Calcitonin levels are similar in goitrous euthyroid patients with or without thyroid antibodies, as well as in hypothyroid patients.

OBJECTIVE Some authors, after studying retrospectively immunostained sections of thyroid specimens, found C-cell hyperplasia (CCH) unrelated to medullary thyroid carcinoma to be frequent in thyroid glands affected by chronic lymphocytic thyroiditis (CLT); others failed to observe this association. The purpose of the present study was to further investigate prospectively the existence of the proposed relationship between CLT and CCH by measuring circulating calcitonin (CT) levels. DESIGN Basal serum CT was measured in 174 euthyroid goitrous women with negative thyroid autoantibodies (TA-Neg) and 124 age-matched goitrous euthyroid women with positive antibodies (TA-Pos). A calcium-infusion test was performed in 27 TA-Neg and 31 TA-Pos age-matched euthyroid goitrous women. Basal CT was also determined in 51 hypothyroid women and 40 control normal healthy women. METHODS Serum CT was measured using a specific and sensitive two-site immunoassay which detects mainly the CT-32 monomer. Thyroid autoantibodies (anti-thyroid peroxidase and anti-thyroglobulin) were measured in serum by quantitative RIAs. RESULTS Basal serum CT was found to be similar in TA-Neg and TA-Pos euthyroid as well as hypothyroid and normal control groups. A test of independence performed on the frequency distribution of the patients among sequential classes of serum CT showed that basal CT levels are independent of the presence of thyroid autoantibodies or hypothyroidism. Calcium-stimulated CT as well as the increase in CT were similar in TA-Neg and TA-Pos euthyroid goitrous women. There was no correlation between thyrotropin and CT in the hypothyroid group. CONCLUSION Positive thyroid antibodies in goitrous patients do not predispose to hypercalcitoninemia. Elevated CT found in a patient with goitre and positive thyroid antibodies should not be ascribed to the underlying thyroiditis; this patient should be investigated for some other cause of the high CT.

[1]  A. Pinchera,et al.  Routine measurement of serum calcitonin in nodular thyroid diseases allows the preoperative diagnosis of unsuspected sporadic medullary thyroid carcinoma. , 1994, The Journal of clinical endocrinology and metabolism.

[2]  K. Molberg,et al.  Physiologic versus neoplastic C‐cell hyperplasia of the thyroid: Separation of distinct histologic and biologic entities , 1996, Cancer.

[3]  H. Imura,et al.  THYROTROPHIN RELEASING HORMONE INDUCED CALCITONIN SECRETION IN PATIENTS WITH MEDULLARY CARCINOMA OF THE THYROID , 1987, Clinical endocrinology.

[4]  M. Nadji,et al.  C-cell hyperplasia in thyroid tissue adjacent to follicular cell tumors. , 1988, Human pathology.

[5]  M. Brennan,et al.  Symptomatic C-cell hyperplasia associated with chronic lymphocytic thyroiditis. , 1991, The American journal of surgical pathology.

[6]  C. Fenoglio-Preiser,et al.  Endocrine changes associated with the human aging process: III. Effect of age on the number of calcitonin immunoreactive cells in the thyroid gland. , 1985, Human pathology.

[7]  V. Livolsi C cell hyperplasia/neoplasia. , 1997, The Journal of clinical endocrinology and metabolism.

[8]  O. Clark,et al.  Iodine deficiency produces hypercalcemia and hypercalcitonemia in rats. , 1978, Surgery.

[9]  B. Caillou,et al.  Construction and clinical validation of a sensitive and specific assay for serum mature calcitonin using monoclonal anti-peptide antibodies. , 1988, Clinica chimica acta; international journal of clinical chemistry.

[10]  T. Tomita,et al.  C‐cell hyperplasia in secondary hyperparathyroidism , 1992, Histopathology.

[11]  K. E. Schwartz,et al.  Calcitonin in nonthyroidal cancer. , 1979, The Journal of clinical endocrinology and metabolism.

[12]  M. Rieu,et al.  Prevalence of sporadic medullary thyroid carcinoma: the importance of routine measurement of serum calcitonin in the diagnostic evaluation of thyroid nodules , 1995, Clinical endocrinology.

[13]  P. Caron,et al.  Interest of routine measurement of serum calcitonin: study in a large series of thyroidectomized patients. The French Medullary Study Group. , 1997, The Journal of clinical endocrinology and metabolism.

[14]  R. Gagel,et al.  The goitrous patient with an elevated serum calcitonin--what to do? , 1997, The Journal of clinical endocrinology and metabolism.

[15]  J. Tucci,et al.  C-cell hyperplasia of the thyroid in a patient with goitrous hypothyroidism and Hashimoto's thyroiditis. , 1989, The American journal of surgical pathology.

[16]  V. Livolsi,et al.  Demonstration by immunoperoxidase staining of hyperplasia of parafollicular cells in the thyroid gland in hyperparathyroidism. , 1973, The Journal of clinical endocrinology and metabolism.

[17]  J. Albores–Saavedra C-cell hyperplasia. , 1989, The American journal of surgical pathology.

[18]  S. Yokoyama,et al.  An Immunohistochemical Study of Calcitonin–containing Cells in Benign and Malignant Thyroid Lesions , 1990, Acta pathologica japonica.

[19]  R. Perdrisot,et al.  Thyroïdite chronique auto-immune et hyperplasie des cellules C. Etude de la sécrétion de calcitonine chez 24 patients. , 1991 .

[20]  S. C. Garner,et al.  Hypercalcitoninism and C-cell hyperplasia in rats with goiters produced by a low iodine diet or propylthiouracil. , 1978, The Journal of pharmacology and experimental therapeutics.

[21]  A. Pinchera,et al.  Expression of thyrotropin receptor (TSH-R), thyroglobulin, thyroperoxidase, and calcitonin messenger ribonucleic acids in thyroid carcinomas: evidence of TSH-R gene transcript in medullary histotype. , 1994, The Journal of clinical endocrinology and metabolism.

[22]  B. Croker,et al.  Age-associated C-cell hyperplasia in the human thyroid. , 1982, The American journal of pathology.

[23]  J. Holst,et al.  C-cell hyperplasia accompanying thyroid diseases other than medullary carcinoma: an immunocytochemical study by means of antibodies to calcitonin and somatostatin. , 1991, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[24]  L. Weiss,et al.  Medullary carcinoma arising in a thyroid with Hashimoto's disease. , 1983, American journal of clinical pathology.