Histocompatibility Lymphocytic Antigen(HLA) Typing in Patients with Acute Exacerbation of Hashimoto's Thyroiditis.

Ishihara, Takashi; Mori, Toru; Waseda, Norio; Ikekubo, Katsuji; Konishi, Hiroyuki; Imura, Hiroo

doi:10.1507/endocrj1954.35.231

Cited by 9 publications

(5 citation statements)

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“…A painful tender thyroid gland, transient thyrotoxicosis, and suppressed RAIU is also demonstrated in a few patients with Hashimoto's thyroiditis (acute exacerbation of Hashimoto's thyroiditis [13] or painful chronic thyroiditis [15]). The presence of painful thyroiditis is unlikely in our patient, since (1) the prevalence of HLA-B35 is significantly lower in painful thyroiditis than in subacute thyroiditis [13], (2) ultrasonography shows low amplitude echos throughout the whole thyroid in painful thyroiditis [15], and (3) patients with painful thyroiditis show permanent hypothyroidism when they have positive antimicrosomal antibodies in high titers [15]. We have recently reported two patients with Graves' disease associated with subacute thyroiditis [16].…”

Section: Discussionmentioning

confidence: 93%

“…It is well known that persons with HLA-B35 are susceptible to subacute thyroiditis [13,14]. The incidence of HLA-B35 in Japanese patients with subacute thyroiditis was reported to be 50% by Ishihara et al [13] and 67.4% by Tamai et al [14]. A painful tender thyroid gland, transient thyrotoxicosis, and suppressed RAIU is also demonstrated in a few patients with Hashimoto's thyroiditis (acute exacerbation of Hashimoto's thyroiditis [13] or painful chronic thyroiditis [15]).…”

Section: Discussionmentioning

confidence: 98%

“…1 & 2) indicated that the inflammatory lesion moved from the left to the right lobe, suggesting the presence of creeping thyroiditis, (4) aspiration cytology revealed the presence of multinucleated giant cells [11,12], (5) the AMC and TBII became undetectable during the investigation period [11,12], and (6) she was positive for HLA-B35. It is well known that persons with HLA-B35 are susceptible to subacute thyroiditis [13,14]. The incidence of HLA-B35 in Japanese patients with subacute thyroiditis was reported to be 50% by Ishihara et al [13] and 67.4% by Tamai et al [14].…”

Section: Discussionmentioning

confidence: 98%

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Non-Suppressed Thyroidal Radioactive Iodine Uptake(RAIU) in Thyrotoxic phase in a Case of Subacute Thyroiditis with Thyroid-Stimulating Antibodies(TSAb).

et al. 1992

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Abstract. In this paper, we report a 49-year-old female with subacute thyroiditis who had thyroidstimulating antibodies (TSAb) and thyroid-stimulation-blocking antibodies (TSBAb) in serum. Although she was in the thyrotoxic phase and TSH was suppressed in May, 1990, her radioactive iodine uptake (RAIU) was not suppressed (35.5%) and a thyroid scan disclosed a diffuse goiter with no defect. Serum assays revealed the presence of TSAb, but TSBAb were negative. In August, 1990, the right lobe became undetectable by thyroid scan when the RAIU was 20.7% with the TSH level remaining suppressed. At that time, TSAb were negative, while TSBAb were positive. When the RAIU was 31.1% in October, 1990, both thyroid lobes became visible and the TSH level was normalized. TSBAb became negative, and although TSAb reappeared it later became undetectable. These results indicate that the changes in the patient's thyroid scan and RAIU were attributable to the presence of TSAb.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

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Non-Suppressed Thyroidal Radioactive Iodine Uptake(RAIU) in Thyrotoxic phase in a Case of Subacute Thyroiditis with Thyroid-Stimulating Antibodies(TSAb).

et al. 1992

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“…Inflammation Á Fever of unknown origin Á Nontender goiter Rare cases of painful Hashimoto's thyroiditis that present with persistent fever and thyroid tenderness have been reported [1][2][3][4]. Although most cases of painful Hashimoto's thyroiditis are resolved by the administration of glucocorticoids, total thyroidectomy is required in some cases [1,2,5,6].…”

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confidence: 99%

Sustained fever resolved promptly after total thyroidectomy due to huge Hashimoto’s fibrous thyroiditis

