Clinical and immunological characteristics with unique HLA associations of patients with euthyroid ophthalmopathy.

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概要

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• Clinical and immunological characteristics of 30 patients with euthyroid ophthalmopathy (EO), who had typical Graves' ophthalmopathy but had never been persistently thyrotoxic, were analyzed.As for their thyroid states, EO had normal sized-thyroid or small goiter with normal 99 m-Tc pertechnetate uptake, but were found to have low serum TSH concentrations in one third of the studied subjects. Anti-thyroid microsomal antibody was detected in 34%, and TSH receptor antibodies (TBII and TSAb) were also detected in rather low frequency and low titers. These abnormal thyroid findings were not associated each other, and EO was considered to show frequent abnormality on their thyroid.To clarify whether EO has common genetic back-ground with Graves' or Hashimoto's patients, HLA-typing including class 2 antigens using restriction fragment length polymorphism method was carried out. Comparing to the control subjects, EO was found to be significantly associated with increases of HLA-B 12, B 40 (w 61), DR 9 and DQw 3, and decreases of Cw 1 and Dw 15. Graves' (88 cases) and Hashimoto's (46 cases) patients also showed significant associations with 8 and 4 antigens, respectively. However, except for DQw 3 the indicated antigens in EO did not overlap with those seen by 2 thyroid disorders.Further, comparisons among these 3 disease groups revealed that EO had essentially different genetic back-ground from 2 thyroid disorders. This finding was confirmed even from comparisons with subgroups of Graves' patients; those with ophthalmopathy, those without family history of diffuse goiter (19 of 23 EO studied did not claim for the family history) and those with small goiter. Comparisons between Graves' and Hashimoto's patients gave non-significant results in most of antigens indicated by the comparisons with the control subjects, and only DPw2 and DPw4 remained significant. This appeared relevant to their intimate relationship.In conclusion, EO patients have frequent immunological abnormality related to the thyroid, and their incapability to develop into persistent hyperthyroidism is considered to relate with their unique genetic back-ground and also with poor productions of TSH receptor antibodies.

• 日本臨床免疫学会の論文

著者

• 須川 秀夫

  京都大学分子病診療学・第2内科

• 小杉 眞司

  京都大学分子病診療学・第2内科

• 森 徹

  京都大学分子病診療学・第2内科

• 井上 大輔

  京都大学分子病診療学・第2内科

• 榎本 哲也

  京都大学分子病診療学・第2内科

• 井村 裕夫

  京都大学分子病診療学・第2内科

関連論文

• Clinical and immunological characteristics with unique HLA associations of patients with euthyroid ophthalmopathy.

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