Yilmaz Müge Özsan, Çelik Muhammet Murat, KelesÇ Fatma Öztürk, Özcan Oguzhan
Endocrinology and Metabolism Department, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey.
Internal Medicine Department, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey.
Arch Endocrinol Metab. 2020 Feb;64(1):66-70. doi: 10.20945/2359-3997000000198. Epub 2020 Mar 13.
Objective Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder that is frequently seen in the eastern Mediterranean region. The thyroid gland can be affected in FMF patients through autoimmunity or amyloidosis. Here, we aimed to evaluate the structure and functions of the thyroid gland in addition to possible autoimmunity in FMF patients. Subjects and methods The study was conducted by the Endocrinology and Metabolism and Internal Medicine Departments. Thirty FMF patients and 30 age and gender-matched healthy controls were enrolled in the study. Free thyroxin (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (anti-TPO) autoantibodies were investigated. Detailed thyroid grayscale and Doppler Ultrasonography examinations and shear-wave elastosonography (SWE) were performed in the patient and control groups. Results Anti-TPO was detected in 24% (n = 7) of the patients. On the grayscale US, mean thyroid volumes were similar between the FMF and the control groups (p > 0.05). By Doppler US, thyroid vascularity observed was detected in 10.3% (n = 3) of the patients. SWE revealed that the mean velocity value of right vs. left lobe in the patient group was 1.77 ± 0.45 m/s and 1.95 ± 0.51 m/s, respectively. Compared to the control group, the mean velocity values were significantly higher in the right (p = 0.004) and left (p = 0.01) lobes of the patient group. The mean stiffness value in the patient group was also significantly higher in the right and left lobes [10.13 ± 5.65 kPa (p = 0.005) and 12.24 ± 6.17 kPa (p = 0.02), respectively]. Conclusion Recognizing the complications of FMF early in the course of the disease is as important as the early diagnosis of the disorder. Based on this, thyroid functions and changes in its structure should be evaluated carefully for early diagnosis of a possible coexisting thyroid disorder. Arch Endocrinol Metab. 2020;64(1):66-70.
目的 家族性地中海热（FMF）是一种常出现在地中海东部地区的常染色体隐性自身炎症性疾病。FMF患者的甲状腺可能会因自身免疫或淀粉样变性而受到影响。在此，我们旨在评估FMF患者甲状腺的结构和功能以及可能存在的自身免疫情况。
对象与方法 本研究由内分泌与代谢科及内科开展。30例FMF患者和30例年龄及性别匹配的健康对照者纳入研究。检测游离甲状腺素（fT4）、游离三碘甲状腺原氨酸（fT3）、促甲状腺激素（TSH）及抗甲状腺过氧化物酶（抗TPO）自身抗体。对患者组和对照组进行详细的甲状腺灰阶和多普勒超声检查以及剪切波弹性成像（SWE）。
结果 24%（n = 7）的患者检测到抗TPO。在灰阶超声检查中，FMF组和对照组的平均甲状腺体积相似（p > 0.05）。通过多普勒超声检查，10.3%（n = 3）的患者观察到甲状腺血管情况。SWE显示，患者组右叶和左叶的平均速度值分别为1.77 ± 0.45 m/s和1.95 ± 0.51 m/s。与对照组相比，患者组右叶（p = 0.004）和左叶（p = 0.01）的平均速度值显著更高。患者组右叶和左叶的平均硬度值也显著更高[分别为10.13 ± 5.65 kPa（p = 0.005）和12.24 ± 6.17 kPa（p = 0.02）]。
结论 在疾病过程中尽早识别FMF的并发症与尽早诊断该疾病同样重要。基于此，应仔细评估甲状腺功能及其结构变化，以便早期诊断可能并存的甲状腺疾病。《内分泌与代谢档案》。2020；64(1):66 - 70。
