亚急性甲状腺炎伴促甲状腺素受体抗体高度阳性及甲状腺放射性碘摄取率增高。

Subacute thyroiditis with highly positive thyrotropin receptor antibodies and high thyroidal radioactive iodine uptake.

作者信息

Fujii Sumie, Miwa Umeo, Seta Takashi, Ohoka Takio, Mizukami Yuji

机构信息

Department of Internal Medicine, Ishikawa Prefectural Central Hospital, Kanazawa.

出版信息

Intern Med. 2003 Aug;42(8):704-9. doi: 10.2169/internalmedicine.42.704.

DOI:10.2169/internalmedicine.42.704

PMID:12924496

Abstract

A 48-year-old woman with transient thyrotoxicosis, having a slightly high thyroidal 99mTc uptake (3.9% at 20 m) or radioactive iodine uptake (RAIU) (17.3% at 4 hour) and subacute thyroiditis (SAT)-like symptoms, signs and histological diagnosis (extensive cellular destruction and granulomatous inflammatory change), showed positive TRAb (59.9%) and TSAb (194%) activity. The high levels of TRAb and slightly high RAIU were still observed after one month of prednisolone treatment. Nine months later, the TRAb and TSAb levels finally normalized and her thyroid function has remained normal since then. We suspect that the slightly high RAIU were due to the presence of both the TRAb and the TSAb and the course of this case might mimic neonatal Graves' disease.

摘要

一名48岁患有短暂甲状腺毒症的女性，甲状腺99mTc摄取率略高（20分钟时为3.9%）或放射性碘摄取率（RAIU）（4小时时为17.3%），伴有亚急性甲状腺炎（SAT）样症状、体征及组织学诊断（广泛的细胞破坏和肉芽肿性炎症改变），其TRAb呈阳性（59.9%）且TSAb活性为194%。泼尼松龙治疗1个月后，仍观察到TRAb水平较高及RAIU略高。9个月后，TRAb和TSAb水平最终恢复正常，此后其甲状腺功能一直保持正常。我们怀疑RAIU略高是由于TRAb和TSAb同时存在，且该病例的病程可能类似新生儿Graves病。