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年轻特纳综合征患者自身免疫性甲状腺疾病的非典型表型特征。

Atypical phenotypic aspects of autoimmune thyroid disorders in young patients with Turner syndrome.

机构信息

Department of Human Pathology in Adulthood and Childhood, University of Messina, Via Consolare Valeria, 98124, Messina, Italy.

出版信息

Ital J Pediatr. 2018 Jan 17;44(1):12. doi: 10.1186/s13052-018-0447-3.

DOI:10.1186/s13052-018-0447-3
PMID:29343299
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5773039/
Abstract

UNLABELLED

Aim of this commentary is to analyze the current views about the phenotypic features of Hashimoto's thyroiditis (HT) and Graves' disease (GD) in Turner syndrome (TS) girls, in terms of epidemiology, clinical and biochemical presentation, long-term course and metamorphic autoimmunity evolution. In TS GD course is not atypical, whereas HT course is characterized by both a mild presenting picture and a severe long-term evolution of thyroid function tests. Furthermore, TS girls seem to have an increased risk of switching over time from HT to GD. On the light of these findings, it may be concluded that TS girls with HT need a careful monitoring of thyroid status over time.

CONCLUSIONS

  1. In children the association with TS is able to condition a peculiar phenotypic expression of HT in terms of epidemiology, presentation course and long-term metamorphic autoimmunity; 2) by contrast, children with TS do not exhibit an atypical clinical and biochemical course of GD, but only a significantly higher prevalence of this disease.
摘要

目的

本评论旨在分析特纳综合征 (TS) 女孩中桥本甲状腺炎 (HT) 和格雷夫斯病 (GD) 的表型特征的当前观点,包括流行病学、临床和生化表现、长期病程和自身免疫性疾病演变。在 TS 中,GD 病程并非非典型,而 HT 病程的特点是临床表现较轻,但甲状腺功能测试的长期演变较为严重。此外,TS 女孩似乎随着时间的推移从 HT 向 GD 转变的风险增加。基于这些发现,可以得出结论,患有 HT 的 TS 女孩需要随着时间的推移仔细监测甲状腺功能状态。

结论

1)在儿童中,与 TS 的关联能够影响 HT 的表型表达,表现在流行病学、表现过程和长期的形态发生自身免疫方面;2)相比之下,患有 TS 的儿童并没有表现出 GD 的临床和生化过程不典型,只是这种疾病的患病率明显更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37cb/5773039/b580d2c3b911/13052_2018_447_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37cb/5773039/420e4042adca/13052_2018_447_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37cb/5773039/b580d2c3b911/13052_2018_447_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37cb/5773039/420e4042adca/13052_2018_447_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37cb/5773039/b580d2c3b911/13052_2018_447_Fig2_HTML.jpg

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Eur J Endocrinol. 2017 Sep;177(3):G1-G70. doi: 10.1530/EJE-17-0430.
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Analysis of the factors affecting the evolution over time of subclinical hypothyroidism in children.儿童亚临床甲状腺功能减退症随时间演变的影响因素分析。
Ital J Pediatr. 2017 Jan 3;43(1):2. doi: 10.1186/s13052-016-0322-z.
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The Evolution of Thyroid Function after Presenting with Hashimoto Thyroiditis Is Different between Initially Euthyroid Girls with and Those without Turner Syndrome.
一名特纳综合征合并格雷夫斯病女性患者因甲巯咪唑导致皮疹和胆汁淤积性肝损伤:病例报告及文献复习。
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Basedow-Graves' disease in a pediatric patient with Sticlker syndrome, a new endocrine finding to improve personalized treatment.斯蒂克勒综合征患儿伴发格雷夫斯病,一种新的内分泌发现可改善个体化治疗。
Ital J Pediatr. 2020 Dec 1;46(1):178. doi: 10.1186/s13052-020-00945-x.
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Autoimmune Thyroid Disease in Specific Genetic Syndromes in Childhood and Adolescence.儿童和青少年特定遗传性综合征中的自身免疫性甲状腺疾病。
Front Endocrinol (Lausanne). 2020 Aug 19;11:543. doi: 10.3389/fendo.2020.00543. eCollection 2020.
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Clinical case report: A case of Turner syndrome with Graves' disease.临床病例报告:1例患有格雷夫斯病的特纳综合征患者。
Medicine (Baltimore). 2020 Mar;99(11):e19518. doi: 10.1097/MD.0000000000019518.
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Autoimmunity Predisposition in Girls With Turner Syndrome.特纳综合征女孩的自身免疫易感性
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10
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Thyroid. 2014 Apr;24(4):744-7. doi: 10.1089/thy.2013.0452. Epub 2014 Jan 29.