Lio S, Pontecorvi A, Caruso M, Monaco F, D'Armiento M
Acta Endocrinol (Copenh). 1984 May;106(1):67-70. doi: 10.1530/acta.0.1060067.
Sixty-two patients affected with subacute thyroiditis (SAT) were followed for a mean period of 14 months (range 1-40), by monitoring thyroid hormone levels in basal condition, pituitary TSH reserve, antithyroglobulin (TgAb) and antimicrosomal antibodies ( MsAb ), in order to study the natural course of the disease and to characterize its intermediate phase. In the first phase the mean serum iodothyronine levels were within normal limits, nevertheless elevated T3 and T4 levels were detected in 34 (54%) and 20 (32%) patients, respectively. The next phase was characterized by normal serum iodothyronine levels; TRH stimulation test, however, showed a significant increase of pituitary TSH reserve in 35 (56%) patients. All parameters reverted gradually towards normal in all but 3 patients, who showed overt permanent hypothyroidism. TgAb and MsAb were positive in the early stage in 15 (24%) and 40 (64%) patients, respectively, disappearing at the end of the follow-up period in all but one patient; this particular patient belonged to the group of 3 patients affected with permanent hypothyroidism. Our data indicate that the onset of SAT is characterized by transient hyperthyroidism and that transient subclinical hypothyroidism characterizes the next phase. TRH stimulation test is required for the diagnosis of the latter and for the identification of the few who develop permanent hypothyroidism.
对62例亚急性甲状腺炎（SAT）患者进行了平均14个月（范围1 - 40个月）的随访，通过监测基础状态下的甲状腺激素水平、垂体促甲状腺激素（TSH）储备、抗甲状腺球蛋白（TgAb）和抗微粒体抗体（MsAb），以研究该疾病的自然病程并对其中间阶段进行特征描述。在第一阶段，平均血清碘甲状腺原氨酸水平在正常范围内，然而分别在34例（54%）和20例（32%）患者中检测到T3和T4水平升高。下一阶段的特征是血清碘甲状腺原氨酸水平正常；然而，促甲状腺激素释放激素（TRH）刺激试验显示，35例（56%）患者的垂体TSH储备显著增加。除3例出现明显永久性甲状腺功能减退的患者外，所有参数在其他患者中均逐渐恢复正常。TgAb和MsAb分别在15例（24%）和40例（64%）患者的早期呈阳性，除1例患者外，在随访期末均消失；该特殊患者属于3例患有永久性甲状腺功能减退的患者组。我们的数据表明，SAT的发病以短暂性甲状腺功能亢进为特征，而短暂性亚临床甲状腺功能减退是下一阶段的特征。TRH刺激试验对于后者的诊断以及识别少数发展为永久性甲状腺功能减退的患者是必要的。
