A clinical study of chronic noninfectious thyroiditis and autoimmunization

The sera of a relatively large number of patients with and without thyroiditis have been tested for the presence of circulating antibodies against thyroid extract by the tanned cell hemagglutination technique as well as by precipitation. Due to the greater sensitivity of the hemagglutination test, all reported results are based upon that method of examination. In the control group of patients, results were as follows. 1. 1. In 120 patients hospitalized for a variety of conditions exclusive of thyroid diseases, no thyroid antibodies could be demonstrated. 2. 2. Among 29 patients with pathology of the thyroid other than some type of thyroiditis, antibodies were found in 3. The sera of these 3 patients were all obtained following operation for the following conditions: (a) recurrent exophthalmic goiter, (b) malignant adenoma, and (c) diffuse colloid goiter. Circulating antibodies were demonstrated in the sera of 5 out of 20 patients diagnosed clinically as some type of noninfectious thyroiditis but without histologic examination. Four of these patients had the symptoms of the subacute or chronic nonspecific type of disease and one had the clinical pictrue usually associated with Hashimoto's disease. 3. 3. Forty patients in whom sections of the thyroid were available for examination were classified in 4 groups on the basis of histologic study as follows: (a) subacute thyroiditis (DeQuervain), 4; (b) struma fibrosa (Riedel), 4; (c) struma lymphomatosa (Hashimoto), 14; (d) chronic nonspecific thyroiditis, 18. Circulating antibodies were demonstrated in some of the patients comprising each of these groups except in those patients considered to have struma lymphomatosa. In this latter group, no antibodies could be demonstrated in any of the 14 patients. The greatest number of positive reactions occurred in the chronic nonspecific thyroiditis group.