Li Yang, Yan Mu-Qiao, Song Yan-Ning, Zhang Qin, Gong Chun-Xiu
Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Department of Health Care, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Endocrine. 2025 Apr;88(1):143-150. doi: 10.1007/s12020-024-04148-w. Epub 2025 Jan 6.
This study aimed to determine the detection rate of autoimmune polyendocrine syndrome (APS) among children with Graves' disease (GD) at a single center and to compare clinical characteristics between those with isolated GD and those GD with APS (APS-GD).
A retrospective analysis was conducted on the clinical data of 555 patients and were categorized into isolated GD and APS-GD groups based on their progression status. The time for FT to return to normal was used as an indicator of short-term treatment effectiveness.
In all, 63 (11.4%) had coexisting APS; 52 (82.5%) were female. The most common component of APS was type 1 diabetes mellitus (T1DM) [24 (4.3%)]. Among APS-GD patients, after the diagnosis of the first component, the cumulative incidences of a second disease within the first, second, and third years were 63.4%, 74.6%, and 82.0%, respectively and till the end of the first decade reached 95.0%. The isolated GD group had higher levels of FT, TT, and TRAb. Under the same initial dosage, the median time for FT to normalize was 22.0 (14.0, 30.0) d for the isolated GD group and 25.0 (13.5, 31.0) d for the APS group (P = 0.936).
The study uncovered a high comorbidity rate of APS in children with GD, suggesting that patients with APS-GD have a higher risk of progression to additional endocrine gland disorders. Yet, both groups showed no significant difference in their short-term therapeutic response. These findings are crucial for guiding the clinical management and follow-up of pediatric GD patients.
本研究旨在确定单中心格雷夫斯病（GD）患儿自身免疫性多内分泌腺综合征（APS）的检出率，并比较单纯GD患儿与合并APS的GD患儿（APS-GD）的临床特征。
对555例患者的临床资料进行回顾性分析，根据病情进展情况分为单纯GD组和APS-GD组。以游离甲状腺素（FT）恢复正常的时间作为短期治疗效果的指标。
共有63例（11.4%）合并APS；其中52例（82.5%）为女性。APS最常见的组成部分是1型糖尿病（T1DM）[24例（4.3%）]。在APS-GD患者中，在诊断出首个组成部分后，在第一、第二和第三年内第二种疾病的累积发病率分别为63.4%、74.6%和82.0%，到第一个十年末达到95.0%。单纯GD组的FT、总甲状腺素（TT）和促甲状腺素受体抗体（TRAb）水平较高。在相同初始剂量下，单纯GD组FT恢复正常的中位时间为22.0（14.0，30.0）天，APS组为25.0（13.5，31.0）天（P = 0.936）。
本研究发现GD患儿中APS的合并率较高，提示APS-GD患者进展为其他内分泌腺疾病的风险更高。然而，两组在短期治疗反应上无显著差异。这些发现对于指导儿科GD患者的临床管理和随访至关重要。
