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先天性风疹综合征中的自身免疫

Autoimmunity in congenital rubella syndrome.

作者信息

Clarke W L, Shaver K A, Bright G M, Rogol A D, Nance W E

出版信息

J Pediatr. 1984 Mar;104(3):370-3. doi: 10.1016/s0022-3476(84)81097-5.

Abstract

Two hundred one deaf adolescents with congenital rubella syndrome and 83 age-matched deaf control subjects were evaluated for the presence of organ-specific antibodies directed against thyroid microsomes, thyroglobulin, pancreatic islets, adrenal cortex, and gastric parietal cells. Positive thyroid microsomal or thyroglobulin antibodies were found in 23.3% (47/201) of the rubella group and in 12.0% (10/83) of control subjects. Nine of 46 (19.6%) in the rubella group and two of nine (22.2%) control subjects with thyroid autoimmunity had thyroid gland dysfunction as indicated by elevated serum TSH concentrations. Neither islet cell nor adrenal cortical antibodies were detected in any subject tested; parietal cell antibodies were detected in 5.5% (8/146) of those in the rubella group and 8.8% (6/68) of control subjects tested, but occurred most frequently in subjects with thyroid autoimmunity (6/36, 16.7% vs 8/178, 4.5%; P less than 0.05). It is recommended that all patients with congenital rubella syndrome be screened for thyroid autoimmunity and that those with positive antibody titers be evaluated for the presence of thyroid dysfunction.

摘要

对201名患有先天性风疹综合征的失聪青少年和83名年龄匹配的失聪对照受试者进行了评估,以检测针对甲状腺微粒体、甲状腺球蛋白、胰岛、肾上腺皮质和胃壁细胞的器官特异性抗体。风疹组中23.3%(47/201)的受试者和对照组中12.0%(10/83)的受试者甲状腺微粒体或甲状腺球蛋白抗体呈阳性。风疹组中46名(19.6%)患有甲状腺自身免疫的受试者中有9名,对照组9名(22.2%)患有甲状腺自身免疫的受试者中有2名血清促甲状腺激素(TSH)浓度升高,提示甲状腺功能障碍。在所有检测的受试者中均未检测到胰岛细胞抗体和肾上腺皮质抗体;风疹组中5.5%(8/146)的受试者和对照组中8.8%(6/68)检测的受试者检测到壁细胞抗体,但在患有甲状腺自身免疫的受试者中最为常见(6/36,16.7%对8/178,4.5%;P<0.05)。建议对所有先天性风疹综合征患者进行甲状腺自身免疫筛查,对抗体滴度呈阳性的患者评估是否存在甲状腺功能障碍。

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