Ferrari Silvia Martina, Elia Giusy, Virili Camilla, Centanni Marco, Antonelli Alessandro, Fallahi Poupak
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy.
Front Endocrinol (Lausanne). 2017 Jun 19;8:138. doi: 10.3389/fendo.2017.00138. eCollection 2017.
Most of the studies present in the literature show a high prevalence, and incidence, of new cases of hypothyroidism and autoimmune thyroiditis (AT) in systemic lupus erythematosus (SLE) patients, overall in female gender. A limited number of cases of Graves' disease have been also reported in SLE patients, in agreement with the higher prevalence of thyroid autoimmunity. It has been also demonstrated that a Th1 predominance is associated with AT in SLE patients. Furthermore, a higher prevalence of papillary thyroid cancer has been recently reported in SLE, in particular in the presence of thyroid autoimmunity. However, studies in larger number of SLE patients are needed to confirm findings about thyroid cancer. On the whole, data from literature strongly suggest that female SLE patients, with a high risk (a normal but at the higher limit thyroid-stimulating hormone value, positive antithyroid peroxidase antibodies, a hypoechoic pattern, and small thyroid), should undergo periodic thyroid function follow-up, and appropriate treatments when needed. A careful thyroid monitoring would be opportune during the follow-up of these patients.
文献中呈现的大多数研究表明，系统性红斑狼疮（SLE）患者中，总体而言女性甲状腺功能减退症和自身免疫性甲状腺炎（AT）新病例的患病率和发病率较高。也有少数关于SLE患者发生格雷夫斯病的病例报告，这与甲状腺自身免疫的较高患病率一致。研究还表明，Th1优势与SLE患者的AT相关。此外，最近报告SLE患者中甲状腺乳头状癌的患病率较高，特别是在存在甲状腺自身免疫的情况下。然而，需要对更多SLE患者进行研究以证实关于甲状腺癌的发现。总体而言，文献数据强烈表明，具有高风险（促甲状腺激素值正常但处于较高水平、抗甲状腺过氧化物酶抗体阳性、低回声模式和甲状腺较小）的女性SLE患者应接受定期甲状腺功能随访，并在需要时进行适当治疗。在这些患者的随访期间进行仔细的甲状腺监测是合适的。
