Objective To sum up experiences in diagnosis and treatment for Hashimoto′s disease (HD). Methods Clinical records of 78 patients who underwent operations and were diagnosed as Hashimoto′s disease by histologic examination in our hospital from Jan. 1988 to Dec. 1998 were analyzed. Results Seventy females and 8 males, aged 9 to 70 years (average of 41.6 years). HD was coexistent with 10.3% of thyroid gland malignant tumor, 23.1% of adenoma and 30.8% of other thhroid gland diseases. The misdiagnosis rate was 35.9% and missed diagnosis rate was 46.2%. The clinical feature of HD and most common cause of misdiagnosis and missed diagnosis have been discussed. Conclusion It is emphasized that patients with diffuse goiter, palpable nodules, lighty color on scintillation scintigraphy, elevation of antimicosomiaux and antithyroglobuline but no finding on Bus should be highly suspected of having Hashimoto′s disease.
摘要:目的: 探讨儿童慢性淋巴细胞性甲状腺炎的临床特点、诊断方法、治疗及预后。 方法 : 对77例CLT患儿的临床资料进行回顾性分析。 结果 : 77例CLT患儿男女比例1:67,平均年龄1021±233岁(5～15岁)。86％患儿有甲状腺肿大;初诊时表现甲亢患儿51例,甲低20例,甲功正常6例; TGAb阳性率的94％,TPOAb阳性率96％;1例甲状腺细针吸取细胞学检查诊断合并甲状腺乳头状癌。治疗随访1～39月,77例患儿中出现甲低37例。 结论 : 儿童CLT多见于青春期女性,儿童和青春期患者病初表现甲亢较成人多见,TGAb 和TPOAb是CLT诊断的重要指标,随着病程延长,表现甲低患儿比例逐渐增高。Abstract: Objective: To study the clinical feature, diagnosis, treatment and prognosis of Chronic lymphocytic thyroiditis in children. Methods : Analyze the clinical data of 77 children with Chronic lymphocytic thyroiditis. Results : The proportion of men to women was 1:67 in all 77 children, and the mean age at diagnosis was 1021±233(age range 5~15 years). The percentage of positive TGAb and TPOAb were 94% and 96%, respectively in all the 77 children. One children was diagnosed Chronic lymphocytic thyroiditis coexistent with thyroid papillary carcinoma by FNAB. There were 37 children had hypothyrodism in all the 77 after 1～39 months. Conclusion : CLT is more frequent in females, and at the time of diagnosis more children and adolescents had hypethyrodism than adults. TGAb and TPOAb are important markers for the diagnosis of CLT. The percentage of children had hypothyrodism is increasing along with the course of disease.
【Abstract】Objective To study the relation between iodine and experimental autoimmune thyroiditis(EAT). Methods Establishment of animal model was performed with iodine and thyroglobulin(TG).The rats were randomly divided into 5 groups: normal control group(NC), low iodine group (LI,500 μg/L), high iodine group(HI,500 mg/L), TG+Freund adjuvant group(TG) and TG+Freund adjuvant+HI group(TG+HI). The rats in TG group and TG+HI group were rejected hypodermically with TG emulsified by complete Freund adjuvant, and strengthen immunity was conducted with TG emulsified by incomplete Freund adjuvant on 15 days. After that, strengthen immunity was done weekly till the end of the experiment. Serum TGAb and TPOAb were measured by radioimmunoassay. Observation of the pathological changes of thyroid gland was also done. Results Thyroid follicular destruction and lymphocytic infiltration in the TG+HI group (3.83±1.72) and HI group (3.00±0.89) were significantly higher than that of the NC group(0.67±0.82)，P＜0.05. The results of the TG group were higher compared with the NC group, but there were no significant differences between them（Pgt;0.05）. The levels of TGAb in the TG+HI (4.990±1.505)，HI (3.589±1.240) and TG group (4.883±1.198) were significant higher than those of the NC group (0.642±0.454) and the LI group (0.707±0.240)，P＜0.01. The levels of TPOAb in TG+HI group (1.475±0.523) and TG group (1.316±0.606) were significantly higher than those of the NC group (0.365±0.196) and the LI group（P＜0.01）. Serum TGAb and TPOAb levels were positively correlated with the histological grades of lymphocytic thyroiditis(r=0.9,P＜0.05）. Conclusion Excessive iodine intake may induce the occurrence of EAT. The induction of EAT with excessive iodine and TG may be more efficient.
