风湿和自身免疫性甲状腺疾病：因果关系还是偶然关系？

Rheumatic and autoimmune thyroid disorders: a causal or casual relationship?

出版信息

Autoimmun Rev. 2015 Jan;14(1):57-63. doi: 10.1016/j.autrev.2014.10.007.

DOI:10.1016/j.autrev.2014.10.007

Abstract

A number of dysfunctions may affect the thyroid gland leading either to hyper- or hypothyroidism which are mediated by autoimmune mechanisms. Thyroid abnormalities may represent an isolated alteration or they may be the harbinger of forthcoming disorders as is the case of well-characterized polyendocrine syndromes. Also, they may precede or follow the appearance of rheumatic manifestations in patients affected with connective tissue diseases or rheumatoid arthritis. The mechanisms by which autoimmune thyroid disorders may be linked to systemic autoimmune diseases have not been fully unraveled yet, however alterations of common pathways are suggested by shared genetic variants affecting autoantigen presentation and regulation of the immune response. On the other hand, the higher prevalence of autoimmune thyroid disorders over rheumatic diseases compels the chance of a mere causal concomitancy in the same patient. The aim of our paper is to provide an overview of available data on thyroid involvement in different rheumatic diseases and to go over the main rheumatic manifestations in the context of autoimmune thyroid diseases.

摘要

许多功能障碍可能会影响甲状腺，导致甲状腺功能亢进或甲状腺功能减退，这是由自身免疫机制介导的。甲状腺异常可能是孤立的改变，也可能是即将发生的疾病的先兆，如特征明确的多发性内分泌综合征。此外，在患有结缔组织疾病或类风湿关节炎的患者出现风湿表现之前或之后，它们也可能出现。自身免疫性甲状腺疾病与系统性自身免疫性疾病之间的关联机制尚未完全阐明，然而，影响自身抗原呈递和免疫反应调节的共同途径的遗传变异表明存在共同的改变。另一方面，自身免疫性甲状腺疾病比风湿性疾病更为常见，这使得在同一患者中，两者只是偶然同时存在的可能性更大。我们的论文旨在概述不同风湿性疾病中甲状腺受累的现有数据，并在自身免疫性甲状腺疾病的背景下回顾主要的风湿性表现。