College of Physicians and Surgeons, Columbia University Medical Center, New York.
Department of Psychiatry, New York State Psychiatric Institute, New York.
Int J Eat Disord. 2015 Nov;48(7):932-5. doi: 10.1002/eat.22420. Epub 2015 May 6.
Anorexia nervosa (AN) is typically associated with altered thyroid function tests, notably a low total and free T3 , and lower, but within normal range, free T4 and TSH. A 16-year-old girl with a four-year history of AN presented with elevated TSH that fluctuated with changes in weight. TSH was within normal limits (1.7-3.64 mIU/L) following periods of weight loss and elevated with weight gain (5.9-21.66 mIU/L). Antithyroperoxidase antibodies were markedly elevated, suggesting chronic Hashimoto's thyroiditis. Of note, the elevated TSH that would be expected in Hashimoto's thyroiditis was blunted by weight loss associated with AN. Physicians should be aware that AN may contribute to masking thyroid abnormalities in Hashimoto's thyroiditis.
神经性厌食症（AN）通常与甲状腺功能改变有关，尤其是总 T3 和游离 T3 降低，游离 T4 和 TSH 正常但偏低。一名 16 岁女孩患有四年神经性厌食症，表现为 TSH 升高，且随体重变化而波动。当体重减轻时，TSH 处于正常范围内（1.7-3.64 mIU/L），而当体重增加时则升高（5.9-21.66 mIU/L）。抗甲状腺过氧化物酶抗体明显升高，提示慢性桥本甲状腺炎。值得注意的是，由于 AN 导致的体重减轻掩盖了桥本甲状腺炎中预期会升高的 TSH。医生应注意到，AN 可能会导致桥本甲状腺炎中的甲状腺异常被掩盖。
