THYROID AUTOANTIBODIES - 03/09/11
Résumé |
Hashimoto56 described dense lymphoid infiltration causing goiter and hypothyroidism in 1912; however, it was not until 1956 that autoantibodies, that is, antithyroglobulin antibodies (anti-Tg), were detected in this condition,115 leading to the novel concept that diseases could be caused by an autoimmune process. Evidence for a serum thyroid-stimulating factor was presented in the same year,1 a substance later shown to be antibodies to the thyroid-stimulating hormone (TSH) receptor.73 The discovery of antibodies to the thyroid microsomal antigen followed in 1964,116 a substance later recognized as thyroid peroxidase (TPO). Since then, several other antigenic targets in the thyroid have been proposed, the most consistent of which have been the rare finding of anti–thyroid hormone autoantibodies114 and the recent recognition of the sodium-iodide symporter (NIS) as an autoantigenic target.37
Commercial assays to measure anti-Tg, anti-TPO, and anti–TSH receptor antibodies are now available. Widespread application of these tests has identified autoimmune thyroid disease as the most common autoimmune condition, with approximately 2% of women and 0.2% of men affected at the clinical level.134 The prevalence of subclinical disease is now known to be tenfold higher.139 This article reviews the immunobiology of thyroid autoantibodies and the available detection techniques and discusses current indications for thyroid autoantibody testing in clinical practice.
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| Address reprint requests to Colin M. Dayan, MB, FRCP, PhD, University Division of Medicine Laboratories, Bristol Royal Infirmary, Bristol, United Kingdom BS2 8HW, e-mail: Colin.Dayan@bris.ac.uk |
Vol 30 - N° 2
P. 315-337 - juin 2001 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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