Toublanc J E, Grüters A, Bogner U, Fulla Y, Dugue M A
Département de Pédiatrie Générale, Hôpital Saint-Vincent-de-Paul, Paris.
Arch Fr Pediatr. 1991 Feb;48(2):89-94.
Antibody-dependent cell mediated cytotoxicity (ADCC) and thyroid growth immunoglobulin blocking (TGI block) which have been found in autoimmune thyroiditis in adults, as well as TSH receptors binding inhibitory antibodies (TBI ab) and antimicrosomal (Mc ab) and antithyroglobulin (Tg ab) antibodies were search in 42 mothers-infants pairs called at hospital after a positive screening for congenital hypothyroidism. The etiologic diagnoses were: 12 athyreosis, 12 ectopies, 7 anatomically normal glands and 11 transients. Tg ab and Mc ab were measured by commercial hemagglutination tests, TBI ab were determined using a radio ligand assay. ADCC in a 51Cr release assay by human thyroid cells in culture and TGI block by incorporation of 3H-thymidine using the same cells. Results were 38% for TBI ab in infants mainly in patients with dysgenesis without any concordance between mothers and infants. ADCC were found in 24% and TGI block in 24% with respectively mothers-infants concordance of 90% and 84%. Five mothers had autoimmune diseases (2 thyroiditis, 2 Graves' diseases and 1 insulin-dependent diabetes). Beside these rare cases of maternal diseases, the significantly high number of antibodies without any expression in the mothers suggests that autoimmunity plays a role in the etiology of congenital hypothyroidism.
在对先天性甲状腺功能减退症筛查呈阳性后被召至医院的42对母婴中，检测了成人自身免疫性甲状腺炎中发现的抗体依赖性细胞介导的细胞毒性（ADCC）和甲状腺生长免疫球蛋白阻断（TGI阻断），以及促甲状腺激素受体结合抑制性抗体（TBI ab）、抗微粒体（Mc ab）和抗甲状腺球蛋白（Tg ab）抗体。病因诊断为：12例甲状腺缺如、12例异位、7例腺体解剖结构正常和11例暂时性病例。Tg ab和Mc ab通过商业血凝试验检测，TBI ab使用放射性配体测定法测定。通过培养的人甲状腺细胞在51Cr释放试验中检测ADCC，使用相同细胞通过掺入3H-胸腺嘧啶核苷检测TGI阻断。结果显示，婴儿中TBI ab的阳性率为38%，主要见于发育异常患者，母婴之间无一致性。ADCC的阳性率为24%，TGI阻断的阳性率为24%，母婴一致性分别为90%和84%。5名母亲患有自身免疫性疾病（2例甲状腺炎、2例格雷夫斯病和1例胰岛素依赖型糖尿病）。除了这些罕见的母亲疾病病例外，母亲中大量抗体无任何表达，这表明自身免疫在先天性甲状腺功能减退症的病因中起作用。
