Grünebaum M, Lebowitz R L
AJR Am J Roentgenol. 1977 Oct;129(4):629-30. doi: 10.2214/ajr.129.4.629.
It has recently been shown that hypothyroidism complicates cystinosis. The radiographic bone changes of hypothyroidism (retarded skeletal age) cannot be detected while the patient has overt rickets, since the secondary ossification centers are not ossified. When the rickets is treated and the secondary ossification centers fail to appear (the skeletal age remains retarded), then the diagnosis of hypothyroidism should be suspected. After treatment with thyroid hormone is begun and a growth spurt occurs, rickets that has been controlled may reactivate. The previous doses of vitamin D will no longer be adequate because of the patient's growth spurt.
最近研究表明，甲状腺功能减退使胱氨酸病复杂化。当患者患有明显的佝偻病时，由于二级骨化中心未骨化，甲状腺功能减退的影像学骨改变（骨骼年龄延迟）无法被检测到。当佝偻病得到治疗且二级骨化中心未出现（骨骼年龄仍然延迟）时，则应怀疑甲状腺功能减退的诊断。开始用甲状腺激素治疗后出现生长突增时，已得到控制的佝偻病可能会复发。由于患者的生长突增，先前的维生素D剂量将不再足够。
