SUMMARYHashimoto's thyroiditis (HT) has been characterized for many years as a well-defined clinicopathologic entity, but is now considered a heterogeneous disease. IgG4-related HT is a new subtype characterized by thyroid inflammation rich in IgG4-positive plasma cells and marked fibrosis. It may be part of the systemic IgG4-related disease. We report a case of a 56-year-old Portuguese man who presented with a one-month history of progressive neck swelling and dysphagia. Laboratory testing revealed increased inflammatory parameters, subclinical hypothyroidism and very high levels of thyroid autoantibodies. Cervical ultrasound (US) demonstrated an enlarged and heterogeneous thyroid gland and two hypoechoic nodules. US-guided fine needle aspiration cytology was consistent with lymphocytic thyroiditis. The patient was submitted to total thyroidectomy and microscopic examination identified typical findings of HT, marked fibrosis limited within the thyroid capsule and lymphoplasmacytic infiltration, with > 50 IgG4-positive plasma cells per high-power field and an IgG4/ IgG ratio of > 40%. After surgery, serum IgG4 concentration was high-normal. Symptoms relief and reduction in laboratory inflammatory parameters were noticed. Thyroid function is controlled with levothyroxine. To our knowledge we report the first case of IgG4-related HT in a non-Asian patient. We also perform a review of the literature regarding IgG4-related disease and IgG4-related HT. Our case highlights this new variant of the well known HT, and helps physicians in recognizing its main clinical features, allowing for proper diagnosis and treatment. Arq Bras Endocrinol Metab. 2014;58(8):862-8 SUMÁRIO A tireoidite de Hashimoto (TH) foi caracterizada durante muitos anos como uma entidade clinicopatológica bem definida, mas é atualmente considerada uma patologia heterogênea. A TH associada a IgG4 apresenta-se como um novo subtipo, sendo caracterizada por inflamação da tireoide com numerosos plasmócitos IgG4-positivos e fibrose extensa. É possível que pertença ao espectro da doença sistêmica associada a IgG4. Relatamos o caso de um homem português de 56 anos que se apresentou com aumento progressivo do volume cervical e disfagia, com um mês de evolução. A avaliação laboratorial revelou elevação dos parâmetros inflamatórios, hipotireoidismo subclínico e níveis muito elevados de autoanticorpos tireoidianos. Por ultrassonografia cervical demonstrou-se tireoide aumentada, heterogênea, com dois nódulos hipoecoicos. Foi realizada citologia aspirativa com agulha fina guiada por ultrassom, compatível com tireoidite linfocítica. O doente foi submetido à tireoidectomia total e o exame histológico revelou achados típicos de TH, extensa fibrose localizada dentro da cápsula tireoidiana e infiltrado linfoplasmocitário, com > 50 plasmócitos IgG4-positivos por campo de grande ampliação e uma relação IgG4/IgG > 40%. Após cirurgia, a concentração sérica de IgG4 encontrava-se no limite superior do normal. Ocorreu melhoria sintomática e redução dos parâmetros inflamatór...
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The need of a higher role of solar energy within the energy mix in the coming decades obliges the systems to increase their performance and reliability. It is demanded that the solar absorbers, as the key component of solar thermal systems, should be low cost with high efficiency for extended lifetimes under different kinds of environments. Commercially, there are two different types of solutions as selective solar absorbers coatings: coatings obtained by physical vapor deposition (PVD) and by paint coatings (PC). These coatings present different physical and chemical characteristics. Therefore, it is important to know how these coatings degrade over time in different environments. Results obtained with two different PVD coatings and three PC, under different accelerated aging tests, are presented. The aging tests performed included different environmental stress corrosion conditions: temperature, humidity, chlorides, sulphur dioxide and nitrogen oxides. Cyclic variation of corrosion promoting gases (sulfur dioxide and nitrogen dioxide), higher humidity, salt spraying and drying seem to be an aging test that reflects the different environments where the solar thermal collectors are exposed. In addition to the contaminants, drying / wetting cycles also play an important role in degradation mechanisms of absorber coatings.
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