20 JUVENILE AUTOIMMUNE THYROID DISEASE: CYTOLOGY AND IMMUNOPHENOTYPE OF THYROID INFILTRATING CELIS AND THEIR SEROLOGIC CORRELATION. (PART II)

Abstract

The influence of infiltrating lymphocytic immunophenotype (Part I) and cytological findings on samples obtained by fine needle aspiration biopsy (FNABT) were correlated with the presence (+) and titers of circulating thyroid antibodies (Ab) in 43 patients with autoimmune thyroid disease (chronic Lymphocitic Thyroiditis= CLT, n=23 and Graves Disease= GD, n=20). Ab (Antimicrosomal= MiAb and Antithyroglobulin= TgAb)were determined by hemagglutination. CLT:Cytology: 23/23 pts had CLT MiAb+: 17/23 (74%); Titers:Range 1/400 - 1/25.600. TgAb+: 5/23(22%)Titers:range 1/100 -1/600. GD: Cytology: 7/20 pts were CLT, 12/20 were normal and 1/20 adenomatous goiter (AB). Antibodies were determined in 18/20: MiaAb+: 15/18 (83%) Titers: range 1/400 - 1/409.600; TgAb+:10/18 (55%) Titers: range 1/100 to 1/6400. 6/7 pts with CLT cytology had MiAb+ and 4/7 TgAb+. 9/11 pts (10 with normal cytology and 1 A. Goiter) had MiAb ranged 1/400 - 1/102.400 and in 6/11 had TgAb ranged 1/100-1/6400. Less serological expression were seen in CLT (were) the prevalence of intrathyroid T-Cells and other sings of cellular aggression (Part I) would suggest mainly a cellular immune reaction. 2) Higher titers of both Ab were found in GD, Together with the prevalence of B lymphocytes among the infiltrating cells (Part I) would sustain mainly a humoral mechanism of autoimmunity. 3) Normal cytology in GD along with high titers of Ab would suggest antigen presentation in lymphoid organs (ei.nodes) but not within the thyroid itself. Thyroid gland would be a “passive captive” of specific events of the whole immune system, as Volpe has suggested.