三名原发性甲状腺功能减退症患者血清中同时存在刺激型和阻断型促甲状腺激素受体抗体。

Presence of both stimulating and blocking types of TSH-receptor antibodies in sera from three patients with primary hypothyroidism.

作者信息

Kasagi K, Takeda K, Goshi K, Takamatsu J, Hidaka A, Hatabu H, Misaki T, Iida Y, Kuma K, Konishi J

机构信息

Department of Nuclear Medicine, Kyoto University, Japan.

出版信息

Clin Endocrinol (Oxf). 1990 Feb;32(2):253-60. doi: 10.1111/j.1365-2265.1990.tb00861.x.

DOI:10.1111/j.1365-2265.1990.tb00861.x

PMID:1971776

Abstract

A case report of three patients with primary hypothyroidism who had potent TSH-binding inhibitor immunoglobulins (TBII) and both thyroid stimulating (TSAb) and thyroid stimulation-blocking antibodies (TSBAb) has been described. Two patients displayed symptoms and signs indistinguishable from those in primary myxoedema (cases 1 and 2), and another patient had a history of Graves' disease (case 3). TBII, TSAb and TSBAb activities were 90.0, 1084.2 and 94.5% in case 1, 91.5, 826.6 and 95.8% in case 2, 76.0, 230.0 and 95.0% in case 3, respectively (normal range, less than 11.0%, less than 145.0 and less than 22.0%, respectively. The results indicate that both stimulating and blocking types of TSH-receptor antibodies exist in these patients. The possible mechanism whereby hypothyroidism developed has been discussed.

摘要

本文描述了3例原发性甲状腺功能减退患者的病例报告，这些患者体内存在强效促甲状腺激素结合抑制性免疫球蛋白（TBII）以及甲状腺刺激抗体（TSAb）和甲状腺刺激阻断抗体（TSBAb）。其中2例患者表现出与原发性黏液性水肿难以区分的症状和体征（病例1和病例2），另1例患者有格雷夫斯病病史（病例3）。病例1中TBII、TSAb和TSBAb的活性分别为90.0%、1084.2%和94.5%；病例2中分别为91.5%、826.6%和95.8%；病例3中分别为76.0%、230.0%和95.0%（正常范围分别为低于11.0%、低于145.0%和低于22.0%）。结果表明，这些患者体内同时存在刺激性和阻断性的促甲状腺激素受体抗体。文中还讨论了甲状腺功能减退发生的可能机制。