Hunter Area Pathology Service, Hunter Mail Region Centre, Newcastle, New South Wales, Australia.
Endocr Pract. 2010 Jul-Aug;16(4):566-9. doi: 10.4158/EP09359.OR.
To assess the histologic prevalence of immune-mediated thyroid, pituitary, and adrenal diseases in postmortem cases with hepatitis C.
We reviewed 108 consecutive cases of chronic hepatitis C in patients in whom a complete postmortem examination was performed. All microscopic and histologic slides of the thyroid, pituitary, and adrenal reports were reviewed and assessed for evidence of autoimmune diseases. These were compared with a control group of 100 postmortem cases without hepatitis C.
In chronic hepatitis C infection, there is a heightened immune response resulting in many autoimmune diseases. The commonest endocrinopathy in association with this chronic infection is thyroid disease, a finding confirmed in our current study. Among the 108 postmortem cases of hepatitis C, there were 14 cases (13%) with evidence of thyroiditis. No cases of pituitary or adrenal disease were found. The mean age of the patients was 52 years (range, 29 to 68). This frequency compared with 7 cases of thyroid disease (7%) in the control group (no significant difference between the 2 groups).
On the basis of our postmortem data, thyroid disease was the only major endocrinopathy associated with hepatitis C infection, with a prevalence of 13%. This was comparable with other serologic and nonhistologic antemortem findings. There was no evidence of pituitary or adrenal involvement.
评估丙型肝炎死后病例中免疫介导的甲状腺、垂体和肾上腺疾病的组织学流行情况。
我们回顾了 108 例连续的慢性丙型肝炎患者病例，这些患者均进行了完整的死后检查。对所有甲状腺、垂体和肾上腺报告的显微镜和组织学切片进行了审查，并评估了自身免疫性疾病的证据。将这些结果与 100 例无丙型肝炎的死后对照病例进行了比较。
在慢性丙型肝炎感染中，存在增强的免疫反应，导致许多自身免疫性疾病。与这种慢性感染相关的最常见的内分泌疾病是甲状腺疾病，我们目前的研究证实了这一点。在 108 例丙型肝炎死后病例中，有 14 例（13%）有甲状腺炎的证据。未发现垂体或肾上腺疾病。患者的平均年龄为 52 岁（范围为 29 至 68 岁）。这一频率与对照组 7 例甲状腺疾病（7%）相比（两组之间无显著差异）。
根据我们的尸检数据，甲状腺疾病是与丙型肝炎感染相关的唯一主要内分泌疾病，患病率为 13%。这与其他血清学和非组织学生前发现相当。没有证据表明垂体或肾上腺受累。
