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Medicine Endocrinology 45d73f7e

Which of the following antibodies is involved in the tissue destructive process associated with hypothyroidism in Hashimoto's and atrophic thyroiditis?

A
Thyroperoxidase antibody
B
Thyroglobulin antibody
C
TSH receptor antibody
D
Thyroid stimulating antibody
High-Yield Explanation
In Hashimoto's thyroiditis, there is a marked lymphocytic infiltration of the thyroid with germinal center formation, atrophy of the thyroid follicles accompanied by oxyphil metaplasia, absence of colloid, and mild to moderate fibrosis. In atrophic thyroiditis, the fibrosis is much more extensive, lymphocyte infiltration is less pronounced, and thyroid follicles are almost completely absent. These tissue destructive processes are due to antithyroid peroxidase antibodies (TPOAb). TPO antibodies fix complement, and complement membrane-attack complexes are formed and are able to cause damage to thyroid cells due to antibody dependent cell cytotoxicity and activation of apoptotic pathways unlike anti thyroglobulin antibodies (TgAb) which are also found in autoimmune thyroid disorder. Reference : page 2290 Harrison's Principles of Internal Medicine 19th edition

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