ЗМІНА ПОГЛЯДІВ НА ВЕДЕННЯ ПАЦІЄНТІВ З ХРОНІЧНОЮ ЛІМФОЦИТАРНОЮ ЛЕЙКЕМІЄЮ: ОГЛЯД ЛІТЕРАТУРИ І ВЛАСНІ ДОСЛІДЖЕННЯ

Abstract

Autoimmune thyroiditis (AT) — is a genetically determined chronic autoimmune disease of the thyroid gland (TG), which is characterized by the production of the peroxidase and thyroglobulin antibodies, and clinically manifested by an increased TG and dysfunction of production of peripheral thyroid hormones. AT is the most common cause of acquired hypothyroidism in childhood and adolescence periods. Depending on the functional state of the TG, AT can have euthyrosis, hypothyroidism, and subclinical hypothyroidism phase. The short stage of hyperthyroidism is a feature of AT course in childhood and adolescence. It is well known that thyroid function is closely associated with the hypothalamic­-pituitary­-ovarian system, above all, thanks to the common central regulatory mechanisms. Thyroid and reproductive system mutually influence each other. Disorders of the thyroid function can cause precocious or delayed puberty, menstrual disorders, anovulation, infertility, miscarriage or fetal pathology. In the pubertal period, AT may adversely affect the course of puberty, leading to physical development disorders, menstrual dysfunction in the form of oligomenorrhea, puberty bleeding, amenorrhea, and anovulation. It would be wrong to assess the negative impact of AT only because of the dysfunction of the TG. It is believed that AT may be the cause of autoimmune ovary failure, the formation of autoimmune oophoritis that subsequently can lead to the premature ovarian insufficiency. The link between polycystic ovary syndrome (PCOS) and AT has been described in many studies. Data about the presence of thyroid antibodies in women with PCOS are different. Unfortunately, the impact of AT on the formation of the reproductive health in girls is insufficiently studied, the correlation between the degree of thyroid dysfunction in case of AT, the degree of formation of reproductive function of adolescent girls and the type of menstrual dysfunction is not clearly established, that needs further research. Timely detection of hidden forms of hypothyroidism and AT, adequate treatment of thyroid dysfunction in puberty, will allow to normalize changes in the reproductive system promptly and prevent the formation of pathological lesions of the reproductive organs in girls that will enhance the reproductive health of future mothers.