Kubota

Matsuzuka

Ohye

et al. 2007

Endocr

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We encountered a 55-year-old female patient with Hashimoto's thyroiditis who showed persistent fever, and could not find any source of fever other than the large nontender goiter. Her fever continued with positive CRP for 6 months. Although we did not assume that the inflammation was related to Hashimoto's thyroiditis, total thyroidectomy was performed for cosmetic reasons; however, fever was resolved immediately after thyroidectomy. Pathological diagnosis was Hashimoto's chronic thyroiditis. Immunohistochemical staining showed that the follicular cells were positive for IL-1alpha, IL-1beta, and TNF-alpha. We believed that fever was induced by inflammatory cytokines produced in thyroid. The case indicated that Hashimoto's thyroiditis with nontender goiter could cause idiopathic fever.

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“…Patient 1 exhibited a similar clinical course and was highly likely to have developed SAT. HT, when exacerbated acutely, causes thyrotoxicosis that results in persisting hypothyroidism [ 22 ]. However, patient 1 developed transient hypothyroidism with oral PSL administration and later became euthyroid, a condition that persisted thereafter.…”

Section: Discussionmentioning

confidence: 99%

HLA typing of patients who developed subacute thyroiditis and Graves’ disease after SARS-CoV-2 vaccination: a case report

et al. 2023

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Background Cases of subacute thyroiditis (SAT) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination have been reported. A human leukocyte antigen (HLA) allele, HLA-B*35, appears to be involved in the pathogenesis of SAT. Case presentation We conducted HLA typing of one patient with SAT and another with both SAT and Graves’ disease (GD), which developed after SARS-CoV-2 vaccination. Patient 1, a 58-year-old Japanese man, was inoculated with a SARS-CoV-2 vaccine (BNT162b2; Pfizer, New York, NY, USA). He developed fever (38 °C), cervical pain, palpitations, and fatigue on day 10 after vaccination. Blood chemistry tests revealed thyrotoxicosis and elevated serum C-reactive protein (CRP) and slightly increased serum antithyroid-stimulating antibody (TSAb) levels. Thyroid ultrasonography revealed the characteristic findings of SAT. Patient 2, a 36-year-old Japanese woman, was inoculated twice with a SARS-CoV-2 vaccine (mRNA-1273; Moderna, Cambridge, MA, USA). She developed fever (37.8 °C) and thyroid gland pain on day 3 after the second vaccination. Blood chemistry tests revealed thyrotoxicosis and elevated serum CRP, TSAb, and antithyroid-stimulating hormone receptor antibody levels. Fever and thyroid gland pain persisted. Thyroid ultrasonography revealed the characteristic findings of SAT (i.e., slight swelling and a focal hypoechoic area with decreased blood flow). Prednisolone treatment was effective for SAT. However, thyrotoxicosis causing palpitations relapsed thereafter, for which thyroid scintigraphy with 99mtechnetium pertechnetate was conducted, and the patient was diagnosed with GD. Thiamazole treatment was then initiated, which led to improvement in symptoms. Conclusion HLA typing revealed that both patients had the HLA-B*35:01, -C*04:01, and -DPB1*05:01 alleles. Only patient 2 had the HLA-DRB1*11:01 and HLA-DQB1*03:01 alleles. The HLA-B*35:01 and HLA-C*04:01 alleles appeared to be involved in the pathogenesis of SAT after SARS-CoV-2 vaccination, and the HLA-DRB1*11:01 and HLA-DQB1*03:01 alleles were speculated to be involved in the postvaccination pathogenesis of GD.

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Histocompatibility Lymphocytic Antigen(HLA) Typing in Patients with Acute Exacerbation of Hashimoto's Thyroiditis.

Abstract: Histocompatibility lymphocytic antigen (HLA) typing was performed in 6

Cited by 9 publications

References 7 publications

Non-Suppressed Thyroidal Radioactive Iodine Uptake(RAIU) in Thyrotoxic phase in a Case of Subacute Thyroiditis with Thyroid-Stimulating Antibodies(TSAb).

Non-Suppressed Thyroidal Radioactive Iodine Uptake(RAIU) in Thyrotoxic phase in a Case of Subacute Thyroiditis with Thyroid-Stimulating Antibodies(TSAb).

Sustained fever resolved promptly after total thyroidectomy due to huge Hashimoto’s fibrous thyroiditis

HLA typing of patients who developed subacute thyroiditis and Graves’ disease after SARS-CoV-2 vaccination: a case report

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