[Acid phosphatase of leukocytes in patients with diffuse toxic goiter in evaluating the stage of the disease].

Acid phosphatase (AP) of lymphocytes and neutrophils was examined cytochemically in 23 patients with associated diffuse toxic goiter (DTG) and thyrotoxicosis during thiamazol treatment, in 20 persons with a DTG remission, and in 5 patients with postradiation and postoperative hypothyroses. AP activity with multiple-granule distribution of the enzyme was high in the majority of the patients with thyrotoxicosis, decreasing with thiamazol treatment. Thyrotoxicosis recurred in 4 out of 11 patients whose lymphocytes had an increased amount of AP during a DTG remission. In 9 patients with normal AP content, no relapses were noted during a DTG remission. Two patients with iatrogenic hypothyroses associated with high lymphocytic AP activity manifested elevated titres of antithyroglobulin immunoglobulins (ATI). In 3 patients with normal content of cellular AP, the ATI titre was low. Cellular AP, a non-specific marker of immunogenesis activity, makes it possible to presumably differentiate the stages of DTG and to evaluate to a definite degree the character of a remission. The preserved high activity of lymphocytic AP in patients with a DTG remission is a prognostically unfavourable factor as regards thyrotoxicosis relapses. The high titre of ATI and activity of lymphocytic AP attest to the predominant autoimmune component of such hypothyroses in part of DTG patients. The authors stress that such patients should receive combined thyroid and glucocorticoid therapy.