van der Gaag R D, Drexhage H A, Dussault J H
Lancet. 1985 Feb 2;1(8423):246-50. doi: 10.1016/s0140-6736(85)91028-1.
Among 34 mothers of infants with sporadic congenital hypothyroidism detected in the Quebec screening programme, 15 had immunoglobulins blocking thyroid growth induced by thyroid-stimulating hormone (TSH) when tested in the sensitive Feulgen cytochemical bioassay. At the time of delivery all the mothers were clinically and biochemically euthyroid, and in general the growth-blocking immunoglobulins were found in the absence of thyroid antimicrosomal antibodies. 2 mothers, however, had significant titres of antimicrosomal antibodies. They became hypothyroid 1 and 3 years after delivery. 8 of 16 post-partum infant blood samples were positive for immunoglobulins blocking TSH-induced thyroid growth. 4 of 7 positive mothers tested up to 3 years after delivery had become negative, thus indicating a trend for these immunoglobulins to disappear from the maternal circulation. Thus, transplacental passage of maternal immunoglobulins influencing TSH-induced processes of thyroid growth may play a part in the pathogenesis of sporadic congenital hypothyroidism.
在魁北克筛查项目中检测出的34名散发性先天性甲状腺功能减退症患儿的母亲中，有15名母亲在灵敏的福尔根细胞化学生物测定中检测出存在阻断促甲状腺激素（TSH）诱导的甲状腺生长的免疫球蛋白。分娩时所有母亲的临床和生化检查均显示甲状腺功能正常，并且一般来说，在没有甲状腺微粒体抗体的情况下发现了生长阻断免疫球蛋白。然而，有2名母亲的微粒体抗体滴度很高。她们在分娩后1年和3年出现甲状腺功能减退。16份产后婴儿血样中有8份检测出存在阻断TSH诱导的甲状腺生长的免疫球蛋白。7名呈阳性的母亲中，有4名在分娩后长达3年的检测中转为阴性，这表明这些免疫球蛋白有从母体循环中消失的趋势。因此，影响TSH诱导的甲状腺生长过程的母体免疫球蛋白经胎盘传递可能在散发性先天性甲状腺功能减退症的发病机制中起作用。
