橋本病による若年性甲状腺機能低下症の姉妹例に認められた抗T3, 抗T4自己抗体に関する検討:第2報合成L-T4治療による影響

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We previously reported that two sisters with juvenile hypothyroidism due to Hashimoto's thyroiditis (Case 1 : 13 years old, Case 2 : 10 years old) had antibodies against thyroid hormones. Treatment was started with 12.5μg of L-T4 per day in Jan. 1980. The doses were gradually increased, and after 1 year of treatment, both patients were clinically euthyroid on 100μg of L-T4 per day, and the heights of Case 1 and of Case 2 had increased by 9cm and by 10cm, respectively. Serum TSH levels were decreased from 1088μU/ml to 1.7μU/ml in Case 1, and from 1300μU/ml to 2.1μU/ml in Case 2. The titers of antithyroglobulin antibodies as measured by solid phase RIA decreased in both patients after the treatment. The bindings of 125I-T3 and of 125I-T4 to sera in the presence of 8-anilino-1- naphthalene sulfonic acid to block binding to TBG (non-treated sera) were markedly higher in the two patients before therapy than those in ten normal controls (11.8% and 52.3% in Case 1, 46.8% and 21.5% in Case 2, and 5.9 ± 0.6% and 4.1 ± 0.5% (mean ± SD) in the controls, respectively). After the 1 year treatment, the bindings of 125I-T3 and 125I-T4 decreased to normal levels in Case 1 (5.8% and 3.8%, respectively). In Case 2, the 125I-T4 binding decreased to the normal level (4.7%), whereas the125T3 binding decreased but still remained above the normal level (10.6%). In order to exclude the interference of endogenous and/or therapeutic thyroid hormones with the binding of labelled hormones to sera, the sera were treated with dextran-coated charcoal at pH3.0 (acid-treated sera). The bindings of 125-T3 and 125 I-T4 to acid-treated sera were clearly higher in both patients before therapy than those in ten normal controls (16.9% and 60.7% in Case 1, 75.0% and 46.4% in Case 2, and 6.9 ± 0.7% and 6.8 ± 0.7% (mean ± SD) in the controls, respectively), and these values were compatible with those from non-treated sera. After the 1 year treatment, however, the results of acid-treated sera were different from those of non-treated sera. That is, the bindings of 125I-T3 and of 125I-T4 to acid-treated sera from both patients decreased but remained above normal levels (9.3% and 26.5% in Case 1, and 29.4% and 22.5% in Case 2, respectively). These results indicate the presence of antibodies against thyroid hormones even in the euthyroid state during L-T4 treatment, and also the data obtained from the non-treated sera were affected by endogenous and/or therapeutic thyroid hormones. The importance of acid-charcoal treatment for the detection of anti-thyroid hormone antibodies during thyroid hormone administration was suggested. In the serum from another sister of the reported patients, we also found unusual T4binding proteins which were only detected by the acid-charcoal treatment. The implications of decrement of anti-thyroglobulin antibodies and of anti-thyroid hormone antibodies were discussed.
日本内分泌学会の論文

橋本病による若年性甲状腺機能低下症の姉妹例に認められた抗T<SUB>3</SUB>, 抗T<SUB>4</SUB>自己抗体に関する検討:第2報合成L-T<SUB>4</SUB>治療による影響

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橋本病による若年性甲状腺機能低下症の姉妹例に認められた抗T<SUB>3</SUB>, 抗T<SUB>4</SUB>自己抗体に関する検討:第2報 合成L-T<SUB>4</SUB>治療による影響

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橋本病による若年性甲状腺機能低下症の姉妹例に認められた抗T<SUB>3</SUB>, 抗T<SUB>4</SUB>自己抗体に関する検討:第2報合成L-T<SUB>4</SUB>治療による影響