Selection and analysis of cases with atypical responses in the pituitary-thyroid axis from a large thyroid database.

从大型甲状腺数据库中选择和分析垂体-甲状腺轴非典型反应的病例。

基本信息

批准号：
02671068
负责人：
ICHIHARA Kiyoshi
金额：
$ 1.34万
依托单位：
Osaka University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1991
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-02671068/
关键词：
thyrotropin free thyroxin epitope analysis computer analysis immunoassay immuno assay thyroxin bioassay

项目摘要

The relation between TSH and free T4 index (FT41) was analyzed from a large laboratory database in order to select cases showing atypical responses in the pituitary thyroid axis, characterized by high TSH despite high FT41. From among 7700 data, 67 cases with such inappropriate secretion of TSH were singled out and their clinical features and serial changes in the hormone levels were examined. Twenty-seven cases among them were children with cretinism under constant replacement therapy. Another four cases were those who underwent total thyroidectomy for thyroid cancer. The level of TSH remained high despite sufficient replacement therapy. In both groups of patients, the level of TSH, however, fluctuated inversely with variations of FT41 in response to the changing replacement dosage, thus, suggesting the presense of intact negative-feedback mechanism but with a skewed set point.In another serie of study, the relation between TSH and free T4 (FT4) were examined and identical groups of patients were found. In addition, three patients with Hashimoto's thyroiditis were found, who had no apparent reasons for the inappropriate secretion of TSH. Biochemical analyses of those cases were carried out, inclusing gel chromatography, a test for immunoreactivity for serially diluted samples, a search for autoantibodies against TSH or T4. None of them were positive.Recently, there have been many reports of changes in glycation patterns of TSH molecule resulting in altered bioactivity. Therefore, further study is required to identifiy such a change in the glycation pattern in our cases. Anyway, our approach to search for atypical cases is so efficient that it will facilitate discoveries of novel disorders involving the pituitary-thyroid axis.

从大型实验室数据库中分析了TSH和游离T4指数（FT41）之间的关系，以选择显示垂体甲状腺轴的非典型响应的病例，尽管FT41较高，但其特征是TSH高。从7700个数据中，有67例TSH分泌不当的病例被选出，并检查了它们的临床特征和激素水平的串行变化。其中有27例是在持续替代疗法下患有克雷抗药的儿童。另外四例是那些接受甲状腺癌的甲状腺全切除术的人。尽管有足够的替代疗法，TSH的水平仍然很高。然而，在两组患者中，TSH的水平与FT41的变化相反，响应不断变化的替代剂量，因此表明了完整的负面反馈机制的表现，但在研究的另一个串行中，研究了TSH和Free TSH和Free T4（FT4）的关系（FT4）（ft4）（FT4）（识别）。此外，还发现了三名桥本甲状腺炎患者，他们没有明显的理由进行TSH分泌。对这些情况进行了生化分析，包括凝胶色谱法，对连续稀释样品的免疫反应性测试，搜索针对TSH或T4的自身抗体。它们都不是积极的。因此，在我们的情况下，需要进一步的研究以确定糖化模式的这种变化。无论如何，我们寻找非典型病例的方法是如此有效，以至于它将促进涉及垂体 - 甲状腺轴的新型疾病的发现。