Autoimmune disease of the thyroid and colon, with a report of a case of chronic ulcerative colitis in association with Hashimoto's disease and penicillin allergy.
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A simple anti-gamma-globulin consumption test for use in suspected Hashimoto's disease is described. Results in cases with positive and negative tanned red-cell tests are described.
Sera from certain patients with Hashimoto's disease or a related condition contain a non-precipitating antithyroglobulin which produces in double-diffusion tests with thyroglobulin a line of clearing in the agar. Two such sera are described. Other sera from examples of the disease give negative precipitin tests with thyroglobulin but combine with sera containing ;clear line', non-precipitating antithyroglobulin to give a positive precipitin test. The serum from 15 out of 26 precipitin-negative cases of Hashimoto's disease showed this latent property. Eight of the 15 were tested by the tanned red cell technique and showed substantial titres of antithyroglobulin.
The preparation of stable formolized sheep cells coated with thyroglobulin and their use for the detection of auto-antibodies in human thyroiditis is described. This provides an easy laboratory test which gives results closely comparable with those using fresh tanned cells. The agglutination titres do not closely parallel the antibody content of the serum but a good correlation may be obtained by inhibiting agglutination with thyroglobulin. The diagnostic usefulness of the test in treating disorders of the thyroid is discussed and related to the results of tests for the other two immune systems involved in thyroiditis. The tanned red cell test may be used to differentiate Hashimoto's disease from thyroid cancer and non-toxic colloid goitre, and to assess the choice of treatment in patients with Graves' disease. It has proved of particular value in genetic studies of auto-immunity.
A comparison is made of tests for thyroglobulin antibody, using gel diffusion, electroprecipitin, bentonite flocculation, tanned red cell agglutination, and latex slide agglutination techniques on sera from cases of Hashimoto's disease and other thyroid disorders. Any increase in gamma globulin was also noted from the serum electrophoretic pattern. The gel diffusion and electroprecipitin tests are shown to be comparable in their sensitivity, as are the bentonite flocculation and tanned red cell agglutination tests. The flocculation and agglutination tests were oversensitive. The latex slide test in conjunction with the electro-precipitin test is recommended for routine use in the detection of Hashimoto's disease.
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