Kostić N, Jelić S, Han R, Ristić S, Bozanić M
Department of Internal medicine, Dr. Dragisa Misović Clinical Hospital Centre, Belgrade.
Srp Arh Celok Lek. 1990 Jul-Aug;118(7-8):303-6.
We investigated the incidence of thyroid auto-antibodies and their relationship to antigastric antibodies in 20 euthyroid patients with pernicious anaemia. To evaluate possible thyroid dysfunction we also measured total level of thyroid hormones (TT3 and TT4) and TSH in our patients. Histologic evidence of autoimmune atrophic gastritis and intestinal metaplasia was obtained in 15 patients. We found that it was surprisingly high incidence of thyroid auto-antibodies in patients with pernicious anaemia, particularly in the group with intestinal metaplasia (antithyreoglobulin antibodies 71% and antimicrosomal antibodies 100%). The incidence of antigastric antibodies in these patients was similar to that of those with significant antithyroid antibodies (16/18). Total triiodo thyronine and TSH were significantly higher in the patients with pernicious anaemia than in the control group (p less than 0.05), in the normal range. The results of our study suggest that this upset in immunological physiology is due to a more generalized defect in immune tolerance.
我们调查了20例患有恶性贫血的甲状腺功能正常患者中甲状腺自身抗体的发生率及其与抗胃抗体的关系。为了评估可能存在的甲状腺功能障碍，我们还检测了这些患者的甲状腺激素总水平（TT3和TT4）以及促甲状腺激素（TSH）。15例患者获得了自身免疫性萎缩性胃炎和肠化生的组织学证据。我们发现，恶性贫血患者中甲状腺自身抗体的发生率出奇地高，尤其是在肠化生组（抗甲状腺球蛋白抗体为71%，抗微粒体抗体为100%）。这些患者中抗胃抗体的发生率与有显著抗甲状腺抗体的患者相似（16/18）。恶性贫血患者的总三碘甲状腺原氨酸和促甲状腺激素在正常范围内显著高于对照组（p<0.05）。我们的研究结果表明，这种免疫生理紊乱是由于免疫耐受方面更广泛的缺陷所致。
