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Detection of enterovirus in the thyroid tissue of patients with graves' disease

We so often wonder what causes our disorders/diseases. Here is a paper with a tantalising glimpse of what might be behind Graves disease. Certainly it is still speculation but there does seem to be some hard evidence to suggest they could be onto something.

J Med Virol. 2012 Dec 21. doi: 10.1002/jmv.23476. [Epub ahead of print]

Detection of enterovirus in the thyroid tissue of patients with graves' disease.

Hammerstad SS, Tauriainen S, Hyöty H, Paulsen T, Norheim I, Dahl-Jørgensen K.


The Hormone Laboratory, Oslo University Hospital-Aker, Oslo, Norway; Department of Endocrinology, Oslo University Hospital-Aker, Oslo, Norway. .


The etiology and pathogenesis of Graves' disease (GD) are still unknown, although it is thought that both genetic and environmental factors are important. Some indirect evidence implies that a viral infection may be a possible etiologic factor in autoimmunity. The main objective of this study was to examine direct evidence of the presence of enteroviruses (EVs) in the thyroid tissue of patients with GD. Thyroid tissue from 22 patients with newly diagnosed GD was obtained by core needle biopsy, while tissue from 24 patients with chronic GD and 24 control subjects without any autoimmune thyroid diseases was collected during neck surgery. Formalin-fixed, paraffin-embedded thyroid tissue samples were examined for the presence of enterovirus capsid protein using immunohistochemistry and for enterovirus RNA using in situ hybridization. Enterovirus capsid protein was detected in 17 (37%) patients and in 4 (17%) control subjects (P?=?0.103). Enterovirus RNA was identified in thyroid tissue from nine (20%) patients, but in none of the control subjects (P?=?0.016). Eight (90%) of the nine virus RNA positive patients were also positive for enterovirus protein. This is the first study to analyze thyroid tissue for EVs, including patients with untreated, newly diagnosed GD. The results suggest that EVs are more frequently present in thyroid tissue of patients than controls. Further studies are indicated to explore this association to find out if a low-grade chronic enteroviral infection might be involved in the pathogenesis of GD and if this could offer new therapeutic and preventive opportunities. J. Med. Virol. © 2012 Wiley Periodicals, Inc.

Copyright © 2012 Wiley Periodicals, Inc.




As we are not all virologists with wonderful understanding of these things, thought I'd try to add a bit of explanation. Wiki has this to say about enteroviiruses:

Enteroviruses are a genus of positive-sense single-stranded RNA viruses associated with several human and mammalian diseases. Serologic studies have distinguished 66 human enterovirus serotypes on the basis of antibody neutralization tests. Additional antigenic variants have been defined within several of the serotypes on the basis of reduced or nonreciprocal cross-neutralization between variant strains. On the basis of their pathogenesis in humans and animals, the enteroviruses were originally classified into four groups, polioviruses, Coxsackie A viruses (CA), Coxsackie B viruses (CB), and echoviruses, but it was quickly realized that there were significant overlaps in the biological properties of viruses in the different groups. Enteroviruses isolated more recently are named with a system of consecutive numbers: EV68, EV69, EV70, and EV71, etc.

Enteroviruses affect millions of people worldwide each year, and are often found in the respiratory secretions (e.g., saliva, sputum, or nasal mucus) and stool of an infected person. Historically, poliomyelitis was the most significant disease caused by an enterovirus, poliovirus. There are 62 non-polio enteroviruses that can cause disease in humans: 23 Coxsackie A viruses, 6 Coxsackie B viruses, 28 echoviruses, and 5 other enteroviruses. Poliovirus, as well as coxsackie and echovirus are spread through the fecal-oral route. Infection can result in a wide variety of symptoms ranging from mild respiratory illness (common cold), hand, foot and mouth disease, acute hemorrhagic conjunctivitis, aseptic meningitis, myocarditis, severe neonatal sepsis-like disease, and acute flaccid paralysis

<more by following link>



Picture is of the structure of a bovine enterovirus.

7 Replies

That is really interesting. I have read of speculation that a viral infection may precipitate rheumatoid arthritis in some cases (my ?RA appeared shortly after a particularly bad bout of 'flu, which is why I looked into it) and the Epstein Barr virus possibly being responsible for all kinds of things of that ilk. But that was all speculation. I wish I could remember more about it, but that was 3 years and much brain-fog ago.

Very interesting paper and thanks for posting it :)

Carolyn x


Might also have some relationship to Sjogren;'s Syndrome.



Curiouser and curiouser! This is all quite intriguing and I would love to understand the mechanism behind it all. More reading for me then :D


Does anyone know if glandular fever is an enterovirus? I mention this because I read somewhere that having had this is quite common in autoimmune under active thyroid sufferers including myself and my brother who now has rheumatoid arthritis (but not thyroid issues).

Very interesting, thanks!


I think not (but only from brief searches) - but there is indeed quite a lot of suspicion over Epstein-Barr virus as well.


I've just done a quick search myself which suggests that glandular fever one of the illnesses caused by the Epstein Barr virus so am now more confused but thanks for responding!


Very interesting reading, When i was twelve i had the oral polio vaccine as lots of other kids did in the late fifties but i had a severe reaction to it and passed out about an hour after taking it, i felt very unwell afterwards too. I developed Graves Disease 22years later. Is there a link there, who knows, but its interesting in the light of this article.


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