Possible induction of Graves' disease and painless thyroiditis by gonadotropin-releasing hormone analogues
Possible induction of Graves' disease and painless thyroiditis by gonadotropin-releasing hormone analogues
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DOI：
10.1089/105072503768499707
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发表时间：
2003-08-01
期刊：
影响因子：
6.6
通讯作者：
Nakata, Y
中科院分区：
文献类型：
--
作者：
Amino, N;Hidaka, Y;Nakata, Y
长期服用促性腺激素释放激素（GnRH）类似物可导致血清雌激素水平下降，这可能加重亚临床或轻度自身免疫性甲状腺疾病。2例患者在开始使用醋酸布西林4个月后出现与抗促甲状腺激素（TSH）受体抗体活性升高相关的Graves甲状腺毒症。GnRH类似物治疗在诊断时停止，但用了2年多的甲巯咪唑治疗才获得Graves病的缓解。另一名患者在开始服用醋酸leuprolide 4个月后出现无痛性甲状腺炎，与抗甲状腺微粒体抗体增加有关。这些结果提示GnRH类似物可能引起Graves甲状腺毒症或破坏性甲状腺毒症的临床发病。临床医生应该意识到这一现象。所有接受GnRH类似物治疗的患者应检查抗甲状腺抗体和自身免疫性甲状腺疾病家族史，并应进行相应的随访。
Prolonged administration of gonadotropin-releasing hormone (GnRH) analogues induce a decrease in serum estrogen level, which may aggravate subclinical or mild autoimmune thyroid disease. Two patients developed Graves' thyrotoxicosis in association with an increase in anti-thyrotropin (TSH) receptor antibody activities at 4 months after initiation of buserelin acetate. GnRH analogue therapy was discontinued at the time of diagnosis but it took more than 2 years of methimazole therapy to obtain remission of Graves' disease. Another patient developed painless thyroiditis in association with an increase in antithyroid microsomal antibodies at 4 months after initiation of leuprolide acetate. These results indicate that GnRH analogues possibly induce clinical onset of Graves' thyrotoxicosis or destruction-induced thyrotoxicosis. Clinicians should be aware of this phenomenon. All patients who are to receive GnRH analogue therapy should be examined for antithyroid antibodies and family history of autoimmune thyroid disease, and should be followed accordingly.