Identification and characterization of circulating thyroid hormone autoantibodies in thyroid diseases, in autoimmune non thyroid illnesses and in lymphoreticular system disorders

This paper describes the identification of circulating autoantibodies to thyroid hormones in 5 patients with Graves’ disease (n = 2), Hashimoto’s thyroiditis (n = 1), primary myxedema (n = 1) and Sjögren syndrome (n = 1) out of 351 individuals. The 351 patients suffered from different autoimmune thyroid disorders, thyroid cancer or lymphoreticular system disorders as well as autoimmune non thyroid illnesses. Immunoglobulin G (IgG) binding of one or both tracer thyroid hormones and in one case also of reverse triiodothyronine, was demonstrated by radioimmunoprecipitation experiments and by reverse flow zone electrophoresis or cellulose acetate electrophoresis and autoradiography. In all cases the binding of radiolabeled thyroid hormones to IgG was displaced by an excess of the respective non radioactive thyroid hormone. Thyroglobulin displaced the binding in 2 cases but preadsorption with human thyroglobulin was ineffective in other 2 cases. Radioimmunoelectrophoresis and autoradiography of the Immunoelectrophoresis plates indicated that in 2 cases the light chains involved in the binding were k chains of the G3 subclass and to a lesser extent of the G1 subclass, in another case they were λ chains and therefore of restricted heterogeneity. In a case of myxedema coma IgG were polyclonal (k and λ chains of the G1 > G2 > G3 subclasses). The thyroxine (T4) or triiodothyronine (T3) antibodies interfere with the hormone measurement in unextracted serum by falsely lowering their concentrations when non specific separation methods are used and raising their concentrations when double antibody radioimmunoassays are used.In one serum containing anti-T4 antibodies, the association constant (Ka) was 0.63 × 106 l/M and absolute binding (Ab0) was1.54 x10-7 l/M. In another serum with anti-T3 IgG, Ka was 4.44 × 107 l/M and Abo 6.22 × 10-9 l/M. In the case of myxedema coma Ka ranged between 3.1 and 4.3 × 108 l/M. © 1983, Italian Society of Endocrinology (SIE). All rights reserved