1/12. Uncommon histopathological findings in fatal measles infection: pancreatitis, sialoadenitis and thyroiditis.AIMS : We report uncommon histopathological findings in fatal measles infection. methods AND RESULTS : We describe the autopsies of four patients who died during a measles outbreak in Sao Paulo, brazil, in 1997. Two of the patients were children receiving chemotherapy for non-Hodgkin's lymphoma, one was an adult with acquired immunodeficiency syndrome (AIDS) and the fourth was an apparently healthy woman. All patients had their deaths attributed to measles pneumonia. The autopsies revealed extensive giant cell pneumonia and diffuse alveolar damage, severe acute pancreatitis, necrotizing sialoadenitis and thyroiditis due to measles. measles antigen was detected in lung tissue using a monoclonal anti-measles antibody. CONCLUSIONS: : pancreatitis, thyroiditis and sialoadenitis are not previously reported histopathological findings in measles infection. pancreatitis is a potentially severe complication and should be considered when treating patients with atypical measles.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/12. Intrathyroidal branchial cleft-like cyst in chronic thyroiditis.An extremely rare case of intrathyroidal branchial cleft-like cyst is reported. A 71-year-old man complained of a growing mass in the right lateral neck. A cystic mass in the upper lobe of the right thyroid was demonstrated by ultrasonography and computed tomography. The surgical specimen revealed a cystic mass with dense fibrous capsule, 22 x 20 x 10 mm in size. Microscopically, the cyst walls and the surrounding thyroid tissue contained severe lymphoid cell infiltration with lymphoid follicle. Squamous epithelium lined the cyst wall. Immunohistochemically, squamous epithelium was positive for keratin, cytokeratin 19, carcinoembryonic antigen, and epithelial membrane antigen, but negative for calcitonin and chromogranin a. The patient is currently well with no evidence or recurrence for 43 months.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
3/12. central nervous system involvement in autoimmune polyglandular syndrome.We present a 33 year-old man, admitted because of transient deterioration of visual acuity. magnetic resonance imaging showed diffuse central nervous system (CNS) demyelination, which largely resolved spontaneously within 4 months. The patient fulfilled the diagnostic criteria of APS type III, having autoimmune thyroiditis and alopecia universalis. In this patient, autoimmune activation against CNS antigens is thought to be the cause of reversible CNS demyelination.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/12. association between human leukocyte antigen (HLA) and interferon- induced thyroid diseases in four patients with HCV-related chronic hepatitis.OBJECTIVES: The interferon-alpha (IFN-alpha) therapy for HCV hepatitis may exacerbate or induce underlying thyroid disorders. Besides viral factors, the human leukocyte antigen (HLA) may be an independent risk factor. methods: We evaluated fifteen patients with HCV chronic hepatitis during a period of 40 months. At the enrollment, all the patients were negative for thyroid disorders, excluding one patient with subclinical hypothyroidism. Eleven patients received IFN-alpha therapy. The HLA system was examined in every patient, evaluating antigens (n=40) of locus A, B and Cw and alleles (n=19) of locus DRB1* and DQB1*. The HLA system was also examined in healthy subjects (n=107) as a control group. RESULTS: The HCV genotype distribution in patients was: 1b=20%, 2a=60%, 3a=20%. Four IFN-treated patients presented clinical thyroid disorders, including autoimmune hypothyroidism (n=2), transient thyrotoxicosis (n=1) and subacute thyroiditis (n=1). The HLA susceptibility to thyroid disorders (antigen/allele frequency) in the whole group of patients was not different in respect to controls and normal Italian population. The patients with HCV chronic hepatitis that developed thyroid diseases after IFN- treatment had a double and specific association with the HLA system (Mantel-Haenszel X(c)(2)=4.706, p<0.05). CONCLUSIONS: This case report suggests that HLA system examination is an important and promising diagnostic aspect that may be considered in order to evaluate the appearance of thyroid disorders during the IFN-alpha treatment for HCV-related chronic hepatitis.- - - - - - - - - - ranking = 7keywords = antigen (Clic here for more details about this article) |
