Sasaki N, Tsuyusaki T, Inomata H, Niimi H, Nakajima H
Endocrinol Jpn. 1983 Apr;30(2):219-28. doi: 10.1507/endocrj1954.30.219.
In order to investigate the degree of pituitary reserve of TSH secretion and the fluctuation of thyroid function in children with chronic lymphocytic thyroiditis, TSH response to TRH was examined in 42 patients, and the thyroid function was carefully followed up in two patients retrospectively and in four prospectively. Increased basal TSH levels were revealed in seven patients (16.8%), and an exaggerated response of TSH to TRH loading in 15 (35.8%). We retrospectively observed spontaneous recovery of thyroid function in two cases. In one of them, two episodes of a transient decrease in thyroid function over a period of several years were noted. Prospectively, low normal T4, elevated TSH and normal T3 were detected in two cases at the first visit. Thereafter, TSH levels decreased to the normal range and the exaggerated response of TSH to TRH became normal. In two other cases, typical transient hypothyroidism occurred during the observation period. These fluctuations lasted for only a few months, and concomitant changes in the size of the thyroid gland were observed. No signs or symptoms suggesting viral infection were noted during the study period. Nor were changes in titers of thyroid auto-antibodies detected. These results show that the secretion of TSH is exaggerated and the thyroid function is decreased in adolescents with chronic lymphocytic thyroiditis, but the thyroid function may fluctuate from euthyroid to hypothyroid within a short period. The causes of these changes, especially of the transient hypothyroidism remain to be classified.
为了研究慢性淋巴细胞性甲状腺炎患儿促甲状腺激素（TSH）分泌的垂体储备程度以及甲状腺功能的波动情况，对42例患者进行了TSH对促甲状腺激素释放激素（TRH）的反应检测，并对2例患者进行了回顾性、4例患者进行了前瞻性的甲状腺功能密切随访。7例患者（16.8%）基础TSH水平升高，15例患者（35.8%）TSH对TRH负荷的反应过度。我们回顾性观察到2例患者甲状腺功能自发恢复。其中1例患者在数年期间出现了2次甲状腺功能短暂下降。前瞻性观察中，2例患者初诊时检测到T4略低于正常、TSH升高而T3正常。此后，TSH水平降至正常范围，TSH对TRH的过度反应也恢复正常。另外2例患者在观察期内出现典型的短暂性甲状腺功能减退。这些波动仅持续数月，同时观察到甲状腺大小的相应变化。研究期间未发现提示病毒感染的体征或症状，也未检测到甲状腺自身抗体滴度的变化。这些结果表明，慢性淋巴细胞性甲状腺炎青少年患者TSH分泌过度且甲状腺功能降低，但甲状腺功能可能在短时间内从甲状腺功能正常波动至甲状腺功能减退。这些变化的原因，尤其是短暂性甲状腺功能减退的原因仍有待分类。
