Yamamoto M, Shibuya N, Chen L C, Ogata E
Fourth Department of Internal Medicine, University of Tokyo School of Medicine, Japan.
Endocrinol Jpn. 1988 Feb;35(1):135-42. doi: 10.1507/endocrj1954.35.135.
Two postpartum and 7 spontaneous episodes of transient hypothyroidism developed during 5 years of observation in a florist with autoimmune thyroiditis and seasonal allergic rhinitis. The spontaneous episodes recurred twice a year regularly in spring and in autumn, the seasons of her allergic rhinitis. In most of these episodes as well as in the postpartum ones, hypothyroidism was preceded by transient thyrotoxicosis. In addition to the similarity in the clinical course, the changes in antimicrosomal antibody titers in pregnancy-unrelated episodes were almost identical to those in postpartum episodes. Throughout the observation periods, she had supranormal serum total immunoglobulin (Ig) E concentrations and high antigen-specific Ig E levels for various pollen extracts such as cedar and ragweed. However, we failed to demonstrate a correlation between thyroid function and total or any antigen-specific Ig E level. The present findings suggest that the pregnancy-unrelated thyroid dysfunction in our patient developed as a result of silent thyroiditis and through similar immunological mechanisms to those in postpartum thyroiditis. And it is suspected, though unproved, that the seasonal recurrence of pregnancy-unrelated thyroiditis has some causal relation to her allergic disease.
在一名患有自身免疫性甲状腺炎和季节性变应性鼻炎的花店店员5年的观察期内，出现了2次产后及7次自发性短暂性甲状腺功能减退发作。自发性发作每年在春季和秋季规律地复发两次，这两个季节也是她变应性鼻炎的发病季节。在大多数这些发作以及产后发作中，甲状腺功能减退之前均有短暂性甲状腺毒症。除了临床过程相似外，与妊娠无关的发作中抗微粒体抗体滴度的变化与产后发作几乎相同。在整个观察期间，她的血清总免疫球蛋白（Ig）E浓度高于正常，并且对雪松和豚草等各种花粉提取物具有高抗原特异性Ig E水平。然而，我们未能证明甲状腺功能与总Ig E水平或任何抗原特异性Ig E水平之间存在相关性。目前的研究结果表明，我们患者中与妊娠无关的甲状腺功能障碍是由于寂静性甲状腺炎并通过与产后甲状腺炎相似的免疫机制发展而来。并且怀疑，尽管未经证实，但与妊娠无关的甲状腺炎的季节性复发与她的变应性疾病有某种因果关系。
