Fiducia M, Lauretta R, Lunghi R, Kyanvash S, Pallotti S
Dipartimento di Fisiopatologia Medica, Policlinico Umberto I, Università degli Studi di Roma, La Sapienza, Roma, Italy.
Minerva Med. 2007 Apr;98(2):95-9.
Aim of the study is a prospective evaluation of the simultaneous presence of antinuclear antibodies (ANA) in patients with Hashimoto's thyroiditis as a sign of a possible occurrence of another autoimmune disease.
Thirty two patients with Hashimoto's thyroiditis have been selected. No other immunological parameters have been used for the selection. All the patients have been submitted to ANA research and to thyroid colour-Doppler ultrasonography. Moreover, subgroups of patients have been submitted to the research of other autoimmunity parameters: 25 patients to AMA (anti-mitochondrial antibodies), ASMA (anti-smooth muscle antibodies), ENA (extractable nuclear antigens) and anti-double stranded-DNA; 7 patients to anti-gastric mucosa; 8 patients to ACA (anti-cardiolipin antibodies) IgM and IgG; 12 patients to rheuma-screen. Twenty five patients were under L-thyroxine therapy at the time of the samples.
Forty-seven percent of the patients were ANA positive. Of them 60% showed a title of 1:40. The most frequent sonography picture was pseudo-nodular (66%) with predominance in ANA negative subgroups (71%) than in ANA positive one (60%). On the basis of all the autoimmune parameters evaluated in every subgroups, 72% of our patients were positive to at least one autoimmunity parameter and/or have an autoimmune disease besides Hashimoto's thyroiditis.
The conclusion is drawn that the patient with Hashimoto's thyroiditis should be considered as an autoimmune patient. Thus, it is necessary to carry out an autoimmune screening with ANA in every new diagnosed patients and to study in depth the familiar and phatological history. Periodical checking of the autoimmune parameters should not be underestimated in these patients.
本研究旨在对桥本甲状腺炎患者同时存在抗核抗体（ANA）进行前瞻性评估，以作为可能发生另一种自身免疫性疾病的标志。
选取了32例桥本甲状腺炎患者。入选时未使用其他免疫参数。所有患者均接受了ANA检测和甲状腺彩色多普勒超声检查。此外，部分患者亚组还接受了其他自身免疫参数检测：25例患者检测抗线粒体抗体（AMA）、抗平滑肌抗体（ASMA）、可提取核抗原（ENA）和抗双链DNA；7例患者检测抗胃黏膜抗体；8例患者检测抗心磷脂抗体（ACA）IgM和IgG；12例患者进行风湿筛查。25例患者在采样时正在接受左甲状腺素治疗。
47%的患者ANA呈阳性。其中60%的患者滴度为1:40。最常见的超声图像为假结节（66%），在ANA阴性亚组中占比更高（71%），高于ANA阳性亚组（60%）。根据各亚组评估的所有自身免疫参数，72%的患者至少对一项自身免疫参数呈阳性和/或除桥本甲状腺炎外还患有自身免疫性疾病。
得出的结论是，桥本甲状腺炎患者应被视为自身免疫性患者。因此，有必要对每例新诊断患者进行ANA自身免疫筛查，并深入研究家族史和病史。对于这些患者，不应低估对自身免疫参数的定期检查。
