Study on the clinical features of Hashimoto′s thyroiditis with elevated serum IgG4

Q4 Medicine

中华内分泌代谢杂志 Pub Date : 2020-02-25 DOI:10.3760/CMA.J.ISSN.1000-6699.2020.02.008

Xiaogai Zhang, Fan Jiang, Guofang Chen, Shu-hang Xu, Chao Liu

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引用次数: 0

Abstract

Objective To investigate the clinical features of Hashimoto′s thyroiditis(HT) with elevated serum IgG4 levels and to guide the clinical practice. Methods Serum IgG4 concentrations were detected in patients with HT by nephelometric immunoassay. These patients were classified into two groups according to the IgG4 levels: positive group(IgG4≥1.35 g/L), and negative group(IgG4<1.35 g/L). The clinical characteristics of these two groups, including age, gender, medical history, serological features, and ultrasound were compared. Results Nine out of 111 patients with HT were positive with IgG4(8.11%), all of them were women. There was no significant difference in gender, age, BMI, dose of levothyroxine administration, FT3, FT4, and TSH levels between the two groups. The volume of thyroid in positive group was larger than that in negative group [57.81(38.36, 74.93) ml vs 25.07(18.48, 42.14) ml, P=0.015], and the level of thyroglobulin antibodies(TgAb; P=0.011) and thyroid peroxidase antibodies(TPOAb; P=0.025) in positive group were also significantly higher than those in negative group. Moreover, the positive group had a slightly higher risk of PTC than that of negative group(11.1% vs 2.94%, P=0.290), though the difference was not significant. Correlation analysis showed that IgG4 was positively associated with TgAb, TPOAb, and thyroid volume. Conclusions The levels of TgAb and TPOAb are higher, the volume of thyroid gland is greater, and the risk of PTC with lymph node metastasis is more frequent in HT patients with elevated serum IgG4. For HT patient with elevated serum IgG4, their thyroid function and morphology should be more closely monitored. Key words: IgG4; Hashimoto′s thyroiditis; Papillary thyroid carcinoma

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桥本甲状腺炎伴血清IgG4升高的临床特征研究

目的探讨桥本甲状腺炎(Hashimoto’s thyroiditis, HT)伴血清IgG4水平升高的临床特点，以指导临床。方法采用比浊免疫法检测HT患者血清IgG4浓度。根据IgG4水平将患者分为阳性组(IgG4≥1.35 g/L)和阴性组(IgG4<1.35 g/L)。比较两组患者的临床特征，包括年龄、性别、病史、血清学特征和超声检查。结果111例HT患者中IgG4阳性9例(8.11%)，均为女性。两组患者在性别、年龄、BMI、左旋甲状腺素给药剂量、FT3、FT4和TSH水平上无显著差异。阳性组甲状腺体积大于阴性组[57.81(38.36,74.93)ml vs 25.07(18.48, 42.14) ml, P=0.015]，甲状腺球蛋白抗体(TgAb;P=0.011)和甲状腺过氧化物酶抗体(TPOAb;P=0.025)，阳性组显著高于阴性组。阳性组发生PTC的风险略高于阴性组(11.1% vs 2.94%， P=0.290)，但差异无统计学意义。相关分析显示，IgG4与TgAb、TPOAb、甲状腺体积呈正相关。结论血清IgG4升高的HT患者TgAb、TPOAb水平较高，甲状腺体积较大，发生PTC伴淋巴结转移的风险较高。对于血清IgG4升高的HT患者，应密切监测其甲状腺功能和形态。关键词:IgG4;桥本甲状腺炎;甲状腺乳头状癌

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来源期刊

中华内分泌代谢杂志 Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

0.60

自引率

0.00%

发文量

7243

期刊介绍： The Chinese Journal of Endocrinology and Metabolism was founded in July 1985. It is a senior academic journal in the field of endocrinology and metabolism sponsored by the Chinese Medical Association. The journal aims to be the "Chinese broadcaster of new knowledge on endocrinology and metabolism worldwide". It reports leading scientific research results and clinical diagnosis and treatment experience in endocrinology and metabolism and related fields, as well as basic theoretical research that has a guiding role in endocrinology and metabolism clinics and is closely integrated with clinics. The journal is a core journal of Chinese science and technology (a statistical source journal of Chinese science and technology papers), and is included in Chinese and foreign statistical source journal databases such as the Chinese Science and Technology Papers and Citation Database, Chemical Abstracts, and Scopus.