Zhao Dakun,Liu Liyuan,Yu Yang,et al.Analysis of thyroid function status in patients with immunoglobulin 4-related disease[J].Journal of Chongqing Medical University,2022,47(11):1339-1342.
Zhao Dakun,Liu Liyuan,Yu Yang,et al.Analysis of thyroid function status in patients with immunoglobulin 4-related disease[J].Journal of Chongqing Medical University,2022,47(11):1339-1342. DOI: 10.13406/j.cnki.cyxb.003091.
Analysis of thyroid function status in patients with immunoglobulin 4-related disease
To summarize and analyze the data of thyroid function of patients with immunoglobulin 4-related disease(IgG4-RD),so as to raise the clinicians' awareness on monitoring the thyroid function of patients.
Methods
2
The clinical data of IgG4-RD patients who were hospitalized and diagnosed in Peking University First Hospital from July 2005 to September 2020 were collected through searching the electronic medical record retrieval system by using “immunoglobulin 4-related diseases” as the key word. We analyzed the thyroid function status and the changes before and after the treatment of IgG4-RD patients and the changes of thyroid function of some patients with follow-up data.
Results
2
A total of 89 IgG4-RD patients(69 males and 20 females) were enrolled in the current study. Among 66 patients(74.2%) with thyroid function test results,21 patients had thyroid dysfunction,including non-thyroid illness syndrome(NTIS,
n
=12),subclinical or overt hypothyroidism(
n
=8)and central hypothyroidism(
n
=1). Among them,5 patients had the follow-up results,3 patients got the normalization of thyroid function during the course of treatment and one patient remained subclinical hypothyroidism. And the decreased T3 level was improved in one patient with NTIS.
Conclusion
2
Thyroid dysfunction is common in IgG4-RD patients,and NTIS is the main manifestation. The etiology of thyroid dysfunction in patients with IgG4-RD needs to be identified. The thyroid dysfunction may be restored in some patients with the treatment of IgG4-RD.
关键词
Keywords
references
Perugino CA , Stone JH . IgG4-related disease:an update on pathophysiology and implications for clinical care [J ] . Nat Rev Rheumatol , 2020 , 16 ( 12 ): 702 - 714 .
Wallace ZS , Zhang YQ , Perugino CA , et al . Clinical phenotypes of IgG4-related disease:an analysis of two international cross-sectional cohorts [J ] . Ann Rheum Dis , 2019 , 78 ( 3 ): 406 - 412 .
Umehara H , Okazaki K , Masaki Y , et al . Comprehensive diagnostic criteria for IgG4-related disease(IgG4-RD),2011 [J ] . Mod Rheumatol , 2012 , 22 ( 1 ): 21 - 30 .
Zhang W , Stone JH . Management of IgG4-related disease [J ] . Lancet Rheumatol , 2019 , 1 ( 1 ): e55 - e65 .
Deshpande V , Zen Y , Chan JK , et al . Consensus statement on the pathology of IgG4-related disease [J ] . Mod Pathol , 2012 , 25 ( 9 ): 1181 - 1192 .
Chen B , Chen LL , Gao X , et al . Guidelines for diagnosis and treatment of adult hypothyroidism [J ] . Chin J Endocrinol Metab , 2017 , 33 ( 2 ): 167 - 180 .
Komatsu K , Hamano H , Ochi Y , et al . High prevalence of hypothyroidism in patients with autoimmune pancreatitis [J ] . Dig Dis Sci , 2005 , 50 ( 6 ): 1052 - 1057 .
Sah RP , Chari ST . Clinical hypothyroidism in autoimmune pancreatitis [J ] . Pancreas , 2010 , 39 ( 7 ): 1114 - 1116 .
Shimizuguchi R , Kamisawa T , Endo Y , et al . Hypothyroidism in patients with autoimmune pancreatitis [J ] . World J Gastrointest Pharmacol Ther , 2018 , 9 ( 2 ): 16 - 21 .
Abraham SC , Wilentz RE , Yeo CJ , et al . Pancreaticoduodenectomy(Whipple resections)in patients without malignancy:are they all 'chronic pancreatitis'? [J ] . Am J Surg Pathol , 2003 , 27 ( 1 ): 110 - 120 .
Watanabe T , Maruyama M , Ito T , et al . Clinical features of a new disease concept,IgG4-related thyroiditis [J ] . Scand J Rheumatol , 2013 , 42 ( 4 ): 325 - 330 .
Yu Y , Liu JM , Yu N , et al . IgG4 immunohistochemistry in Riedel's thyroiditis and the recommended criteria for diagnosis:a case series and literature review [J ] . Clin Endocrinol(Oxf) , 2021 , 94 ( 5 ): 851 - 857 .
Hay ID . Thyroiditis:a clinical update [J ] . Mayo Clin Proc , 1985 , 60 ( 12 ): 836 - 843 .
Hamano H , Arakura N , Muraki T , et al . Prevalence and distribution of extrapancreatic lesions complicating autoimmune pancreatitis [J ] . J Gastroenterol , 2006 , 41 ( 12 ): 1197 - 1205 .
Honda K , Tamai H , Morita T , et al . Hashimoto's thyroiditis and HLA in Japanese [J ] . J Clin Endocrinol Metab , 1989 , 69 ( 6 ): 1268 - 1273 .
Klein J , Sato A . The HLA system. Second of two parts [J ] . N Engl J Med , 2000 , 343 ( 11 ): 782 - 786 .
Igarashi H , Ito T , Oono T , et al . Relationship between pancreatic and/or extrapancreatic lesions and serum IgG and IgG4 levels in IgG4-related diseases [J ] . J Dig Dis , 2012 , 13 ( 5 ): 274 - 279 .