Ann Intern Med. 1978 Mar;88(3):379-91.
Thyroid-related autoimmune diseases (Graves' thyroid disease, Graves' ophthalmopathy, and Hashimoto's thyroiditis) may occur alone or in any association. The diagnosis of Hashimoto's thyroiditis requires multiple criteria; pathologic changes in the thyroid are not due to antibodies but may result from cytotoxic lymphocytes or a deficiency of suppressive T cells. In Graves' and Hashimoto's diseases the increased prevalence of HLA-B8 may not be significant, but that of HLA-AW30 in Hashimoto's disease is. In 48 first-degree relatives of patients with Graves' disease, thyroid abnormalities were frequent but not correlated with HLA type. Elevated serum thyroglobulin levels in all patients with hyperthyroidism fell to normal after surgical resection or radioiodine therapy. Patients whose illness recurred after antithyroid drug treatment was stopped had higher pretreatment thyroglobulin levels and no fall during treatment; those whose illness remitted had lower initial levels and a significant fall during treatment. Sodium ipodate lowered serum triiodothyronine and thyroxine levels in hyperthyroid patients and may be useful in the treatment of hyperthyroidism.
甲状腺相关自身免疫性疾病（格雷夫斯病、格雷夫斯眼病和桥本甲状腺炎）可能单独出现或任意组合出现。桥本甲状腺炎的诊断需要多个标准；甲状腺的病理变化并非由抗体引起，而是可能由细胞毒性淋巴细胞或抑制性T细胞缺乏导致。在格雷夫斯病和桥本甲状腺炎中，HLA - B8患病率的增加可能不显著，但桥本甲状腺炎中HLA - AW30的患病率增加是显著的。在48名格雷夫斯病患者的一级亲属中，甲状腺异常很常见，但与HLA类型无关。所有甲亢患者血清甲状腺球蛋白水平在手术切除或放射性碘治疗后降至正常。抗甲状腺药物治疗停止后疾病复发的患者治疗前甲状腺球蛋白水平较高，治疗期间无下降；疾病缓解的患者初始水平较低，治疗期间显著下降。碘番酸钠可降低甲亢患者血清三碘甲状腺原氨酸和甲状腺素水平，可能对甲亢治疗有用。
