietal cells using an unfixed, air-dried section of rodent stomach mucosa. The cytoplasm of only the parietal cells is stained. Magnification, ×100.
Progression to diabetes in children positive for anti-islet cell autoantibodies in DAISY (Diabetes Autoimmunity Study in the Young) relative to the number of anti-islet cell autoantibodies expressed (autoantibodies to GAD65 [glutamic acid decarboxylase], ICA512 [IA-2, insulinoma-associated antigen], and insulin). Adapted with permission from Diabetes Care ( 60 ).
Progression to diabetes in children positive for anti-islet cell autoantibodies in DAISY (Diabetes Autoimmunity Study in the Young) relative to the number of anti-islet cell autoantibodies expressed (autoantibodies to GAD65 [glutamic acid decarboxylase], ICA512 [IA-2, insulinoma-associated antigen], and insulin). Adapted with permission from Diabetes Care ( 60 ).
Current biochemical anti-islet autoantibody assays.
Current biochemical anti-islet autoantibody assays.
General outline of high-throughput fluid-phase 96-well plate assays for anti-insulin autoantibodies. In the illustrated example, 125I-insulin is utilized, but the assay formats are identical for the GAD65, IA-2, and ZnT8 assays. Ag, antigen; Ab, antibody.
General outline of high-throughput fluid-phase 96-well plate assays for anti-insulin autoantibodies. In the illustrated example, 125I-insulin is utilized, but the assay formats are identical for the GAD65, IA-2, and ZnT8 assays. Ag, antigen; Ab, antibody.
Standard curve for calculation of NIDDK units. The x axis is the number of cpm from the assay after removal of the background cpm, and the y axis is log 2 NIDDK units.
Standard curve for calculation of NIDDK units. The x axis is the number of cpm from the assay after removal of the background cpm, and the y axis is log 2 NIDDK units.
Format of the electrochemiluminescence (ECL) assay. In the illustrated example, biotin and Sulfo-Tag proinsulin were utilized, but the assay format is identical for GAD65. Adapted with permission from Diabetes ( 86 ).
Format of the electrochemiluminescence (ECL) assay. In the illustrated example, biotin and Sulfo-Tag proinsulin were utilized, but the assay format is identical for GAD65. Adapted with permission from Diabetes ( 86 ).
Detection of serum pituitary antibodies by indirect immunofluorescence using acetone-fixed cryostat sections cut from a human anterior pituitary gland. (A) A few isolated cells are recognized by the patient antibodies (type 1 pattern). The arrow shows the granularity, suggesting that antibodies recognize small vesicles scattered in the cytosol. (B) Multiple clustered cells are highlighted by the patient serum (type 2 pattern), which diffusely stains the entire cytosol (arrow).
Detection of serum pituitary antibodies by indirect immunofluorescence using acetone-fixed cryostat sections cut from a human anterior pituitary gland. (A) A few isolated cells are recognized by the patient antibodies (type 1 pattern). The arrow shows the granularity, suggesting that antibodies recognize small vesicles scattered in the cytosol. (B) Multiple clustered cells are highlighted by the patient serum (type 2 pattern), which diffusely stains the entire cytosol (arrow).
Biochemically characterized autoantigens
Biochemically characterized autoantigens
Summary of techniques used to detect pituitary antibodies in human serum a
Summary of techniques used to detect pituitary antibodies in human serum a
Summary of 42 cohort studies using IF and pituitary gland substrate to detect the presence of serum pituitary antibodies
Summary of 42 cohort studies using IF and pituitary gland substrate to detect the presence of serum pituitary antibodies