Objective To summarize research status of correlation of chronic lymphocytic thyroiditis (CLT) and papillary thyroid carcinoma (PTC), in order to provide a basis for early diagnosis, prognosis, and prevention of PTC. Method The literatures about the recent studies of the correlation of the CLT and PTC were reviewed according to the results searched from PubMed database, SpringerLink database, Web of Science database, Wanfang database, CNKI database, and VIP database. Results The most of patients with CLT combined with PTC are young women, the characteristics are multifocal and occult, the prognosis is good. Its genesis might be related to the ionizing radiation, iodine intake, endocrine disorders, immune disorders, molecular biology, and other factors. But there are still different controversies about its specific pathogenesis and surgical treatment. Conclusions CLT is closely related to PTC. However, relationship between CLT combined with PTC and changing regularity of molecular biology, pathogenesis, or prognosis needs further to be studied and followed-up for a longer-term.
ObjectiveTo investigate the diagnosis and treatment of primary thyroid lymphoma.MethodThrough reading of relevant literatures at home and abroad in recent years, the diagnosis and treatment progress of primary thyroid lymphoma were summarized.ResultsThe pathogenesis of primary thyroid lymphoma was associated with chronic inflammatory stimuli such as Hashimoto’s thyroiditis. Its preoperative diagnosis mainly relied on ultrasound-guided biopsy. The treatment depended mainly on its pathological type and tumor stage. Surgical resection was mainly used for pathological biopsy and relieving compression symptoms, and radiotherapy and chemotherapy were the main treatments.ConclusionsPrimary thyroid lymphoma is a rare thyroid malignancy. Being familiar with and understands its clinicopathological features have important guiding significance for preoperative diagnosis, clearing pathological type and staging, and selection of reasonable treatment measures.
From May 1982 to September 1994, 13 cases patients with acute suppurative thyroiditis were treated. Their ages ranged from 6 to 39 years with a mean of 13. 9 years (nine of them were children). In this group, 8 cases had a pre-existing thyroid mass. Correct diagnosis were made preoperatively in 11 cases and the other two were misdiagnosed before operation. Eleven patients underwent incision and drainge, amony them 6 cases had been followed up with no recurrence. Based on this result and re-viewing literatures, the author draw the conclusion that acute suppurative thyoiditis is related with fistula of pyriform fossa, incision and drainage must be carried out and if there is fistula present, fistulectomy should be performed.
ObjectiveTo summarize the research progress of related genes in Hashimoto’s thyroiditis with papillary thyroid carcinoma.MethodLiteratures about Hashimoto’s thyroiditis with papillary thyroid carcinoma were reviewed by searching the literatures in domestic and foreign database.ResultsIn recent years, the incidence of Hashimoto’s thyroiditis with thyroid carcinoma (especially papillary thyroid carcinoma) was on the increase, the two might have the same molecular pathology mechanism.ConclusionThere is a close association between Hashimoto’s thyroiditis and papillary thyroid carcinoma, the common molecular genetic changes suggest that Hashimoto’s thyroiditis may have a correlation with papillary thyroid carcinoma.
ObjectivesTo systematically review the efficacy of Bailing capsule for autoimmune antibodies in Hashimoto thyroiditis (HT).MethodsPubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI databases were electronically searched to collect the randomized controlled trials (RCTs) on Bailing capsule in treatment of HT from inception to January 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs involving 428 patients were included. The results of meta-analysis showed that the changes of TGAb and TPOAb in Bailing capsule combined with Euthyrox group were higher than that in control group (MD=−228.91, 95%CI −398.61 to −59.20, P=0.008; MD=−158.19, 95%CI −222.44 to −93.94, P<0.000 01); the changes of TGAb and TPOAb in Bailing capsule combined with Iodine modification diet group were higher than that in control group(MD=−499.27, 95%CI −540.39 to −458.15, P<0.000 01; MD=−407.37, 95%CI −448.60 to −366.14, P<0.000 01).ConclusionsCurrent evidence shows that Bailing capsule combined with other therapies can decrease the levels of TGAb and TPOAb in HT patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.