桥本甲状腺炎、远端肾小管酸中毒、恶性贫血和脑病：一名12岁女孩罕见的自身免疫性疾病组合。

Hashimoto thyroiditis, distal renal tubular acidosis, pernicious anaemia and encephalopathy: a rare combination of auto-immune disorders in a 12-year-old girl.

作者信息

Suzuki N, Mitamura R, Ohmi H, Itoh Y, Yano K, Okuno A, Tateno M, Itoh T

机构信息

Department of Paediatrics, Asahikawa Medical College, Japan.

出版信息

Eur J Pediatr. 1994 Feb;153(2):78-9. doi: 10.1007/BF01959211.

DOI:10.1007/BF01959211

PMID:8157029

Abstract

A case of a 12-year-old girl with a multiple auto-immune disorder is reported. She showed Hashimoto thyroiditis which subsequently developed to hashitoxicosis and distal renal tubular acidosis at 5 years of age, pernicious anaemia at the age of 9 and severe encephalopathy at the age of 12. Laboratory studies revealed very high titres of anti-microsomal and anti-thyroglobulin antibodies and positive gastric parietal cell antibody. As to the encephalopathy, positive oligoclonal IgG bands and high values of IgG index and IgG synthesis ratio in CSF were observed with aggravation of her neurological symptoms. High-dose steroid therapy was effective toward the encephalopathy. Paediatricians should pay careful attention to patients with Hashimoto thyroiditis for association with other autoimmune disorders.

摘要

报告了一例12岁患有多种自身免疫性疾病的女孩。她5岁时出现桥本甲状腺炎，随后发展为桥本毒症和远端肾小管酸中毒，9岁时患恶性贫血，12岁时患严重脑病。实验室检查显示抗微粒体和抗甲状腺球蛋白抗体滴度极高，胃壁细胞抗体呈阳性。关于脑病，随着神经症状加重，脑脊液中观察到寡克隆IgG带阳性以及IgG指数和IgG合成率升高。高剂量类固醇疗法对脑病有效。儿科医生应密切关注桥本甲状腺炎患者是否合并其他自身免疫性疾病。