Premium
INCREASED FREQUENCY OF HLA‐DR3 AND 5 IN THE SYNDROMES OF PAINLESS THYROIDITIS WITH TRANSIENT THYROTOXICOSIS: EVIDENCE FOR AN AUTOIMMUNE AETIOLOGY
Author(s) -
FARID N. R.,
HAWE B. S.,
WALFISH P. G.
Publication year - 1983
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1983.tb00047.x
Subject(s) - medicine , thyroiditis , etiology , anti thyroid autoantibodies , thyroid , human leukocyte antigen , gastroenterology , subacute thyroiditis , endocrinology , graves' disease , thyroid disease , autoantibody , immunology , antigen , antibody
SUMMARY We studied fifty patients with painless thyroiditis with transient thyrotoxicosis (PTTT) and a low radioiodine thyroidal uptake. In 25 PTTT occurred post‐partum ( P ) and in the remainder was unrelated to pregnancy ( U ). Seventeen patients with classical subacute thyroiditis were studied for comparison. All patients were typed for HLA‐A, B, C, DR antigens. Four of the P patients had recurrences with each pregnancy; two had one previous attack of U ; three had a maternal history of GRAVES' disease; 76% of the P patients had small to moderate goitres and 76% antimicrosomal antibody titres at > 1:400. HLA‐B35 was found in 24% of P patients compared to 17% of controls; 71% of patients with subacute thyroiditis were, by contrast, B35. Two of P were HLA‐B8 positive (versus 25% of controls); 11 patients were HLA‐DR3 positive and 15 (60%) HLA‐DR5 positive compared to 23% and 27% of controls yielding a relative risk (RR) = 2·50 ( P < 0·05) and 3·83 ( P < 0·005), respectively. All four P patients with recurrences carried HLA‐DR5. Thirteen of 25 patients in the U subgroup were HLA‐DR3, yielding a RR = 3·38 ( P < 0·01); seven were HLA‐DR5, with a non‐significant RR = 1·12; four of U had first degree relatives with either autoimmune thyroid disorders or Type 1 diabetes mellitus. Thus, both P and U are associated with HLA‐DR3, the P subgroup had in addition an increased frequency of DR5. The observed HLA associations for the PTTT syndromes favours an autoimmune rather than viral aetiology.