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[特纳综合征患者的慢性自身免疫性甲状腺炎]

[Chronic autoimmune thyroiditis in patients with Turner's syndrome].

作者信息

Dumić M, Filipović-Grcić B, Crnojević-Ivanusić R, Vlatković M, Ille J, Hitrec V

出版信息

Lijec Vjesn. 1989 Jun-Jul;111(6-7):190-3.

PMID:2796572
Abstract

Studies concerning adult female patients with Turner's syndrome demonstrated that the impairment of the thyroid function is more often found in these patients than in the general female population. This is primarily related to a greater frequency of autoimmune thyroid diseases. Thyroid function was studied in a group of 23 female patients with Turner's syndrome, aged 7 to 24 years. Mean age was 15.6 years. Twelve patients had the karyotype 45X, three had mosaics 45X/46XX, one had the karyotype 45X/47XXX, while 7 had different structural X chromosome anomalies. They were all clinically euthyroid, except one which had plasma thyroxine (T4) values somewhat lower, and three which had plasma thyroid-stimulating hormone (TSH) concentrations somewhat higher than normal levels which could correspond to the so-called "subclinical" or "compensated" hypothyroidism. Elevated thyroid autoantibodies (TAA) were found in nine patients, whereas only two of these patients had goiter, simultaneously. It may perhaps be concluded that in female patients with Turner's syndrome, the atrophic form of autoimmune thyroiditis is more frequent than that associated with goiter (Hashimoto's thyroiditis), the latter being more prevalent in younger age groups in the general population. In view to the possible progression to hypothyreosis and the need for substitution therapy, the necessity of regular thyroid function follow-up especially in patients with positive TAA titers is emphasized. This is particularly important in female patients of younger age who are still in their growth and development period and in whom low thyroid hormone concentrations may lead to even greater growth retardation which is already compromised with the principal disease.

摘要

关于成年特纳综合征女性患者的研究表明,与一般女性人群相比,这些患者中甲状腺功能损害更为常见。这主要与自身免疫性甲状腺疾病的更高发病率有关。对一组年龄在7至24岁之间的23名特纳综合征女性患者的甲状腺功能进行了研究。平均年龄为15.6岁。12名患者的核型为45,X,3名患者为45,X/46,XX嵌合体,1名患者的核型为45,X/47,XXX,而7名患者有不同的X染色体结构异常。除1名患者的血浆甲状腺素(T4)值略低,以及3名患者的血浆促甲状腺激素(TSH)浓度略高于正常水平,可能对应所谓的“亚临床”或“代偿性”甲状腺功能减退外,她们在临床上均甲状腺功能正常。9名患者发现甲状腺自身抗体(TAA)升高,而这些患者中只有2名同时患有甲状腺肿。或许可以得出结论,在特纳综合征女性患者中,自身免疫性甲状腺炎的萎缩型比与甲状腺肿相关的类型(桥本甲状腺炎)更常见,后者在一般人群的年轻年龄组中更为普遍。鉴于可能进展为甲状腺功能减退以及替代治疗的必要性,强调定期进行甲状腺功能随访的必要性,尤其是TAA滴度呈阳性的患者。这在仍处于生长发育期的年轻女性患者中尤为重要,在这些患者中,低甲状腺激素浓度可能导致更大程度的生长发育迟缓,而生长发育迟缓已经因主要疾病而受到影响。

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