Ruggeri Rosaria M, Giuffrida Giuseppe, Campennì Alfredo
Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy -
Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Minerva Endocrinol. 2018 Sep;43(3):305-322. doi: 10.23736/S0391-1977.17.02757-2. Epub 2017 Oct 9.
The endocrine system is interested by several autoimmune diseases, characterized by different impact and severity, according to the organs involved. Autoimmune thyroid disorders (i.e. Hashimoto's thyroiditis and Graves' disease) and type 1 diabetes mellitus are the most common autoimmune endocrine disorders, while hypophysitis, adrenalitis (90% of cases of primary hypocortisolism or Addison's disease), POF and hypoparathyroidism represent quite rare conditions. Autoimmune endocrine diseases can also coexist in the same individuals and cluster in families. Some of these associations are nosologically codified in the so-called autoimmune polyglandular syndromes, but autoimmune endocrinopathies can also be accompanied by other non-endocrine autoimmune disorders (i.e. connective tissue, skin or gastrointestinal diseases). Pathophysiology generally results from a complex interplay among genetic predisposition and environmental/endogenous factors. In the diagnostic process, measurement of organ-specific autoantibodies, both with a causative role or as an epiphenomenon, is often fundamental and integrates the assessment of hormone axes and the targeted imaging studies.
内分泌系统会受到多种自身免疫性疾病的影响,根据所累及的器官不同,这些疾病具有不同的影响和严重程度。自身免疫性甲状腺疾病(如桥本甲状腺炎和格雷夫斯病)和1型糖尿病是最常见的自身免疫性内分泌疾病,而垂体炎、肾上腺炎(原发性皮质醇增多症或艾迪生病90%的病例)、原发性卵巢功能不全和甲状旁腺功能减退则较为罕见。自身免疫性内分泌疾病也可在同一个体中共存,并在家族中聚集。其中一些关联在所谓的自身免疫性多腺体综合征中有明确的分类,但自身免疫性内分泌病也可能伴有其他非内分泌自身免疫性疾病(如结缔组织病、皮肤病或胃肠道疾病)。病理生理学通常是遗传易感性与环境/内源性因素之间复杂相互作用的结果。在诊断过程中,测量具有致病作用或作为附带现象的器官特异性自身抗体往往至关重要,并且可用于综合评估激素轴和进行靶向影像学检查。