Pichler R, Wölfl Soraya, Bogner St, Sulzbacher H, Shamiyeh A, Maschek Wilhelmine
Institut für Nuklearmedizin und Endokrinologie, Allgemeines Krankenhaus Linz, Krankenhausstrasse 9, A-4020 Linz.
Acta Med Austriaca. 2002;29(4):137-40. doi: 10.1046/j.1563-2571.2002.02008.x.
We present the case of a 60-year old woman with painful swelling of the thyroid gland and temporary thyrotoxicosis. 30 years ago she had experienced a period of hyperthyroidism because of Graves' disease. This time thyrotropin-receptor-antibodies were negative, Tc-99 m scan revealed decreased uptake in both lobes (this pattern normalised later on) and fine needle aspiration presented leucocyte infiltration of the thyroid. Three months later hypothyroidism was observed requiring treatment with levothyroxine. The development of subacute thyroiditis and Graves' disease in the same person is rare, autoimmune factors and a possible relationship are discussed.
我们报告了一例60岁女性病例,该患者甲状腺出现疼痛性肿大并伴有短暂性甲状腺毒症。30年前,她曾因格雷夫斯病经历过一段甲亢时期。此次促甲状腺素受体抗体为阴性,锝-99m扫描显示双侧叶摄取减少(这种模式后来恢复正常),细针穿刺显示甲状腺有白细胞浸润。三个月后观察到甲状腺功能减退,需要用左甲状腺素进行治疗。同一人同时发生亚急性甲状腺炎和格雷夫斯病的情况较为罕见,文中讨论了自身免疫因素及可能存在的关系。