Endocrine Abstracts

Aim, Objectives: Conceptualizing new data related to type and level of autoantibodies in thyroiditis Hashimoto, Graves-Basedow disease and releated conditions.

Material: ###1. Adoption the integrative concepts of immune network (Nobel Prize, 1984) for immune thyroid diseases. 2. Searching on “www.ncbi.nlm.nih.gov/pubmed” for papers with keywords: thyroid autoantibody, thyroiditis (~2500 papers). 4. New (auto)-antibodies (and antigens/epitopes) found in immune thyroid diseases.

Method: ###1. Thyroid diseases pathogenesis is mostly immune. 2. Patients have autoantibodies and the disease is called autoimmune. 3. If there is a pathogenetic antibody, then there must be a pathogenic antigen. 4. Asserting a/one specific immune pathogenic mechanism, there cannot be overlapped disease because there could not be overlapped/more pathogenic mechanisms. 5. Understanding pathogenetic steps means: only one immune mechanism could act. 6. Other antibodies presence (along with the specific one) in patient should be related to upstream and downstream regulation mechanisms of the immune network. 7. Immune thyroid disease name should be linked on a sole mechanism.

Results: 1. Medical literature specify 4 clinical situations: Hashimoto thyroiditis, idiopathic mixedema, Graves-Basedow disease, Riedel thyroiditis. 2. Criteria for defining these entities did not allowed overlapping especially for specific auto-antibodies. 3. Thus a disease should be linked to a single immune mechanism and a single auto-antibody. 4. If there are many antibodies in a clinical situation, then there is more than one diseases. 5. Association of many thyroid immune disease in a patient is not a rare situation.

Conclusions: ###1. Hashimoto thyroiditis is only ATPO related. 2. Graves-Basedow disease is only TRAB related. 3. Riedel thyroiditis is only IgG4 non-ATPO/ATG/TRAB related. 4. Thyroiditis with only ATG should be name specifically. 5. Idiopathic mixedema is that immune destruction with no yet specific antibody/antigen identify complex. 6. Pathogenesis linked on new immune complexes pendrine/anti-pendrine, NIS/anti-NIS could lead to define new clinical entities.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector