Kamijo Keiichi
Department of Internal Medicine, Kamijo Thyroid Clinic, Japan.
Intern Med. 2019 Nov 1;58(21):3121-3123. doi: 10.2169/internalmedicine.3212-19. Epub 2019 Jul 10.
We herein report a rare case of a 41-year-old woman with painless thyroiditis who was positive for thyrotropin (TSH) receptor-blocking (TBAbs) and receptor-stimulating autoantibodies (TSAbs) in the thyrotoxic phase. Her serum thyroid hormone levels were high, and TSH was undetectable. The low uptake of Tc led to the diagnosis of painless thyroiditis. M22-TRAb, TBAb and TSAb were detectable in the thyrotoxic phase. Three months later, she became severely hypothyroid. M22-TRAb and TBAb were still strongly positive, although the TSAb levels had decreased to just above the reference range. In this case, TBAb led to hypothyroidism.
我们在此报告一例罕见的41岁无痛性甲状腺炎女性病例，该患者在甲状腺毒症期促甲状腺激素（TSH）受体阻断抗体（TBAbs）和受体刺激自身抗体（TSAbs）呈阳性。她的血清甲状腺激素水平升高，TSH检测不到。锝摄取率低导致无痛性甲状腺炎的诊断。在甲状腺毒症期可检测到M22-TRAb、TBAb和TSAb。三个月后，她出现严重甲状腺功能减退。尽管TSAb水平已降至略高于参考范围，但M22-TRAb和TBAb仍呈强阳性。在该病例中，TBAb导致了甲状腺功能减退。
