"Carol Davila" University of Medicine and Pharmacy, "Sf. Ioan" Clinical Emergency Hospital, Internal Medicine Department, Bucharest, Romania.
"Carol Davila" University of Medicine and Pharmacy, "Sf. Ioan" Clinical Emergency Hospital, Gastroenterology Department, Bucharest, Romania.
Am J Med Sci. 2020 Sep;360(3):293-299. doi: 10.1016/j.amjms.2020.04.022. Epub 2020 Apr 25.
Hyposplenism is associated with autoimmune diseases, inflammatory bowel disease, severe celiac disease, autoimmune thyroiditis, untreated HIV infection and chronic graft-versus-host disease. The aim of this study was to review the existing data on hyposplenism associated with celiac disease and Hashimoto's autoimmune thyroiditis. Our research was based on a clinical case concerning a 41-year-old female who presented with asthenia, fatigue, dyspepsia and chronic diarrhea. The medical history revealed autoimmune Hashimoto's thyroiditis, type 2 diabetes, fatty liver disease, chronic gastritis and thrombocytosis. Multiple investigations showed hyposplenism and complex autoimmune dysfunction with positive serum markers for celiac disease and type 1 autoimmune hepatitis along with minor symptomatology. The intestinal symptomatology of celiac disease is often hid by hypothyroidism-associated autoimmune thyroiditis. Asymptomatic or minimally symptomatic celiac disease associated with Hashimoto's autoimmune thyroiditis is diagnosed by biomarkers. Hyposplenism in celiac disease can occur regardless of the disease stage, latent or symptomatic.
脾功能低下与自身免疫性疾病、炎症性肠病、严重乳糜泻、自身免疫性甲状腺炎、未经治疗的 HIV 感染和慢性移植物抗宿主病有关。本研究旨在回顾与乳糜泻和桥本氏自身免疫性甲状腺炎相关的脾功能低下的现有数据。我们的研究基于一个临床病例,涉及一名 41 岁女性,表现为乏力、疲劳、消化不良和慢性腹泻。病史显示患有自身免疫性桥本氏甲状腺炎、2 型糖尿病、脂肪肝、慢性胃炎和血小板增多症。多项检查显示脾功能低下和复杂的自身免疫功能障碍,伴有乳糜泻和 1 型自身免疫性肝炎的阳性血清标志物,以及轻微的症状。乳糜泻的肠道症状常被与自身免疫性甲状腺炎相关的甲状腺功能减退所掩盖。无症状或症状轻微的乳糜泻与桥本氏自身免疫性甲状腺炎相关,可通过生物标志物诊断。无论疾病处于何种阶段,有无症状,乳糜泻均可发生脾功能低下。