POSTPARTUM THYROIDITIS - A CLINICAL, HISTOLOGIC, AND IMMUNOPATHOLOGIC STUDY OF 15 CASES
POSTPARTUM THYROIDITIS - A CLINICAL, HISTOLOGIC, AND IMMUNOPATHOLOGIC STUDY OF 15 CASES
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DOI：
10.1093/ajcp/100.3.200
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发表时间：
1993-09-01
影响因子：
3.5
通讯作者：
TAKAZAKURA, E
中科院分区：
文献类型：
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作者：
MIZUKAMI, Y;MICHIGISHI, T;TAKAZAKURA, E
对来自 15 名临床和实验室证实的产后甲状腺炎患者的 15 份标本进行了组织学检查； 8 个标本是在甲状腺功能减退期获取的，另外 7 个标本是在甲状腺恢复正常期获取的。所有标本均显示局灶性或弥漫性慢性甲状腺炎。在甲状腺功能减退期采集的八个标本和早期恢复期采集的四个标本中，滤泡破坏和滤泡增生性改变是常见且特征性的组织学特征。在恢复后期采集的三个标本中，仅观察到淋巴细胞的局灶性浸润。正如作者之前的研究所示，这种组织学变化类似于自发性无症状甲状腺炎。作者认为，产后甲状腺炎和自发性无症状甲状腺炎在临床和组织学上可能属于同一类别。除了进行组织学检查外，作者还通过免疫组织化学方法检查了甲状腺内淋巴细胞亚群和滤泡细胞中HLA-DR抗原的表达，并将其与慢性甲状腺炎（普通型）进行了比较。在产后甲状腺炎中，观察到滤泡细胞中辅助 T 细胞数量显着增加和 HLA-DR 抗原表达增加，表明自身免疫反应性增强。
Fifteen specimens from 15 patients with clinically and laboratory-proven postpartum thyroiditis were examined histologically; 8 specimens were obtained during the hypothyroid phase and the other 7 during the recovery euthyroid phase. All specimens showed focal or diffuse chronic thyroiditis. In the eight specimens taken during the hypothyroid phase and four specimens during the early recovery phase, follicular disruption and hyperplastic change of the follicle were common and characteristic histologic features. In the three specimens taken during the late recovery phase, only focal infiltration of lymphocytes was observed. This histologic change resembled that in spontaneous silent thyroiditis, as shown in the authors' previous study. The authors believe that postpartum thyroiditis and spontaneous silent thyroiditis may fit the same category clinically and histologically. In addition to performing the histologic examination, the authors examined the intrathyroidal lymphocyte subsets and HLA-DR antigen expression in the follicular cells immunohistochemically and compared them with those in chronic thyroiditis (usual type). In postpartum thyroiditis, a significant increase of helper-T-cell numbers and increased expression of HLA-DR antigen in the follicular cells were observed, suggesting an enhancement of autoimmune reactivity.