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亚急性甲状腺炎后出现甲状腺功能减退,随后发展为伴有眼病的格雷夫斯病患者体内甲状腺刺激激素受体抗体的存在:一例报告

Presence of Thyroid-Stimulating Hormone Receptor Antibodies in a Patient with Subacute Thyroiditis followed by Hypothyroidism and Later Graves' Disease with Ophthalmopathy: A Case Report.

作者信息

Hallengren Bengt, Planck Tereza, Åsman Peter, Lantz Mikael

机构信息

Department of Endocrinology, Skåne University Hospital, Malmö, Sweden ; Department of Clinical Sciences, Lund University, Lund, Sweden.

Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden ; Department of Clinical Sciences, Lund University, Lund, Sweden.

出版信息

Eur Thyroid J. 2015 Sep;4(3):197-200. doi: 10.1159/000435915. Epub 2015 Jul 18.

Abstract

BACKGROUND

The development of Graves' disease (GD) after subacute thyroiditis (SAT) is very rare and only a limited number of cases have been reported.

OBJECTIVES

Here, we report a patient with SAT followed by hypothyroidism and later GD, with ophthalmopathy, occurring 11 years after SAT.

CONCLUSION

This case illustrates the appearance of thyroid-stimulating hormone (TSH) receptor antibodies in a female 1 year after SAT, the development of hypothyroidism requiring thyroxine, and later the occurrence of GD with severe ophthalmopathy, 11 years after SAT. The occurrence of SAT and GD may be coincidental but SAT may have induced the appearance of TSH-receptor antibodies, with the bioactivity changing from blocking, leading to hypothyroidism, and later to a stimulating activity that led to GD in a genetically susceptible patient.

摘要

背景

亚急性甲状腺炎(SAT)后发生格雷夫斯病(GD)非常罕见,仅有少数病例报道。

目的

在此,我们报告1例SAT患者,随后出现甲状腺功能减退,之后在SAT发生11年后出现伴有眼病的GD。

结论

该病例表明,女性患者在SAT 1年后出现促甲状腺激素(TSH)受体抗体,出现需要甲状腺素治疗的甲状腺功能减退,随后在SAT发生11年后出现伴有严重眼病的GD。SAT和GD的发生可能是巧合,但SAT可能诱发了TSH受体抗体的出现,其生物活性从阻断性转变为导致甲状腺功能减退,随后转变为刺激性活性,从而在具有遗传易感性的患者中导致GD。

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本文引用的文献

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Graves' disease following subacute thyroiditis.亚急性甲状腺炎后 Graves 病。
Tohoku J Exp Med. 2011 Dec;225(4):301-9. doi: 10.1620/tjem.225.301.

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