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妊娠期间与遗传性血栓形成倾向相关的自身免疫性甲状腺疾病的预后

Prognosis of autoimmune thyroid disease associated with hereditary thrombophilia during pregnancy.

作者信息

Păuleţ Florina-Paula, Ţurcan Natalia, Gherghiceanu Florentina, BohÞlţea Roxana Elena, Nemescu Dragos, CÞrstoiu Monica Mihaela

机构信息

Department of Obstetrics Gynecology, 'Carol Davila' University of Medicine and Pharmacy Doctoral School, University Emergency Hospital Bucharest, 050098 Bucharest, Romania.

Department of Marketing and Medical Technology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

出版信息

Exp Ther Med. 2020 Sep;20(3):2429-2433. doi: 10.3892/etm.2020.8785. Epub 2020 May 22.

Abstract

Autoimmune thyroid pathology has been connected with several systemic autoimmune disorders, namely hereditary thrombophilia and antiphospholipid syndrome. In an iodine-replete country, these diseases need to be evaluated simultaneously. This study was conducted to assess the connection between acute and chronic thyroiditis and inherited thrombophilia and their potential implications in pregnancy. In the analysis of the cases admitted to the Department of Obstetrics Gynecology of the University Emergency Hospital Bucharest from January 2015 up to September 2019, we identified pregnancies marked by autoimmune hypothyroidism and hyperthyroidism associated with hereditary thrombophilia, by standard statistical methods. In this investigation, we determined the prevalence of immunological markers specific for thrombophilia and against thyroid antigens in pregnant women, and explored whether they associate with distinct clinical phenotypes. Besides the well-accounted impact of hereditary thrombophilia during pregnancy - which is emphasized in our study by the incidence of moderate preeclampsia - we also account for a direct and statistically significant relationship between thrombophilia and moderate intensity autoimmune diseases (including autoimmune thyroiditis). Moreover, if these two pathologies are combined there is an increased risk of the presence of another autoimmune disease.

摘要

自身免疫性甲状腺疾病与几种全身性自身免疫性疾病有关,即遗传性血栓形成倾向和抗磷脂综合征。在碘充足的国家,这些疾病需要同时进行评估。本研究旨在评估急性和慢性甲状腺炎与遗传性血栓形成倾向之间的联系及其在妊娠中的潜在影响。在对2015年1月至2019年9月期间布加勒斯特大学急诊医院妇产科收治的病例进行分析时,我们通过标准统计方法确定了伴有遗传性血栓形成倾向的自身免疫性甲状腺功能减退和甲状腺功能亢进的妊娠病例。在这项调查中,我们测定了孕妇中血栓形成倾向特异性免疫标志物和抗甲状腺抗原免疫标志物的患病率,并探讨了它们是否与不同的临床表型相关。除了遗传性血栓形成倾向在妊娠期间有充分记录的影响(本研究中以中度先兆子痫的发生率为重点)外,我们还发现血栓形成倾向与中度强度自身免疫性疾病(包括自身免疫性甲状腺炎)之间存在直接且具有统计学意义的关系。此外,如果这两种病理情况合并存在,则出现另一种自身免疫性疾病的风险会增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3052/7401732/086af4c1404f/etm-20-03-2429-g00.jpg

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