Lutz G, Biersack H J, Bauer R, Kreysel H W
Haut- und Poliklinik der Friedrich-Wilhelms-Univ. Bonn.
Z Hautkr. 1987 Sep 1;62(17):1253-61.
As we had frequently found goiters in patients with alopecia areata, we performed specific thyroid diagnostics in 120 patients suffering from this kind of loss of hair. By means of palpatory, sonographic, and scintigraphic examination of the thyroid gland, we found in 18% no goiters, in 70% diffuse goiters, and in 12% nodular goiters. In 115 patients, the metabolic condition showed euthyroidism, 3 patients had subclinical hypothyroidism, and 2 patients subclinical hyperthyroidism. We did not detect any increased incidence of antibodies against thyroglobulin or thyroid microsomes; only one patient showed Hashimoto's thyroiditis. The resected goiter tissue of 3 patients with thyroid enlargement and alopecia areata predominantly revealed the typical regressive changes usually seen in colloid and common goiters. But, contrary to the scalp biopsies, the goiter tissue only showed slight antigen expression of HLA-DR. On account of the high incidence of non-toxic diffuse goiters, we discuss the possibility of a goitrogenic factor associated with alopecia areata.
由于我们经常在斑秃患者中发现甲状腺肿,我们对120例患有这种脱发的患者进行了特定的甲状腺诊断。通过对甲状腺进行触诊、超声检查和闪烁扫描检查,我们发现18%的患者没有甲状腺肿,70%的患者有弥漫性甲状腺肿,12%的患者有结节性甲状腺肿。115例患者的代谢状况显示甲状腺功能正常,3例患者有亚临床甲状腺功能减退,2例患者有亚临床甲状腺功能亢进。我们没有检测到抗甲状腺球蛋白或甲状腺微粒体抗体的发生率增加;只有一名患者表现为桥本甲状腺炎。3例甲状腺肿大并伴有斑秃的患者切除的甲状腺肿组织主要显示出通常在胶质性甲状腺肿和普通甲状腺肿中可见的典型退行性变化。但是,与头皮活检相反,甲状腺肿组织仅显示出轻微的HLA-DR抗原表达。鉴于非毒性弥漫性甲状腺肿的高发生率,我们讨论了与斑秃相关的致甲状腺肿因子的可能性。