Peculiarities of autoimmune thyroid diseases in children with Turner or Down syndrome: an overview.

Peculiarities of autoimmune thyroid diseases in children with Turner or Down syndrome: an overview.
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DOI:
10.1186/s13052-015-0146-2
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发表时间:
2015-05-15
影响因子:
3.6
通讯作者:
Wasniewska M
Wasniewska M
中科院分区:
医学3区
文献类型:
--
作者:
Aversa T;Lombardo F;Valenzise M;Messina MF;Sferlazzas C;Salzano G;De Luca F;Wasniewska M

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本评论的目的是总结有关自身免疫性甲状腺疾病 (ATD) 与唐氏综合症 (DS) 或特纳综合症 (TS) 之间关系的重要文献新闻。根据文献报道,桥本氏甲状腺炎 (HT) 和格雷夫斯病 (GD) 在患有 DS 或 TS 的儿童中比没有这些染色体病的儿童更常见。促炎细胞因子的上调可能导致 TS 儿童对 ATD 的易感性增强,而免疫系统的失调可能有利于 DS 中 ATD 的发展。在 TS 儿童中,HT 的生化表现比同龄对照儿童要轻。在 DS 和 TS 中,诊断时的 GD 图片与一般儿科人群没有显着差异。 DS 和 TS 中 GD 随时间的演变与在儿科一般人群中观察到的情况没有什么不同,而 TS 和 DS 中 HT 的演变比没有这些染色体病的女孩更严重。结论:与 TS 或 DS 的关联能够通过以下条件影响 ATD 的流行病学和病程:a) 对这些疾病的易感性增加; b) TS 女孩的 HT 生化表现较轻,但演变模式较严重; c) DS 患者中 HT 的生化表现和演变更为严重。
Aim of this commentary is to summarize the salient literature news on the relationships between autoimmune thyroid diseases (ATDs) and either Down syndrome (DS) or Turner syndrome (TS). According to literature reports both Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) are more frequent in children with DS or TS than in those without these chromosomopathies. An up-regulation of proinflammatory cytokines might be responsible for the enhanced susceptibility of TS children to ATDs, whereas a dysregulation of immune system may favor the development of ATDs in DS. In TS children biochemical presentation of HT is less severe than in peer controls. In both DS and TS GD picture at the time of diagnosis is not significantly different than in the pediatric general population. The evolution over time of GD in DS and TS does not differ from that observed in the pediatric general population, whereas the evolution of HT in both TS and DS is more severe than in girls without these chromosomopathies. Conclusions: The association with TS or DS is able to affect both epidemiology and course of ATDs by conditioning: a) an increased susceptibility to these disorders; b) a less severe biochemical presentation and a more severe evolutive pattern of HT in TS girls; c) a more severe biochemical presentation and evolution of HT in DS patients.
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