hypothyroidism 英 /,haɪpəʊ'θaɪrɒɪdɪz(ə)m]/ 美 /'haɪpo'θaɪrɔɪ'dɪzəm/
释 义 n. 甲状腺功能减退；甲状腺官能不足病
例 句 The risk factors responsible for hypothyroidism were not evident from the statistical analysis of these cases. 甲状腺功能减退的相应风险因素在这些病例的统计学分析中并不明显。
作者： Arnaud Jannin
期刊：Clin Chem Lab Med
Autoimmune thyroid diseases (AITD) occur frequently, and two biological markers of thyroid autoimmunity are used routinely: anti-thyroid peroxidase antibodies (TPOAbs) and anti-thyrotropin receptor (TSHR) antibodies (TRAbs). According to the American guidelines, TPO-Abs should not be measured in every patient with hypothyroidism but in those with subclinical hypothyroidism, as in these cases results can modify patient management. Otherwise, measurement of TRAbs is recommended in all cases of hyperthyroidism for the diagnosis of Grave’s disease (GD). In contrast to TPO-Abs, TRAbs are directly responsible for thyroid dysfunction. Stimulating TRAbs, known as thyroid stimulating antibodies (TSAbs), activate the cAMP pathway through TSHR, leading to hyperthyroidism. In some patients, other TRAbs, known as thyroid blocking antibodies (TBAbs) act rather as competitive inhibitors of TSH binding to TSHR, thereby favoring hypothyroidism. The functional activity of TRAbs can be evaluated by a bioassay. The presence of TBAbs has been mainly described in GD, where a “switch” in the production of TSAbs towards TBAbs has been described. The prevalence of TBAbs in patients with AITD has been estimated at 9.3%. Despite a large amount of literature on these antibodies, data about the clinical presentation of hypothyroidic patients with TBAbs are scarce. Indeed, testing for TBAbs is recommended in pregnant women with a history of GD; it is also often done in patients with GD with difficulty in treatment adjustment or secondary progression towards hypothyroidism, as well as in patients with orbitopathy without GD. Between 2010 and 2017, a functional TRAbs bioassay was requested by the Department of Biology at Lille University for 39 patients, including 30 patients with such a background and nine patients having hypothyroidism without a history of hyperthyroidism or ophthalmopathy. We therefore reviewed the clinical presentation of these nine patients (Table 1).