血中抗甲状腺抗体より見た慢性甲状腺炎の臨床的考察
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概要
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The effects of treatment with desiccated thyroid, glucocorticoid and chloroquine on patients with chronic thyroiditis were observed. The clinical course of the disease was studied with special attention to changes of goiter and thyroid antibody in the serum. The titer of circulating antibody was determined by tanned red cell agglutination technic using thyroglobulin as antigen (TRC) and complement fixation test using thyroid microsome as antigen (CF).<BR>With desiccated thyroid, the goiter was less reduced and antibody titer was not decreased. With glucocorticoid, the goiter was reduced and the complement fixation antibody decreased significantly, but these were restored to their original state when this drug was discontinued. With chloroquine, the complement fixation antibody decreased to some extent, goiter however was not reduced. Thyroglobulin antibody was not changed by either therapy.<BR>For the purpose of investigating the immunological effect of these drugs, the changes in the complement fixation ability of aggregated r-globulin, which was shown to be a cytotoxic effect, under the influence of these drugs were studied in vitro. When chloroquine was administered (32-128mg/100ml), its complement fixation ability was decreased remarkably.<BR>As the treatment of chronic thyroiditis, use of glucocorticoid was effective, but was not practical because of the rebound phenomena after discontinuance of the drug. Therefore, chloroquine was used at the same time when glucocorticoid was decreased. By this combined use of glucocorticoid and chloroquine, rebound phenomena of CF titer and goiter were suppressed when glucocorticoid was discontinued. Accordingly, the administration of chloroquine to chronic thyroiditis was effective clinically and immunochemically.<BR>As mentioned above, in the treatment of chronic thyroiditis, TRC antibody titer remai.ned constant, but CF titer changed in accordance with changes of the goiter. When a patient with hyperthyroidism was treated with <SUP>131</SUP>I, TRC titer did not change, While CF titer elevated temporarily as the goiter became smaller. In the experimental thyroiditis which was produced by prolonged sensitization with thyroidextract in rat, TRC titer rose in all cases, but CF titer tended to elevate in rat which showed marked histological findings.<BR>These results suggested that CF antibody titer indicates the presence of active inflamatory change in thyroid tissue, while TRC antibody titer reflects sensitized state in antibody producing tissue.
- 一般社団法人 日本内分泌学会の論文