University of Southern California-Keck School of Medicine, Jane Anne Nohl Division of Hematology, Norris Comprehensive Cancer Center, Room 3466, 1441 Eastlake Avenue, Los Angeles, CA 90033-0800, USA.
Hematol Oncol Clin North Am. 2009 Dec;23(6):1251-60. doi: 10.1016/j.hoc.2009.08.003.
The literature regarding an association between thyroid disease and immune thrombocytopenic purpura (ITP) suggests that autoimmune thyroid disease is a frequent finding in patients with ITP. A strong association between other systemic autoimmune diseases and autoimmune thyroid diseases is also well documented. Therefore, the combination of autoimmune thyroid disease and ITP could reflect a more significant defect in the immune self-tolerance of these patients compared with those who have primary ITP alone. Such defects may characterize an ITP patient population as more refractory to standard ITP therapy. Screening patients for antithyroid antibodies would identify a patient population at greater risk of developing overt thyroid disease. These patients may be further screened with a thyroid-stimulating hormone assay to detect subclinical thyroid disease.
有关甲状腺疾病与免疫性血小板减少性紫癜(ITP)之间关联的文献表明,自身免疫性甲状腺疾病在 ITP 患者中较为常见。其他系统性自身免疫性疾病与自身免疫性甲状腺疾病之间的强关联也有充分的记录。因此,与仅患有原发性 ITP 的患者相比,自身免疫性甲状腺疾病和 ITP 的合并存在可能反映了这些患者的免疫自身耐受存在更严重的缺陷。这种缺陷可能使 ITP 患者人群对标准 ITP 治疗的反应性更差。对甲状腺抗体进行筛查可以识别出发生显性甲状腺疾病风险较高的患者人群。这些患者可能需要进一步进行促甲状腺激素检测以发现亚临床甲状腺疾病。