Cell-mediated autoimmunity in thyroid disease as studied by the leukocyte migration test; correlation to clinical state and effect of treatment.

Abstract

ABSTRACT We have used a modified leukocyte migration test (LMT) for the study of cell-mediated immunity (CMI) against thyroid antigen in 100 thyroid patients and 20 healthy controls. In 57 cases of Graves' disease, the greatest mean inhibition of leukocyte migration was seen in untreated, hyperthyroid patients as compared with patients treated with thyrostatic drugs, radioiodine or surgery. The differences in means between untreated and treated patients were not, however, significant, but the number of patients with a positive LMT (i. e., showing significant inhibition) was greater in the untreated group (92 %) than in the treated groups (50–77 %). Four out of 5 patients with euthyroid Graves' disease were positive. It is concluded that the LMT cannot be used to predict remission in Graves' disease. In the present study, 9 out of 12 cases with toxic nodular goitre had a positive LMT, and there was no difference in mean migration between treated and untreated patients. In 9 cases of symptomless autoimmune thyroiditis the distribution of leukocyte migration was dual: 6 showed significant inhibition and 3 significant stimulation, indicating evidence of CMI in this disease as well. Furthermore, 10 out of 14 cases with spontaneous primary hypothyroidism showed inhibition in the LMT, and there was no difference between untreated cases and cases euthyroid on substitution therapy. Eight patients with non-toxic goitre served as "thyroid controls", and they were all negative in the test.