Nduwayo L, Bacq Y, Valat C, Goudeau A, Lecomte P
Service d'Endocrinologie et maladies métaboliques, CHRU de Tours.
Ann Endocrinol (Paris). 1998 Apr;59(1):9-13.
The aim of this study was to estimate thyroid function and the prevalence of thyroid antibodies among HCV seropositive patients. We undertook a screening for thyroid dysfunction, and antithyroperoxidase (ATPO) and antithyroglobulin (ATG) antibodies, in 215 HCV seropositive patients referred for hepatologic consultation, 118 males and 97 females, mean age 44 +/- 14 years, range 16-80 years. No patient was treated with interferon and all were seronegative for HIV. Eighteen patients (8%) had antithyroid antibodies, 12 with ATPO antibodies (5.6%) and 10 with ATG antibodies (4.7%). Four patients had both ATPO and ATG antibodies (1.8%), one case of Graves' disease and 3 cases of autoimmune hypothyroidism found during this study. Five patients (2.3%) had hyperthyroidism, three cases of Graves' disease, one case of iodine load and a case of Grave's disease incidentally diagnosed during medical examination. Eleven patients (5.1%) had hypothyroidism, one case already known and treated without antithyroid antibodies, 4 cases of autoimmune etiology (3 diagnosed in consultation and one already known and compensated hypothyroidism), one case of amiodarone-induced hypothyroidism discovered during this study, 5 cases of hypothyroidism without antibodies (two cases of compensated hypothyroidism with normal TRH stimulating test, two cases with severe liver cirrhosis and one case with chronic hepatitis). Twelve patients had antithyroid antibodies with normal TSH levels. The prevalence of ATPO and ATG antibodies in our study is similar to the prevalence usually observed in general population and does not suggest a pathogenic role of HCV in autoimmune thyroid disorders.
本研究的目的是评估丙型肝炎病毒(HCV)血清学阳性患者的甲状腺功能及甲状腺抗体的患病率。我们对215例因肝病咨询前来就诊的HCV血清学阳性患者进行了甲状腺功能障碍、抗甲状腺过氧化物酶(ATPO)和抗甲状腺球蛋白(ATG)抗体的筛查,其中男性118例,女性97例,平均年龄44±14岁,年龄范围为16 - 80岁。所有患者均未接受干扰素治疗,且HIV血清学均为阴性。18例患者(8%)有抗甲状腺抗体,12例有ATPO抗体(5.6%),10例有ATG抗体(4.7%)。4例患者同时有ATPO和ATG抗体(1.8%),本研究期间发现1例格雷夫斯病和3例自身免疫性甲状腺功能减退症。5例患者(2.3%)有甲状腺功能亢进,3例格雷夫斯病,1例碘负荷过量,1例在体检时偶然诊断为格雷夫斯病。11例患者(5.1%)有甲状腺功能减退,1例已知且接受治疗但无抗甲状腺抗体,4例为自身免疫病因(3例在咨询时诊断,1例已知且为代偿性甲状腺功能减退),本研究期间发现1例胺碘酮所致甲状腺功能减退,5例无抗体的甲状腺功能减退(2例代偿性甲状腺功能减退且促甲状腺激素释放激素刺激试验正常,2例严重肝硬化,1例慢性肝炎)。12例患者抗甲状腺抗体阳性但促甲状腺激素水平正常。我们研究中ATPO和ATG抗体的患病率与一般人群中通常观察到的患病率相似,并不提示HCV在自身免疫性甲状腺疾病中起致病作用。