Clinical and microscopical studies were made on 61 cases of thyroiditis and 161 cases of other thyroid diseases.
The following findings were obtained :
Most of the usual thyroiditis could be classified either as Hashimoto's disease or as de Quervain's subacute thyroiditis. Hashimoto's disease occurs mainly in women of 20 to 50 years of age demonstrating only a firmly diffuse goiter with no complaints. In Hashimoto's disease, the thyroid showed microscopically atrophic acini and localized or diffuse lymphocytic infiltration, or often, an appearance of lymphofollicle ; occasionally a marked fibrosis was dominant with the disappearance of thyroid acini.
In this disease, antithyroid antibody by Oudin's agar gel diffusion technique was demonstrated with high incidence and high titer. General condition of this disease did not change entirely during an observation period of 5 to 6 years. Treatment is seldom necessary for this disease.
De Quervain's subacute thyroiditis also occurs mainly in women of 20 to 50 yeasrs of age. High fever, headache, pain in the neck and shoulder, and localized firm swelling of thyroid are usually seen in acute stage, disappearing slowly in 1 to 3 weeks after an onset. Red cell sedimentation rate is highly accelerated, and
131I uptake ratio is remark-ably reduced.
131I scintigram showed either no silouette or thinly mottled silouette. Microscopical findings of the thyroid showed destruction of acini, appearace of characteristic giant cells, and fibrosis. Then regenerated acini appeared.
Follow-up study for 5 to 6 years revealed that all the patients complained of nothing, except one with myxedema following thyroidectomy. Therefore, their recovery can be considered complete.
There was no case of Riedel's thyroiditis which lacked resemblance to Hashimoto's disease or subacute thyroiditis. Microscopically, some cases of Grave's disease, thyrotoxicosis and spontaneous myxedema resembled Hashimoto's disease so much that a close relation was thought to exist between them.
Some experiments were performed in order to produce experimental thyroiditis.
(1) Experimental Hashimoto's disease by immunizing a rabbit with the tissue extracts of other rabbit's thyroid.
(2) Experimental suppurative thyroiditis by infecting a rabbit with staphylococcus after having immunized it with the tissue extract of other rabbit's thyroid.
(3) Experimental subacute thyroiditis by infecting a mouse with influenza virus after having immunized it with the tissue extract of other mouse's thyroid.
By these experiments, the author obtained the result of a few pathological findings of experimental thyroiditis.
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