无痛性甲状腺炎及无甲状腺肿的短暂性甲状腺功能亢进症。

Painless thyroiditis and transient hyperthyroidism without goiter.

作者信息

Dorfman S G, Cooperman M T, Nelson R L, Depuy H, Peake R L, Young R L

出版信息

Ann Intern Med. 1977 Jan;86(1):24-8. doi: 10.7326/0003-4819-86-1-24.

Abstract

Eight women had painless thyroiditis, transient thyrotoxicosis, and low radioactive iodine uptakes but were without goiter; they constituted 15% of all thyrotoxicosis cases that we saw during the past year. Standard antithyroid antibody tests by tanned erythrocyte hemagglutination, complement fixation, and colloid and microsomal fluorescence, if present initally, were only weakly psotivie and became negative by 9 months. However, human antithyroglobulin antibody levels by a sensitive radioimmunoassay were elevated initially in all patients. In general, these radioimmunoassayable antibody levels fell, but they had not returned to normal by 9 months. Serial thyroid function tests and standard antithyroid antibody tests were most compatible with subactue thyroidtis. However, the persistence of radioimmunoassayable antithyroblobulin antibodies and recent reports of histologic evidence of lymphocyte thyroiditis in similar patients with goiter leaves open the possibility that this is a previously unrecognized presentation of chronic lymphocytic thyroiditis. Neither the cause nor the ultimate course of this syndrome is known.

摘要

8名女性患有无痛性甲状腺炎、短暂性甲状腺毒症且放射性碘摄取率低，但无甲状腺肿；她们占我们在过去一年中所见到的所有甲状腺毒症病例的15%。通过鞣酸红细胞血凝试验、补体结合试验以及胶体和微粒体荧光法进行的标准抗甲状腺抗体检测，若最初存在，也只是弱阳性，到9个月时变为阴性。然而，通过敏感的放射免疫测定法检测，所有患者的人抗甲状腺球蛋白抗体水平最初均升高。一般来说，这些可通过放射免疫测定的抗体水平会下降，但到9个月时仍未恢复正常。系列甲状腺功能检查和标准抗甲状腺抗体检测结果与亚急性甲状腺炎最为相符。然而，可通过放射免疫测定的抗甲状腺球蛋白抗体持续存在，以及近期关于类似甲状腺肿患者淋巴细胞性甲状腺炎组织学证据的报告，使得有可能这是慢性淋巴细胞性甲状腺炎一种先前未被认识的表现形式。该综合征的病因及最终病程均不明。