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初诊Graves病患儿在基线期及开始抗甲状腺药物治疗后的外周血象和转氨酶活性

Peripheral blood picture and aminotransferase activity in children with newly diagnosed Graves' disease at baseline and after the initiation of antithyroid drug therapy.

作者信息

Artemniak-Wojtowicz Dorota, Witkowska-Sędek Ewelina, Borowiec Ada, Pyrżak Beata

机构信息

Department of Paediatrics and Endocrinology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Cent Eur J Immunol. 2019;44(2):132-137. doi: 10.5114/ceji.2019.87063. Epub 2019 Jul 30.

Abstract

AIM OF THE STUDY

Assessment of the peripheral blood picture and aminotransferase activity in children with newly diagnosed Graves' disease (GD) at baseline and 4-6 weeks after the initiation of antithyroid drug (ATD) therapy.

MATERIAL AND METHODS

Data of 59 children were assessed retrospectively. Baseline analysis included concentrations of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), TSH receptor antibodies (TSH-R Ab), complete blood cell count (CBC), aspartate (AST) and alanine aminotransferase (ALT) activity. Reassessment of CBC and aminotransferase activity was performed 4-6 weeks after the initiation of ATD therapy.

RESULTS

Significant decreases in the neutrophil count, MCV, haemoglobin (Hgb), red blood cell (RBC) count, white blood cell (WBC) count and platelet (PLT) count were found in 37.3%, 32.2%, 22%, 13.6%, 8.5% and 5% of untreated patients, respectively. Increased baseline ALT and AST activity was observed in 44% and 32.2% of children, respectively. Initiation of ATD therapy led to significant changes in Hgb, RBC and PLT count, RDW and ALT activity. Negative associations between TSH-R Ab, TSH and MCV were found. ALT and AST activity were negatively related to baseline TSH levels. ALT activity was also associated with baseline fT4 and fT3.

CONCLUSIONS

The incidence of haematopoiesis and liver abnormalities in GD children seems to be similar to that reported in adult patients. The most common alterations are changes in neutrophil count, RBC parameters and ALT activity. The initiation of ATD therapy usually leads to significant improvement in those parameters.

摘要

研究目的

评估新诊断的格雷夫斯病(GD)患儿在基线时以及抗甲状腺药物(ATD)治疗开始后4 - 6周时的外周血象和转氨酶活性。

材料与方法

对59例患儿的数据进行回顾性评估。基线分析包括促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(fT3)、游离甲状腺素(fT4)、TSH受体抗体(TSH - R Ab)、全血细胞计数(CBC)、天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)活性。在ATD治疗开始后4 - 6周重新评估CBC和转氨酶活性。

结果

分别在37.3%、32.2%、22%、13.6%、8.5%和5%的未治疗患者中发现中性粒细胞计数、平均红细胞体积(MCV)、血红蛋白(Hgb)、红细胞(RBC)计数、白细胞(WBC)计数和血小板(PLT)计数显著降低。分别在44%和32.2%的儿童中观察到基线ALT和AST活性升高。ATD治疗开始导致Hgb、RBC和PLT计数、红细胞分布宽度(RDW)和ALT活性发生显著变化。发现TSH - R Ab、TSH与MCV之间存在负相关。ALT和AST活性与基线TSH水平呈负相关。ALT活性还与基线fT4和fT3相关。

结论

GD患儿造血和肝脏异常的发生率似乎与成年患者报道的相似。最常见的改变是中性粒细胞计数、RBC参数和ALT活性的变化。ATD治疗开始通常会导致这些参数显著改善。

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