9 DIFERENT THYROID INFILTRATING CELLS AND IMMUNOLOGICAL EXPRESSIN IN JUVENILE CHRONIC LYMPHOCYTIC THRYOIDITIS (CLT) AND GRAVES'DISEASE

Abstract

Since Hashimoto's description of “struma lymphomatosa” in 1912, immunological disorders were imputed to many thyroid diseases. Close relation between this condition (whose juvenile form is CLT) and Graves' disease were proposed, but it is not clear if they could be or not expressions of a single entity. To elucidate this aspect, thyroid infiltrating cells and immunological markers as well as citological studies, were perfected on thyroid tissue obtained by means of thyroid fine needle aspiration biopsies (TFNAB) in 20 patients (CLT n=10 and GD, n=10). Material and methods: Samples were analyzed according to Hayry and Von Willebrand's method of Corrected Increment (CI). Morphology as well as HLA-DR expression in follicular cells. Interleukine-2 receptor (IL-2/R) B and T cell markers were performed on cytospin smears, either by immunoperoxidase or indirect immunofluoresoenoe. TFNAB were divided in 2 groups, according to patient's thyroid status:Group 1) CLT, n=12 and Group 2) GD, n=14. Results:(in %±SD): Group 1:a:6.9±1.09;B-cells 34.9±12.6;T-cells 60>12.2;CD4:62.7±5.2;CD8:33.2±5.6;ratio:1.9±0.34.HLA-DR was present in 56.4±22.6 of the follicular thyroid cells. IL-2 was present in 11/12 specimens. Group 2:CI:4.5±1.3 (group 2 vs 1, p<0.001);B-cells:59.2±16.0 (p<0.001);T-cells 41.9±16.2(p <0.001)CD4:56.4±8.4(p< 0.05);CD8:41.4±7.8 (p<0.02), ratiol:1.44±0.5(p<0.02). HLA-DR was expressed in 18.8±18 (p< 0.001) of the follicular thyroid cells. IL-2 was present in 3/14. Comments:Significative differences were found between both groups. a)CI vas significantly higher in group 1:CI above 5.3 result to be a sensible indicator of CLT. b)HLA-DR on epithelial thyroid cells as well as IL-2/R were significantly higher in CLT. c) Infiltrating lymphocites showed that 60% were T-cells in CLT while in GD about 60% expressed B-cell markers. These results would suggest a different impact of humoral and cellular immunoresponse in each of these autoimmune thyroid diseases in juvenile patients.