Department of Pediatrics, University of Messina, Messina, Italy.
Horm Res Paediatr. 2010;73(6):473-6. doi: 10.1159/000313395. Epub 2010 Apr 15.
The development of Graves' disease (GD) from Hashimoto's thyroiditis (HT) has sporadically been reported, but no data are available concerning the prevalence of this sequence of events in GD patients. Our aim was to ascertain HT antecedents in the history of GD children in order to assess for the first time the relative frequency of the event sequence leading from HT to GD in a pediatric population.
In 105/109 patients, no HT antecedents were documented at GD presentation. The remaining 4 patients had previously exhibited a picture of HT with either hypothyroidism or euthyroidism. The interval between HT diagnosis and GD presentation ranged from 1.5 to 2.8 years. Serum thyrotropin receptor antibodies were higher in the patients with no HT antecedents.
In at least 3.7% of the children with GD, hyperthyroidism may be preceded by HT presentation with either hypothyroidism or euthyroidism. The clinical course of GD in these patients is not different from the one observed in those with no HT antecedents. Our report confirms the existence of a continuum between HT and GD within the spectrum of autoimmune thyroid diseases.
从桥本甲状腺炎（HT）发展为格雷夫斯病（GD）的情况时有报道，但关于该序列事件在 GD 患者中的流行程度尚无数据。我们的目的是确定 GD 患儿病史中的 HT 病史，以便首次评估从 HT 到 GD 的事件序列在儿科人群中的相对频率。
在 109 例患者中，105 例在 GD 发病时无 HT 病史。其余 4 例先前曾出现过甲状腺功能减退或甲状腺功能正常的 HT 表现。从 HT 诊断到 GD 发病的间隔时间为 1.5 至 2.8 年。无 HT 病史的患者血清促甲状腺素受体抗体水平更高。
在至少 3.7%的 GD 患儿中，甲状腺功能亢进症可能以前有过甲状腺功能减退或甲状腺功能正常的 HT 表现。这些患者的 GD 临床病程与无 HT 病史的患者不同。我们的报告证实了在自身免疫性甲状腺疾病的范围内，HT 和 GD 之间存在连续体。
