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人类免疫缺陷病毒感染与甲状腺

Human immunodeficiency virus infection and the thyroid.

作者信息

Koutkia Polyxeni, Mylonakis Eleftherios, Levin Robert M

机构信息

Section of Endocrinology, Diabetes and Nutrition, Boston University Medical Center, Boston, Massachusetts 02118, USA.

出版信息

Thyroid. 2002 Jul;12(7):577-82. doi: 10.1089/105072502320288429.

Abstract

Abnormalities of thyroid function are associated with a number of systemic conditions, including patients infected with human immunodeficiency virus (HIV). Most patients with early HIV infection and a stable body weight have normal thyroid function. Subtle abnormalities of a number of thyroid function tests have been reported during the early asymptomatic phase of HIV disease. These include an inappropriately normal triiodothyronine (T(3)) and reduced reverse triiodothyronine (rT(3)), and increased thyroxine-binding globulin (TBG) levels. Opportunistic infections involving the thyroid gland, neoplasms such as lymphoma and Kaposi's sarcoma, and medications can alter the thyroid function in individuals with more advanced HIV infection. If thyroid dysfunction is diagnosed in an HIV-infected patient, it should be treated in the usual manner. However, high index of suspicion and caution in the interpretation of thyroid function tests in patients with HIV disease are needed for optimal diagnosis and treatment.

摘要

甲状腺功能异常与多种全身性疾病相关,包括感染人类免疫缺陷病毒(HIV)的患者。大多数早期HIV感染且体重稳定的患者甲状腺功能正常。在HIV疾病的早期无症状阶段,已报告多项甲状腺功能检查存在细微异常。这些异常包括三碘甲状腺原氨酸(T(3))水平异常正常、反三碘甲状腺原氨酸(rT(3))降低以及甲状腺素结合球蛋白(TBG)水平升高。涉及甲状腺的机会性感染、淋巴瘤和卡波西肉瘤等肿瘤以及药物可改变HIV感染更严重患者的甲状腺功能。如果在HIV感染患者中诊断出甲状腺功能障碍,应以常规方式进行治疗。然而,为了实现最佳诊断和治疗,对于HIV疾病患者的甲状腺功能检查结果,需要高度怀疑并谨慎解读。

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