Bai Y
PUMC Hospital, Beijing.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 1990 Aug;12(4):296-9.
Neurological investigations were performed for 53 cases with chronic lymphocytic thyroiditis diagnosed by pathology and serum antithyroid antibodies determination. Of the 53 cases, 29 had different types and severity with neurological findings, which could be divided into 5 groups: 1) Elevated levels of acetylcholine receptor antibody in 13 cases (24.1%); 2) Myopathy and weakness accompanied by elevated serum enzyme levels (GOT, CPK, LDH and alpha-HBDH) in 7 cases (13%); 3) Peripheral neuropathy in 6 cases (11.1%); 4) Encephalopathy in 2 cases (3.7%); and 5) The changes in sella turcica in 2 cases. Our data showed that the neuropathy was not closely correlated to the duration of chronic lymphocytic thyroiditis and seemed that it had no relation with the thyroid function and titer of antithyroid antibodies. However, neuropathy occurred more often in cases with both chronic lymphocytic thyroiditis and some other autoimmune disorders, suggesting that abnormal immune function might be the common background patients with chronic lymphocytic thyroiditis and neuropathy. The aforementioned data suggest that the hypothyroid function and high titer of antithyroid antibodies might not be a prerequisite for developing neuromyopathies.
对53例经病理及血清抗甲状腺抗体测定确诊为慢性淋巴细胞性甲状腺炎的患者进行了神经学检查。在这53例患者中，29例有不同类型和严重程度的神经学表现，可分为5组：1）13例（24.1%）乙酰胆碱受体抗体水平升高；2）7例（13%）出现肌病和肌无力，同时血清酶水平（谷草转氨酶、肌酸磷酸激酶、乳酸脱氢酶和α-羟丁酸脱氢酶）升高；3）6例（11.1%）出现周围神经病；4）2例（3.7%）出现脑病；5）2例蝶鞍改变。我们的数据显示，神经病变与慢性淋巴细胞性甲状腺炎的病程无密切相关性，似乎与甲状腺功能及抗甲状腺抗体滴度无关。然而，神经病变在同时患有慢性淋巴细胞性甲状腺炎和其他一些自身免疫性疾病的患者中更常发生，提示异常免疫功能可能是慢性淋巴细胞性甲状腺炎和神经病变患者的共同背景。上述数据表明，甲状腺功能减退及抗甲状腺抗体高滴度可能不是发生神经肌肉病变的必要条件。
