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恶性贫血与内分泌腺抗体。

Pernicious anaemia and endocrine glands antibodies.

作者信息

Morawiec-Szymonik Elżbieta, Foltyn Wanda, Marek Bogdan, Kos-Kudła Beata, Kajdaniuk Dariusz

机构信息

Ward of Hematology, City Hospital, Chorzów, Poland.

Department of Pathophysiology and Endocrinology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.

出版信息

Endokrynol Pol. 2019;70(2):143-150. doi: 10.5603/EP.a2018.0086. Epub 2019 Jan 16.

Abstract

INTRODUCTION

The aim of the study was to determine the frequency of occurrence of antibodies participating in the development of endocrine diseases in patients with autoimmune haematopoietic disease, thus documenting the potential suitability of specific diagnostic and screening tests.

MATERIAL AND METHODS

The study group consisted of 124 persons (men and women) with newly diagnosed pernicious anaemia (PA) and a control group (C) of 41 healthy people. Antibodies against: intrinsic factor (IFAb), gastric parietal cells (APCA), thyroid peroxidase (TPOAb), thyroglobulin (TgAb), adrenal cortex (AdrenalAb), and pituitary anterior lobe (PituitaryAb) were determined in the blood.

RESULTS

  1. The risk of the presence of antibodies against endocrine glands in patients with PA can be classified in order: TPOAb and/or TgAb - 41.1%, TPOAb - 36.3%, TgAb - 25.0%, TPOAb and TgAb - 20.2%, AdrenalAb - 1.6%, PituitaryAb - 0.8%. 2. TPOAb and/or TgAb (mainly TPOAb) are more frequently present in patients with PA, who have IFAb and/or APCA. This correlation is most evident in patients with simultaneous occurrence of IFAb and APCA. 3. Among patients with PA, the simultaneous presence of antibodies IFAb and/or APCA with TPOAb and/or TgAb antibodies is most likely in women over 45 years of age. 4. In group C, 12% had at least one of two antithyroid antibodies (TgAb twice as often as TPOAb), and 2.4% had both. AdrenalAb and PituitaryAb are not found in healthy persons.

CONCLUSIONS

In patients with PA, a screening for autoimmune thyroid disease is justified, which should first involve the determination of TPOAb (further TgAb) in the blood. The assessment of antithyroid antibodies should be recommended primarily to patients with PA, who have IFAb and/or APCA, and in particular those with concurrent IFAb and APCA.

摘要

引言

本研究的目的是确定自身免疫性造血疾病患者中参与内分泌疾病发生的抗体的出现频率,从而证明特定诊断和筛查试验的潜在适用性。

材料与方法

研究组由124例新诊断为恶性贫血(PA)的患者(男性和女性)组成,对照组(C)为41名健康人。检测血液中针对以下物质的抗体:内因子(IFAb)、胃壁细胞(APCA)、甲状腺过氧化物酶(TPOAb)、甲状腺球蛋白(TgAb)、肾上腺皮质(AdrenalAb)和垂体前叶(PituitaryAb)。

结果

  1. PA患者中存在针对内分泌腺抗体的风险可按以下顺序分类:TPOAb和/或TgAb - 41.1%,TPOAb - 36.3%,TgAb - 25.0%,TPOAb和TgAb - 20.2%,AdrenalAb - 1.6%,PituitaryAb - 0.8%。2. TPOAb和/或TgAb(主要是TPOAb)在患有IFAb和/或APCA的PA患者中更常见。这种相关性在同时出现IFAb和APCA的患者中最为明显。3. 在PA患者中,年龄超过45岁的女性最有可能同时存在IFAb和/或APCA抗体与TPOAb和/或TgAb抗体。4. 在C组中,12%的人至少有一种两种抗甲状腺抗体(TgAb的出现频率是TPOAb的两倍),2.4%的人两种抗体都有。健康人中未发现AdrenalAb和PituitaryAb。

结论

在PA患者中,对自身免疫性甲状腺疾病进行筛查是合理的,首先应检测血液中的TPOAb(其次是TgAb)。抗甲状腺抗体的评估应主要推荐给患有IFAb和/或APCA的PA患者,尤其是同时患有IFAb和APCA的患者。

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