[Incidence of thyroglobulin and microsomal antibodies in normal subjects (author's transl)]

High frequencies of human T-lymphotropic virus type I (HTLV-I) infection and presence of HTLV-II proviral DNA in blood donors with anti-thyroid antibodies

To investigate the relationship between human T-lymphotropic virus (HTLV) types I and II and the pathogenesis of autoimmune thyroid diseases, we examined serum anti-thyroid antibodies in 1019 blood donors with or without serum anti-HTLV-I antibody as well as proviral DNA for HTLV-II in leukocyte DNA by the polymerase chain reaction in 395 blood donors with or without anti-thyroid antibodies. The frequency of donors with anti-HTLV-I antibody who also showed anti-thyroid antibodies (7.9%) tended to be higher than that (6.3%) among donors who did not have the anti-HTLV-I antibody. The frequency of anti-thyroid antibodies in 125 young male donors aged 16-39 years with anti-HTLV-I antibody (4.8%) was significantly higher (P < 0.05) than that (0.6%) in 164 control donors without the antibody. In blood donors with anti-thyroid antibody, 25.0% of those with anti-HTLV-I antibody and 14.3% of those without the antibody had HTLV-II proviral DNA. In contrast, in donors without anti-thyroid antibody HTLV-II proviral DNA was detected in 2.3% of those with anti-HTLV-I antibody and in 0.6% of those without the antibody. Thus the detection rates in donors with anti-thyroid antibody were significantly higher (P < 0.001) than those in donors without the antibody, regardless of HTLV-I infection. These results suggest that HTLV-I infection and the presence of HTLV-II proviral DNA may be independently related to the pathogenesis of autoimmune thyroid diseases.

Hypothyroidism associated with positive results of the perchlorate discharge test in elderly patients

In 172 patients over the age of 55, determinations were made of thyrotropin concentrations in plasma. Although they showed such symptoms or signs of hypothyroidism as puffy face, dry skin, general malaise, cold intolerance, or constipation, there were no clinical indications of overt hypothyroidism. All the patients were apparently in a normal nutritional state, without any specific medication that might cause thyroid abnormalities. Seventeen (six men and 11 women, 9.9 percent) of the 172 patients, aged 58 to 83, had elevated plasma thyrotropin levels, ranging from 12.1 microU/ml to 170 microU/nl. To investigate the characteristics of hypothyroidism in the elderly, the perchlorate discharge test was performed in these patients. In 15 of the 17 patients, 123I thyroid uptake diminished markedly immediately after the administration of 1 g perchlorate. Thirteen of these 15 patients showed markedly diminished thyroxine (T4) levels in serum, whereas the magnitude of diminution in serum 3,5,3'-triiodothyronine (T3) values was small. Two patients with the negative discharge results showed normal T4 and T3 levels in serum. Four patients had a very small goiter, and the remaining 13 patients had no detectable goiter. Fifteen of the 17 patients had no detectable circulating thyroid antibodies in repeated determinations, and the histologic features of Hashimoto's thyroiditis were not found in the thyroid specimens obtained from two patients. These findings suggest the existence of hypothyroidism attributable to iodine organification defect without evidence of autoimmune thyroiditis in some cases in elderly patients.