Komaki T, Sakata S, Nakamura S, Matsuda M, Kojima N, Miura K
Third Department of Internal Medicine, Gifu University School of Medicine, Japan.
Nihon Naibunpi Gakkai Zasshi. 1989 Jul 20;65(7):615-20. doi: 10.1507/endocrine1927.65.7_615.
We have experienced 3 cases of Hashimoto's thyroiditis with anti-thyroid hormone antibodies. Changes in titers of anti-thyroglobulin(Tg) and anti-thyroid hormone antibodies during 6 year (Cases 1 and 2) and 7 year (Case 3) observation periods were examined in each case. Cases 1 (13-year-old) and 2 (10-year-old) are sisters with hypothyroidism whose chief complaint was short stature. They were diagnosed as having Hashimoto's thyroiditis by needle biopsy of the thyroid gland. Presence of anti-thyroid hormone antibodies were found in the sera of both cases (Case 1: anti-thyroxine(T4) antibodies, Case 2: anti-triiodothyronine(T3) antibodies). They were treated with synthetic T4 or combined therapy of T3 and T4, and serial sera obtained during the 6 year treatment period were tested for the titers of anti-Tg and anti-thyroid hormone antibodies. Case 3 (23-year-old female), who was diagnosed as having Hashimoto's thyroiditis associated with systemic lupus erythematosus (SLE) and Sjögren's syndrome had been treated with prednisolone(PSL) for 8 years. After one year of strating the treatment, she was found to have unusually low serum T3 measured by radioimmunoassay. Further examination revealed the presence of anti-T3 antibodies in her serum. Serial sera obtained during the 7 year observation period were tested for the titers of anti-Tg and anti-T3 antibodies. In cases 1 and 2, replacement therapy with thyroid hormone resulted in the decrease of titers of anti-thyroid hormone antibodies. In addition, increase in serum TSH concentrations was accompanied with increased titers of anti-Tg and anti-thyroid hormone antibodies in all 3 cases. The exact mechanism for it is not clear.(ABSTRACT TRUNCATED AT 250 WORDS)
我们遇到了3例伴有抗甲状腺激素抗体的桥本甲状腺炎病例。对每例患者在6年（病例1和2）和7年（病例3）观察期内抗甲状腺球蛋白（Tg）和抗甲状腺激素抗体滴度的变化进行了检查。病例1（13岁）和病例2（10岁）是姐妹，患有甲状腺功能减退症，主要症状是身材矮小。通过甲状腺穿刺活检诊断为桥本甲状腺炎。两例患者血清中均发现抗甲状腺激素抗体（病例1：抗甲状腺素（T4）抗体，病例2：抗三碘甲状腺原氨酸（T3）抗体）。她们接受了合成T4或T3与T4联合治疗，并对6年治疗期间获得的系列血清进行抗Tg和抗甲状腺激素抗体滴度检测。病例3（23岁女性）被诊断为患有与系统性红斑狼疮（SLE）和干燥综合征相关的桥本甲状腺炎，已接受泼尼松龙（PSL）治疗8年。开始治疗一年后，通过放射免疫测定发现她的血清T3异常低。进一步检查发现她的血清中存在抗T3抗体。对7年观察期内获得的系列血清进行抗Tg和抗T3抗体滴度检测。在病例1和2中，甲状腺激素替代治疗导致抗甲状腺激素抗体滴度下降。此外，在所有3例患者中，血清促甲状腺激素（TSH）浓度升高伴随着抗Tg和抗甲状腺激素抗体滴度升高。其确切机制尚不清楚。（摘要截短至250字）
