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多种自身免疫性疾病、1型糖尿病(T1DM)、自身免疫性甲状腺炎与甲状腺癌:它们之间有关联吗?一例病例报告及文献综述。

Multiple autoimmunity, type 1 diabetes (T1DM), autoimmune thyroiditis and thyroid cancer: is there an association? A case report and literature review.

作者信息

Karavanaki Kyriaki, Karayianni Christina, Vassiliou Ioannis, Tzanela Marinella, Sdogou Triantafyllia, Kakleas Kostas, Tsentidis Charalambos, Vakaki Marina, Soldatou Alexandra, Kallinikou Dimitra, Kostaki Maria, Tsitsopoulos Stathis, Papathanasiou Asteroula

出版信息

J Pediatr Endocrinol Metab. 2014 Sep;27(9-10):1011-6. doi: 10.1515/jpem-2013-0370.

Abstract

Type 1 diabetes mellitus (T1DM) is characterized by selective autoimmune destruction of pancreatic b-cells, resulting in insulin deficiency. Associated autoimmune disorders, such as celiac disease, autoimmune thyroiditis, and gastritis, can coexist in patients with T1DM. These disorders are characterized by the presence of antibodies against tissue transglutaminase (anti-tTG-IgA), thyroglobulin, and thyroid peroxidase (anti-TG, anti-TPO), as well as antibodies against gastric parietal cells. Children with T1DM may also develop organ-specific multiple autoimmunity, with the coexistence of one or more autoimmune disorders. Furthermore, there is a lot of controversy regarding the role of thyroid autoimmunity in the pathogenesis of thyroid cancer. We present a child with T1DM and multiple autoimmunity including autoimmune Hashimoto's thyroiditis (HT), who developed thyroid cancer. The literature on the prevalence of associated autoimmunity in children with T1DM and the prevalence, pathogenesis, and timely diagnosis of thyroid cancer among patients with HT is also reviewed.

摘要

1型糖尿病(T1DM)的特征是胰腺β细胞发生选择性自身免疫性破坏,导致胰岛素缺乏。相关的自身免疫性疾病,如乳糜泻、自身免疫性甲状腺炎和胃炎,可与T1DM患者共存。这些疾病的特征是存在抗组织转谷氨酰胺酶抗体(抗tTG-IgA)、甲状腺球蛋白和甲状腺过氧化物酶抗体(抗TG、抗TPO),以及抗胃壁细胞抗体。患有T1DM的儿童也可能发生器官特异性多重自身免疫,同时存在一种或多种自身免疫性疾病。此外,关于甲状腺自身免疫在甲状腺癌发病机制中的作用存在很多争议。我们报告一名患有T1DM和包括自身免疫性桥本甲状腺炎(HT)在内的多重自身免疫的儿童,该儿童患了甲状腺癌。本文还综述了T1DM儿童相关自身免疫的患病率以及HT患者中甲状腺癌的患病率、发病机制和早期诊断的相关文献。

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