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接受全甲状腺切除术后患者甲状腺相关眼病的发生情况

Development of Thyroid-Associated Ophthalmopathy in Patients Who Underwent Total Thyroidectomy.

作者信息

Jang Sun Young, Lee Ka Hyun, Oh Jong Rok, Kim Bo Yeon, Yoon Jin Sook

机构信息

Department of Ophthalmology, Soonchunhyang Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea.

出版信息

Yonsei Med J. 2015 Sep;56(5):1389-94. doi: 10.3349/ymj.2015.56.5.1389.

Abstract

PURPOSE

To report clinical characteristics of thyroid-associated ophthalmopathy (TAO) in patients who previously underwent total thyroidectomy for thyroid cancer or a benign mass of the thyroid.

MATERIALS AND METHODS

Of the patients who were diagnosed with TAO from March 2008 to March 2012, we performed a retrospective chart review on those who had undergone total thyroidectomy for thyroid cancer or a benign mass of the thyroid before the occurrence of ophthalmopathy.

RESULTS

Of the 206 patients diagnosed with TAO, seven (3.4%) met the inclusion criteria. The mean age of the subjects was 47.4 years, and all were female. Six patients were diagnosed with papillary thyroid cancer, and one was diagnosed with a benign mass. The duration between total thyroidectomy and onset of TAO ranged from 3-120 months (median 48 months). Ophthalmic manifestations varied among cases. Except for the patient who was diagnosed with a benign mass, all patients showed hyperthyroid status and were under Synthroid hormone treatment at the time of TAO development. Five of these six patients had positive levels of thyroid-stimulating hormone (TSH) receptor autoantibodies.

CONCLUSION

TAO rarely develops after total thyroidectomy, and the mechanism of TAO occurrence is unclear. However, most patients showed abnormalities in thyroid function and TSH receptor autoantibodies.

摘要

目的

报告曾因甲状腺癌或甲状腺良性肿块接受全甲状腺切除术的患者的甲状腺相关眼病(TAO)的临床特征。

材料与方法

在2008年3月至2012年3月期间被诊断为TAO的患者中,我们对那些在眼病发生前因甲状腺癌或甲状腺良性肿块接受全甲状腺切除术的患者进行了回顾性病历审查。

结果

在206例被诊断为TAO的患者中,7例(3.4%)符合纳入标准。受试者的平均年龄为47.4岁,均为女性。6例患者被诊断为甲状腺乳头状癌,1例被诊断为良性肿块。全甲状腺切除术后至TAO发病的时间间隔为3 - 120个月(中位数48个月)。不同病例的眼部表现各异。除了被诊断为良性肿块的患者外,所有患者在TAO发生时均表现为甲状腺功能亢进状态,并接受左甲状腺素激素治疗。这6例患者中有5例促甲状腺激素(TSH)受体自身抗体水平呈阳性。

结论

全甲状腺切除术后TAO很少发生,TAO发生的机制尚不清楚。然而,大多数患者甲状腺功能和TSH受体自身抗体存在异常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b27/4541672/902d0ea6f939/ymj-56-1389-g001.jpg

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