Nagaoka K, Ueno Y, Chinen Y, Takegami T, Nakayama A, Ishii K, Imura H, Kuno S, Togashi K, Sato S
Nihon Naibunpi Gakkai Zasshi. 1985 Mar 20;61(3):189-96. doi: 10.1507/endocrine1927.61.3_189.
Anti-triiodothyronine antibody was found in a case of rheumatoid arthritis associated with Hashimoto's thyroiditis. The patient was a 40 year-old woman who had complained of polyarthralgia, joint-swelling and stiffness for seven years. She had a rheumatoid nodule and showed a positive RA test. Radiographic changes of hands and wrists showed osteoporosis, erosions and narrowing of joint space. Nonsteroidal anti-inflammatory drugs had been used for seven years. The diagnosis of Hashimoto's thyroiditis had been made by open biopsy of the thyroid gland seven years before. Serum T4, TSH, TBG, free T4, free T3 and r-T3 were all normal. On the other hand, serum T3 level was almost unmeasurable by radioimmunoassay. Binding of 125I-T3 to the patient's serum was studied by using polyethylene glycol (PEG) and column chromatography. By using the PEG method, the binding of 125I-T3 to the patient's serum was tenfold compared to control serum. Sephadex G-25 column chromatography (0.9 X 1.5 cm) of 125I-T3 with the patient's serum in the presence of 0.1% ANS showed an early radioactive peak, while control serum did not show an early peak. In the next experiments, the patient's serum was labelled with 125I-T3, mixed with human anti-IgG, IgM, IgA, lambda, kappa, incubated at 4 degrees C for 20 hours and centrifuged for 20 min. Strong binding to the anti-IgG and anti-lambda was detected. The presence of this abnormal T3-binding globulin in the patient's serum may have produced an undetectable T3 level.
在一例类风湿关节炎合并桥本甲状腺炎的患者中发现了抗三碘甲状腺原氨酸抗体。该患者为一名40岁女性，主诉多关节痛、关节肿胀和僵硬达七年之久。她有类风湿结节，类风湿因子检测呈阳性。手部和腕部的影像学改变显示骨质疏松、侵蚀以及关节间隙变窄。非甾体抗炎药已使用了七年。七年前通过甲状腺开放性活检确诊为桥本甲状腺炎。血清总甲状腺素（T4）、促甲状腺激素（TSH）、甲状腺素结合球蛋白（TBG）、游离T4、游离T3和反三碘甲状腺原氨酸（r-T3）均正常。另一方面，通过放射免疫测定法几乎检测不到血清T3水平。利用聚乙二醇（PEG）和柱色谱法研究了125I-T3与患者血清的结合情况。采用PEG法时，125I-T3与患者血清的结合量是对照血清的十倍。在存在0.1% 8-苯胺基-1-萘磺酸（ANS）的情况下，用患者血清对125I-T3进行葡聚糖凝胶G-25柱色谱法（0.9×1.5厘米）分离时出现了一个早期放射性峰，而对照血清未出现早期峰。在接下来的实验中，用125I-T3标记患者血清，与抗人IgG、IgM、IgA、λ链、κ链混合，在4℃孵育20小时，然后离心20分钟。检测到与抗IgG和抗λ链有强烈结合。患者血清中这种异常的T3结合球蛋白的存在可能导致了无法检测到的T3水平。
