Sakata S, Takuno H, Nagai K, Kimata Y, Maekawa H, Yamamoto M, Takeda N, Ochi Y, Miura K
Third Department of Internal Medicine, Gifu University School of Medicine, Japan.
J Endocrinol Invest. 1991 Feb;14(2):123-30. doi: 10.1007/BF03350283.
We report four cases found to have anti-bovine thyrotropin (bTSH) antibodies, two with Hashimoto's thyroiditis and the other two, each with subacute thyroiditis and systemic lupus erythematosus (SLE). The unusually high negative titers of anti-TSH receptor antibodies (Case no. 1, -43.1%; Case no. 2, -34.9%; Case no. 3, -55.2%; Case no. 4, -59.9%) led to the incidental finding of the presence of anti-bovine (bTSH) antibodies in each patient. Case no. 1 was diagnosed to have Hashimoto's thyroiditis and was treated with L-thyroxine (L-T4). With the treatment, serum free T4 (FT4)normalized with a decline in the serum TSH concentration. The other patient diagnosed to have Hashimoto's thyroiditis (Case no. 2) remained euthyroid even without supplemental thyroid hormone therapy and the serum concentrations of FT4 and TSH stayed within the normal range. The third is a case of subacute thyroiditis (Case no. 3) with a typical clinical course of the disease. She had the anti-bTSH antibodies on her first outpatient visit. Serial examination of her sera disclosed the antibody titers to be on the same range over the 28 months after the onset of the symptoms. The fourth is a patient with SLE who had been treated with steroid (alternative day therapy of 40 mg/day prednisolone). Titers of the anti-bTSH antibodies spontaneously declined to the negative level 5 months later. None of the four cases had antibodies against human TSH alpha-subunit of bovine LH and alpha-subunit of bovine FSH.(ABSTRACT TRUNCATED AT 250 WORDS)
我们报告了4例被发现存在抗牛促甲状腺激素(bTSH)抗体的病例,其中2例患有桥本甲状腺炎,另外2例分别患有亚急性甲状腺炎和系统性红斑狼疮(SLE)。抗促甲状腺激素受体抗体异常高的阴性滴度(病例1,-43.1%;病例2,-34.9%;病例3,-55.2%;病例4,-59.9%)导致在每位患者中意外发现了抗牛(bTSH)抗体的存在。病例1被诊断为桥本甲状腺炎,并接受了左甲状腺素(L-T4)治疗。随着治疗,血清游离T4(FT4)恢复正常,血清促甲状腺激素浓度下降。另一名被诊断为桥本甲状腺炎的患者(病例2)即使未接受补充甲状腺激素治疗仍维持甲状腺功能正常,FT4和促甲状腺激素的血清浓度保持在正常范围内。第三例是亚急性甲状腺炎患者(病例3),具有该病典型的临床病程。她在首次门诊就诊时就检测出抗bTSH抗体。对其血清的系列检查显示,在症状出现后的28个月内抗体滴度保持在相同范围内。第四例是一名患有SLE的患者,曾接受类固醇治疗(泼尼松龙40mg/天隔日疗法)。5个月后,抗bTSH抗体滴度自发下降至阴性水平。这4例患者均未检测到针对人促甲状腺激素α亚基、牛促黄体生成素α亚基和牛促卵泡激素α亚基的抗体。(摘要截选至250字)