Graves患儿并发自身免疫性疾病的检出率及临床特征：中国单中心研究

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2025-04-01 Epub Date: 2025-01-06 DOI:10.1007/s12020-024-04148-w

Yang Li, Mu-Qiao Yan, Yan-Ning Song, Qin Zhang, Chun-Xiu Gong

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引用次数: 0

摘要

目的：本研究旨在确定单一中心Graves病（GD）患儿自身免疫性多内分泌综合征（APS）的检出率，并比较孤立性GD与伴APS （APS-GD）患儿的临床特征。方法：回顾性分析555例GD患者的临床资料，根据进展情况分为孤立性GD组和APS-GD组。FT4恢复正常的时间作为短期治疗效果的指标。结果：63例（11.4%）合并APS；女性52例（82.5%）。APS最常见的组成部分是1型糖尿病（T1DM）[24(4.3%)]。在APS-GD患者中，第1组分诊断后，第1年、第2年和第3年的第2种疾病累计发病率分别为63.4%、74.6%和82.0%，到第1 10年结束时累计发病率达到95.0%。孤立GD组FT3、TT3和TRAb水平较高。在相同初始剂量下，孤立GD组FT4恢复正常的中位时间为22.0 (14.0,30.0)d， APS组为25.0 (13.5,31.0)d （P = 0.936）。结论：该研究揭示了APS在GD患儿中的高合并率，提示APS-GD患者有更高的进展为其他内分泌腺疾病的风险。然而，两组在短期治疗效果上并无显著差异。这些发现对于指导小儿GD患者的临床管理和随访具有重要意义。

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Detection rate and clinical characteristics of coexisting autoimmune diseases in children with Graves' disease: a single-center study from China.

Purpose: This study aimed to determine the detection rate of autoimmune polyendocrine syndrome (APS) among children with Graves' disease (GD) at a single center and to compare clinical characteristics between those with isolated GD and those GD with APS (APS-GD).

Methods: A retrospective analysis was conducted on the clinical data of 555 patients and were categorized into isolated GD and APS-GD groups based on their progression status. The time for FT₄ to return to normal was used as an indicator of short-term treatment effectiveness.

Results: In all, 63 (11.4%) had coexisting APS; 52 (82.5%) were female. The most common component of APS was type 1 diabetes mellitus (T1DM) [24 (4.3%)]. Among APS-GD patients, after the diagnosis of the first component, the cumulative incidences of a second disease within the first, second, and third years were 63.4%, 74.6%, and 82.0%, respectively and till the end of the first decade reached 95.0%. The isolated GD group had higher levels of FT₃, TT₃, and TRAb. Under the same initial dosage, the median time for FT₄ to normalize was 22.0 (14.0, 30.0) d for the isolated GD group and 25.0 (13.5, 31.0) d for the APS group (P = 0.936).

Conclusion: The study uncovered a high comorbidity rate of APS in children with GD, suggesting that patients with APS-GD have a higher risk of progression to additional endocrine gland disorders. Yet, both groups showed no significant difference in their short-term therapeutic response. These findings are crucial for guiding the clinical management and follow-up of pediatric GD patients.

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.