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桥本甲状腺炎向格雷夫斯病转化致格林-巴利综合征 1 例报告。

Guillain-Barré syndrome with transition from hashimoto's to graves' disease: a case report.

机构信息

Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan.

Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5, Arata-cho, Hyogo-ku, Kobe, Hyogo, 652-0032, Japan.

出版信息

BMC Endocr Disord. 2022 Jun 13;22(1):157. doi: 10.1186/s12902-022-01067-7.

Abstract

BACKGROUND

On rare occasions, there can be a transition from Hashimoto's to Graves' disease. However, there are no reported cases of transition from Hashimoto's to Graves' disease triggered by the onset of Guillain-Barré syndrome.

CASE PRESENTATION

Sixteen years prior, a 55-year-old woman was diagnosed with Hashimoto's disease and followed up without medication. One week after the appearance of signs of intestinal inflammation, weakness in the extremities was observed, and a cerebrospinal fluid test was positive for anti-GM1 IgG antibody, leading to the diagnosis of Guillain-Barré syndrome. In addition, hyperthyroidism was observed at the time of admission, and Graves' disease was diagnosed based on autoantibodies and thyroid echoes. Numbness in the extremities was relieved by high-dose intravenous gamma globulin.

CONCLUSION

With the onset of Guillain-Barré syndrome, helper T cells became predominantly type 1, effector B cells increased in number, and thyroid-stimulating antibodies were produced, leading to the conclusion that Hashimoto's disease progressed to Graves' disease. Therefore, it is necessary to pay attention to the transition of thyroid function during Guillain-Barré syndrome.

摘要

背景

桥本甲状腺炎罕见情况下可向格雷夫斯病转化。然而,尚未有报道提示格林-巴利综合征可诱发桥本甲状腺炎向格雷夫斯病转化。

病例介绍

十六年前,一名 55 岁女性被诊断为桥本甲状腺炎,未接受药物治疗。在出现肠道炎症迹象一周后,出现四肢无力,脑脊液抗 GM1 IgG 抗体阳性,确诊为格林-巴利综合征。入院时还观察到甲状腺功能亢进,根据自身抗体和甲状腺回声诊断为格雷夫斯病。四肢麻木通过大剂量静脉注射丙种球蛋白缓解。

结论

随着格林-巴利综合征的发作,辅助性 T 细胞向 1 型优势转化,效应 B 细胞数量增加,甲状腺刺激抗体产生,由此推断桥本甲状腺炎向格雷夫斯病进展。因此,在格林-巴利综合征期间,有必要关注甲状腺功能的变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dc3/9195218/3c17575c7b71/12902_2022_1067_Fig1_HTML.jpg

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