Subacute (de Quervain's) Thyroiditis: Association with HLA-Bw35 Antigen and Abnormalities of the Complement System, Immunoglobulins and Other Serum Proteins

Abstract

The HLA antigens in 40 patients with subacute thyroiditis were investigated. An association between subacute thyroiditis and HLA-Bw35 antigen as previously reported, was confirmed. Further immunological observations included a decrease in Serum Clq, C4 and C3 activator levels; conversely, there was an increase in serum C3, IgM, alpha1-acid glycoprotein and alpha1-antitrypsin levels. Serum IgA levels were decreased in those patients who were Bw35 negative, but were normal in the patients who were Bw-35 positive, with serum alpha2-macroglobulin levels the opposite was found. These studies support the view that a genetic factor(s), viz., the major histocompatibility system, plays a role in the pathogenesis of subacute thyroiditis. A "nosological clustering" around the Bw35 antigen as a marker for viral susceptibility is suggested.

Recurrence of Subacute Thyroiditis Over 10 Years after the First Attack in Three Cases.

“…A definite association between the occurrence of this disease and the presence of HLA-BW 3 5 has been demonstrated in European Caucasoids (Nyulassy et al, 1977), Chinese (Yeo et al, 1981), and Japanese patients (Kobayashi et al, 1985). In Japanese patients, the frequency of CW3 and DRW8 was also significantly higher than in the control but no increase in the frequency of A26 in subacute thyroiditis compared with normal subjects was reported (Kobayashi et al, 1985).…”

Clinical and cytomorphological study of Dequervains thyroiditis

“…10 The viruses implicated are Mumps, measles, adenovirus, Epstein-Barr virus, Coxsackie and influenza. 9,12,13, Typically, it presents in adults following an upper respiratory infection with fever and diffuse tender enlargement of the thyroid.…”

“…9 Individuals with human leukocyte antigen HLA-BW35 have an increased susceptibility for the development of subacute thyroiditis. 10 Studies have shown that autoimmunity is not a factor in the pathogenesis of this disease. 9 SGT is usually diagnosed clinically and therefore the cytological literature on this condition is rare.…”

Hepatitis C virus infection and thyroid autoimmune disorders: A model of interactions between the host and the environment

“…A case of De Quervain's thyroiditis during a-IFN therapy for HCV-related chronic hepatitis, with persisting negative anti-thyroid Abs after a-IFN therapy, has been reported [78] . The common viral infections (Coxsackie virus, mumps, Epstein-Barr virus, adenovirus, cytomegalovirus) were negative, but we found an association with HLA-Bw35 [79,80] . The patient presented the HCV, the typical HLA class Ⅰ predisposition for the thyroid disease and an exogenous accelerating factor (a-IFN therapy).…”

“…The HCV genotype was 1b (20%), 2a (60%) and 3a (20%), with the distribution (1b:2a:3a) of 1:3:1 and absence of mixed genotype. It is well known that the HLA-B35, -DR3 (DRB1.03 allele) and -DR5 (DRB1.11/ HLA-DRB1.12 alleles) are commonly associated with De Quervain's thyroiditis, thyrotoxicosis/hyperthyroidism and hypothyroidism, respectively [80,[84][85][86][87][88][89][90][91][92] . Arginine at position 74 of HLA-DRB1 chain (DRB-Arg74) may permit autoAg peptides to fit into the binding pocket, to be presented more efficiently to T cells [93] .…”