5/12. Silent thyroiditis in an eleven-year-old girl, associated with transient increase in serum IgM and thyroid hormone.An 11-year-old-girl with silent thyroiditis associated with a transient increase in serum IgM and thyroid hormone is described. The levels of serum IgM decreased from 4.38 g/L to 3.35 g/L after 1.5 months at the same time as thyroid hormones returned to normal. An unidentified antecedent infection or exposure to antigen causing the increase in serum IgM might have triggered the occurrence of silent thyroiditis in this patient, although a search for viral antibodies revealed no significant titer changes during the course of the disease.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/12. Post-partum thyroiditis and goitrous (Hashimoto's) thyroiditis are associated with HLA-DR4.Using new panels of HLA-DR typing sera, we found an increase in the prevalence of HLA-DR4 in 21 patients with Hashimoto's thyroiditis (57%) and 32 patients with post-partum thyroiditis (53%) compared to controls (21%). Hashimoto's thyroiditis was previously found to be associated with HLA-DR5 and Dw5. We feel that the doubts raised by this study warrant the study of DR antigens in thyroid autoimmune disease using large panels of specific sera.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/12. The histopathologic features of lithium-associated thyroiditis.The case of a 62-year-old woman with lithium-associated thyroiditis is presented. lithium can produce goiters associated with hypothyroidism and, less commonly, hyperthyroidism and euthyroidism. The characteristic histopathologic features of the affected thyroid gland included fibrosis, lymphoid follicles with atrophy, and hyperplasia of thyroid follicles. The pathogenetic mechanism appears to be immunologic, with lithium acting as a haptene with a thyroid antigen to induce an "autoimmune" type of thyroiditis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/12. A case of membranous nephropathy associated with thyroid antigens.A 54-year-old woman who had proteinuria due to stage II membranous nephropathy is reported. She was treated with indomethacin for proteinuria and developed drug-induced hepatitis four months later. liver dysfunction gradually recovered, but hormonal studies revealed abrupt fall of T3 and T4 and concomitant elevation of TSH levels within a month. Pathological findings of thyroid specimen and positive antithyroglobulin and antimicrosomal antibodies were compatible to chronic thyroiditis. In the second renal biopsy, glomerular deposits of thyroglobulin, thyroid microsomal antigens and IgG were demonstrated by immunofluorescence. Therefore, membranous nephropathy in this patient is presumed to be caused by immune complexes mediated by thyroid constituents. We believe that this is a precious case because continuous changes in T3, T4 and TSH were followed in a course of chronic thyroiditis, especially in the stage of progress to hypothyroidism, and the chronic thyroiditis was shown to be involved in the membranous nephropathy.- - - - - - - - - - ranking = 5keywords = antigen (Clic here for more details about this article) |
9/12. Acute suppurative salmonella thyroiditis: clinical course and antibody response.A previously healthy 72-year-old man, who had been treated with steroids for one month on a presumptive diagnosis of polymyalgia rheumatica, developed a suppurative thyreoiditis. salmonella enteritidis was isolated from the thyroid aspirate. Although the bacterial strain was sensitive to ampicillin in vitro, the disease was not cured until treatment with trimethoprim-sulfamethoxazole was initiated. The patient developed a high antibody response of the IgM class against both salmonella serogroup B and D O-antigenic determinants, as estimated by enzyme-linked immunosorbent assay (ELISA). absorption studies suggested that most of the antibody response was directed against salmonella 012 determinant(s), common to both salmonella serogroup B and D.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/12. Paucicellular variant of anaplastic thyroid carcinoma. A mimic of Reidel's thyroiditis.Anaplastic thyroid carcinomas usually pose no problems in histologic diagnosis because of the obvious invasive growth, high cellularity, and frank anaplasia. Two cases of a variant of anaplastic thyroid carcinoma with peculiar gross and histologic features closely mimicking those of Riedel's thyroiditis are described in this report. The clinical features were no different from those of the usual anaplastic thyroid carcinomas: occurrence in elderly subjects, presentation with rapidly enlarging neck mass associated with compression symptoms, and rapidly fatal outcome. The tumors were infiltrative, hard, fibrotic masses that partly or completely replaced one lobe of the thyroid, and extended to perithyroid tissues. Histologically, they were predominated by acellular fibrous or infarcted tissue with central dystrophic calcification, as well as hypocellular foci comprising mildly atypical spindle cells intermingled with collagen and small lymphocytes. Both cases showed permeation and plugging of the arteries by tumor. Lymph node metastasis was documented in one case. The spindle cells were positive for epithelial membrane antigen in both cases, and cytokeratin in one. The qualifying term "paucicellular variant" accurately describes this uncommon morphologic variant of anaplastic thyroid carcinoma. It is important to recognize this variant so as not to mistaken it for Riedel's thyroiditis, which is a reactive condition with a very favorable prognosis. The distinguishing features are as follows: presence of infarction, atypical cells in at least some areas, atypical spindle cells obliterating large blood vessels, and immunoreactivity for epithelial markers.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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