Mogucheva E I, Idel'son L I, Granovskaia-Tsvetkova A M, Romashov F N, Alekseev G I
Ter Arkh. 1985;57(7):79-84.
The authors describe 10 patients with associated diffuse toxic goiter and thrombocytopenic purpura and a female patient with associated goiter and a three-shoot autoimmune peripheral cytopenia. In 8 patients thyrotoxicosis preceded the appearance of thrombocytopenia, in 3 patients, both the conditions were diagnosed at a time. In 4 patients, the measurements were taken of the IgG content on the surface of platelets according to Dixon et al. In 3 patients, the IgG content turned out to be appreciably elevated, in one patient, the content of IgG was within normal, however the latter patient was examined after prednisolone intake that had given rise to an increase in the platelet count. Two patients who received radioactive iodine and three patients treated by thyrostatic drugs were later on subjected to splenectomy. In 4 patients, thrombocytopenic purpura remitted after subtotal strumectomy. One female patient was subjected to sectoral resection of the thyroid. Two years after surgery the patient, who was in an euthyroid state, developed thrombocytopenia which required splenectomy. It is possible that in the latter case there was no direct relation between the two diseases. The relationship between the two autoimmune diseases, diffuse toxic goiter and thrombocytopenic purpura, remained unclear in other 10 cases. The relationship between the diseases under consideration and approaches to specifying the character of such a relationship are under discussion.
作者描述了10例伴有弥漫性毒性甲状腺肿和血小板减少性紫癜的患者,以及1例伴有甲状腺肿和三系自身免疫性外周血细胞减少的女性患者。8例患者甲状腺毒症先于血小板减少出现,3例患者两种病症同时被诊断。4例患者根据迪克森等人的方法测量了血小板表面的IgG含量。3例患者的IgG含量明显升高,1例患者的IgG含量在正常范围内,但该患者在服用泼尼松龙后血小板计数增加,随后接受了检查。2例接受放射性碘治疗的患者和3例接受甲状腺抑制药物治疗的患者后来接受了脾切除术。4例患者在甲状腺次全切除术后血小板减少性紫癜缓解。1例女性患者接受了甲状腺部分切除术。术后两年,该患者处于甲状腺功能正常状态,出现血小板减少,需要进行脾切除术。在后一种情况下,两种疾病之间可能没有直接关系。在其他10例病例中,弥漫性毒性甲状腺肿和血小板减少性紫癜这两种自身免疫性疾病之间的关系仍不清楚。正在讨论所考虑的疾病之间的关系以及确定这种关系性质的方法。