Yamauchi Keishi, Yamada Takashi, Sato Akira, Inazawa Kenzi, Aizawa Toru
Department of Diabetes & Endocrinology, Nagano Red Cross Hospital, Nagano.
Intern Med. 2010;49(4):267-71. doi: 10.2169/internalmedicine.49.2154. Epub 2010 Feb 15.
We undertook an investigation on the frequency and magnitude of elevated serum immunoglobulin G (IgG), and effects of treatment with L-thyroxine (T(4)) in patients with Hashimoto's thyroiditis.
Ninety-seven consecutive cases of Hashimoto's thyroiditis, 104 patients with simple goiter, and 75 normal subjects were analyzed retrospectively. Serum total T(4), thyroid stimulating hormone (TSH), microsomal hemagglutination antibody (MHA) titer, and IgG were determined in all subjects.
IgG was significantly elevated in patients with Hashimoto's thyroiditis as a group, and elevation above the upper limit of the normal range was found mostly in patients with hypothyroidism. There is a significant negative correlation between serum total T(4) and IgG, and a significant positive correlation between TSH and IgG in patients with Hashimoto's thyroiditis. In addition, MHA titer was positively correlated with serum IgG. In a longitudinal analysis of hypothyroid patients with Hashimoto's thyroiditis, restoration of euthyroidism by L-T(4) administration was associated with a consistent decrease in serum IgG.
Serum IgG concentration is increased in patients with Hashimoto's thyroiditis, particularly in hypothyroid patients, and treatment with L-T(4) in such patients lowers IgG levels.
我们对桥本甲状腺炎患者血清免疫球蛋白G（IgG）升高的频率和幅度以及左甲状腺素（T4）治疗的效果进行了调查。
回顾性分析了97例连续的桥本甲状腺炎患者、104例单纯性甲状腺肿患者和75名正常受试者。测定了所有受试者的血清总T4、促甲状腺激素（TSH）、微粒体血凝抗体（MHA）滴度和IgG。
桥本甲状腺炎患者作为一个群体，IgG显著升高，且高于正常范围上限的情况大多出现在甲状腺功能减退患者中。在桥本甲状腺炎患者中，血清总T4与IgG之间存在显著负相关，TSH与IgG之间存在显著正相关。此外，MHA滴度与血清IgG呈正相关。在对桥本甲状腺炎甲状腺功能减退患者的纵向分析中，通过给予L-T4恢复甲状腺功能正常与血清IgG持续下降相关。
桥本甲状腺炎患者血清IgG浓度升高，尤其是甲状腺功能减退患者，此类患者用L-T4治疗可降低IgG水平。
