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亚急性甲状腺炎治疗期间 Graves 病的诊断。

Diagnosis of Graves' Disease during Treatment for Subacute Thyroiditis.

机构信息

Division of Diabetes and Endocrinology, Kanto Rosai Hospital, Japan.

出版信息

Intern Med. 2024 Nov 1;63(21):2949-2952. doi: 10.2169/internalmedicine.3923-24. Epub 2024 Sep 4.

Abstract

The co-occurrence of subacute thyroiditis (SAT) and Graves' disease (GD) is rare. A 62-year-old Japanese man presented with shifting neck pain and elevated thyroid hormone level. The patient tested positive for thyroid-stimulating hormone receptor antibodies. Additionally, thyroid hormone levels did not decrease during treatment with prednisolone for SAT. Consequently, concurrent GD was suspected, and diagnostic assistance was obtained by confirming increased uptake on Technetium thyroid scintigraphy. A genetic analysis of human leukocyte antigen (HLA) revealed genotypes associated with susceptibility to SAT (HLA-B35:01) and GD (HLA-DPB105:01). Furthermore, the possibility of coronavirus disease 2019 as a related environmental factor cannot be ruled out in this case.

摘要

亚急性甲状腺炎(SAT)与格雷夫斯病(GD)同时发生较为罕见。一名 62 岁日本男性因颈部疼痛和甲状腺激素水平升高而就诊。患者的促甲状腺激素受体抗体检测呈阳性。此外,在 SAT 治疗中使用泼尼松龙时,甲状腺激素水平并未下降。因此,怀疑同时患有 GD,并通过 Technetium 甲状腺闪烁显像证实摄取增加来获得诊断帮助。人类白细胞抗原(HLA)的基因分析显示,与 SAT(HLA-B35:01)和 GD(HLA-DPB105:01)易感性相关的基因型。此外,在这种情况下,不能排除 2019 冠状病毒病(COVID-19)作为相关环境因素的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5859/11604395/046209d48aee/1349-7235-63-2949-g001.jpg

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