慢性淋巴性甲状腺炎的神经、肌病表现

Neuropathy and M yopathy in Patients with Chronic Lymphocytic Thyroiditis

由于血中抗甲状腺抗体检测的广泛开展,及针吸病理学检查的临床应用,临床慢性淋巴性甲状腺炎(慢淋甲炎)的诊断成为可能.Hershman指出:人群5～10％患有慢淋甲炎,这一数字不一定符合我国的发病率,但是本院近三年中发现的病例数相当于过去30年病例总合的四倍,提示本病在我国并非少见.

Neurological investigations were performed for 53 cases with chronic lymphocytic thyroiditis diagnosed by pathology and serum antithyroid antibodies determination. Of the 53 cases, 29 had different types and severity with neurological findings, which could be divided into 5 groups: 1) Elevated levels of acetylcholine receptor antibody in 13 cases (24.1% ); 2) Myopathy and weakness accompanied by elevated serum enzyme levels ( GOT, CPK ,LDH and α-HBDH )in Teases (13% );3)Peripheral neuropathy in 6 cases (11.1%); 4) Encephalopathy in 2 cases (3. 7% ) ;and 5 )The changes in sella turcica in 2 cases. Our data showed that the neuropathy was not closely correlated to the duration of chronic lymphocytic thyroiditis and seemed that it had no relation with the thyroid function and titer of antithyroid antibodies. However, neuropathy occurred more often in cases with both chronic lymphocytic thyroiditis and some other autoimmune disorders, suggesting that abnormal immune function might be the common background patients with chronic lymphocytic thyroiditis and neuropathy. The aforementioned data suggest that the hypothyroid function and high titer of antithyroid antibodies might not be a prerequisite for developing neuromyopathies.