自身免疫性肝炎与抗甲状腺激素自身抗体相关的甲状腺功能减退症。

Autoimmune hepatitis and hypothyroidism associated with anti-thyroid hormone autoantibodies.

作者信息

Sarui H, Nagai K, Kametani M, Ogawa T, Tokimitsu N, Sakata S

机构信息

Department of Internal Medicine, Takayama Red Cross Hospital, Japan.

出版信息

Intern Med. 1993 Jan;32(1):21-5. doi: 10.2169/internalmedicine.32.21.

DOI:10.2169/internalmedicine.32.21

PMID:8495039

Abstract

A 40-year-old hypothyroid female who had been treated with synthetic thyroxine was admitted to our hospital in October 1988 due to abnormal liver function tests. She had low serum free triiodothyronine (T3; 2.3 pg/ml) and high serum thyrotropin (TSH; 20.8 microU/ml) concentrations. On the other hand, the serum free thyroxine (FT4) level was inappropriately high, being 2.46 ng/dl. Immune precipitation of radiolabeled thyroid hormones with her serum disclosed the binding of 125I-T3 and 125I-T4 to the extent of 9.5% and 11.3%, respectively (normal ranges for 125I-T3 and 125I-T4 binding are less than 6.3% and 5.9%, respectively). 125I-T4 binding to the patient's serum gamma globulin was completely displaced with the addition of unlabeled T4. Further examination disclosed that anti-T4 antibodies in her serum belong to IgG kappa class immunoglobulin.

摘要

一名40岁的甲状腺功能减退女性，一直在接受合成甲状腺素治疗，因肝功能检查异常于1988年10月入住我院。她的血清游离三碘甲状腺原氨酸（T3；2.3 pg/ml）水平较低，血清促甲状腺激素（TSH；20.8微单位/ml）浓度较高。另一方面，血清游离甲状腺素（FT4）水平却异常升高，为2.46 ng/dl。用她的血清对放射性标记的甲状腺激素进行免疫沉淀显示，125I-T3和125I-T4的结合率分别为9.5%和11.3%（125I-T3和125I-T4结合的正常范围分别小于6.3%和5.9%）。加入未标记的T4后，125I-T4与患者血清γ球蛋白的结合被完全取代。进一步检查发现，她血清中的抗T4抗体属于IgG κ类免疫球蛋白。