Hashimoto's thyroiditis, role of antibodies, contradiction between RR/Pathoma

[alternatego]

Hey guys, tried searching the forums for an answer but couldn't find any...

RR states that antimicrosomal and antithyroglobulin antibodies are part of the mechanism that "destroys parenchyma (type II HSR)", while in Pathoma, Dr. Sattar especifically states in his thyroid lecture that those antibodies are MARKERS of thyroid damage due to the type IV HSR destruction of parenchyma, but do NOT play a role in the disease.

Which one is correct?

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[Phlame217]

The disease is initiated by a type 4 rxn which exposes sequestered antigens to the immune system. You then develope said antibodies to these antigens. Typically by this point a lot of damage is done but the antibodies are capable of initiating a type 2 rxn and furthering the damage.

Straight from the mouth of the horse (sitting in Goljan's board review right now)