Inoue G, Sakurai T, Tanaka K, Akamizu T, Masuzaki H, Hosoda K, Hayashi T, Yoshimasa Y, Nakao K
Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Shogoin.
Intern Med. 2001 Jun;40(6):515-8. doi: 10.2169/internalmedicine.40.515.
A 24-year-old female suffered from acute pancreatitis, followed by simultaneous onset of painless goiter, elevation of thyroid hormones and diabetic ketoacidosis. Two months later, her insulin secreting function was severely decreased and positive for anti-GAD and anti-islet cell antibodies, whereas the serum glucagon level was normal, suggesting an autoimmune-related destruction specifically of beta cells. In addition, the initial hyperthyroid state was followed by a hypothyroid phase which later recovered to an euthyroid state, suggesting an initial destruction of thyroid cells. Because anti-thyroidal antibodies were positive, it is likely that the thyroidal destruction was also autoimmune-related. This case implies common pathogenic mechanisms in the autoimmunity related destruction of beta cells and thyroid cells.
一名24岁女性患急性胰腺炎，随后同时出现无痛性甲状腺肿、甲状腺激素升高和糖尿病酮症酸中毒。两个月后，她的胰岛素分泌功能严重下降，抗谷氨酸脱羧酶抗体和抗胰岛细胞抗体呈阳性，而血清胰高血糖素水平正常，提示存在特异性针对β细胞的自身免疫相关破坏。此外，最初的甲状腺功能亢进状态之后出现了甲状腺功能减退阶段，随后恢复到甲状腺功能正常状态，提示甲状腺细胞最初受到破坏。由于抗甲状腺抗体呈阳性，甲状腺破坏很可能也与自身免疫有关。该病例提示β细胞和甲状腺细胞自身免疫相关破坏存在共同的致病机制。
