Autoimmune Thyroid Diseases

IF 4.6 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Seminars in nuclear medicine Pub Date : 2024-03-01 DOI:10.1053/j.semnuclmed.2023.11.002
Petra Petranović Ovčariček MD, PhD , Rainer Görges MD, PhD , Luca Giovanella MD, PhD
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Abstract

Autoimmune thyroid diseases (AITDs) include a wide spectrum of thyroid diseases affecting more commonly women than men. The most frequent forms are Graves’ Disease (GD) and Hashimoto's thyroiditis / Autoimmune Thyroiditis (AIT), but there are also other immunogenic destructive forms of thyroiditis, that is, silent and postpartum thyroiditis. In the last decade, AITDs and other inflammatory thyroid diseases related to anti-tumor molecular drugs are more frequently seen due to the widespread use of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICPIs). Autoimmune thyroiditis related to SARS-CoV-2 infection has been a novel entity in recent years.

Graves’ Disease and AIT may shift from hyperthyroidism to hypothyroidism, which may complicate the differential diagnosis and further treatment strategy. Moreover, all AITDs may manifest with thyrotoxicosis (a clinical condition marked with high serum levels of thyroid hormones) which has to be distinguished from hyperthyroidism (increased thyroid hormone production and secretion as a result of hyperfunctioning thyroid gland) due to different therapeutic approaches. Nuclear medicine techniques, such as radioiodine uptake (RAIU) and thyroid scintigraphy, using 99mTc- pertechnetate (Na[99mTc]TcO4) or 123-Iodine (Na[123I]I), have a crucial role in the differential diagnosis. Measurement of thyroid antibodies, e.g. thyroid peroxidase antibodies (TPO) and thyrotropin receptor antibodies (TRAb), as well as thyroid ultrasound, are complementary methods in the evaluation of thyroid disorders.

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自身免疫性甲状腺疾病。
自身免疫性甲状腺疾病(AITDs)包括广泛的甲状腺疾病,女性比男性更常见。最常见的形式是格雷夫斯病(GD)和桥本甲状腺炎/自身免疫性甲状腺炎(AIT),但也有其他免疫原性甲状腺炎的破坏性形式,即沉默和产后甲状腺炎。近十年来,由于酪氨酸激酶抑制剂(TKIs)和免疫检查点抑制剂(icpi)的广泛使用,AITDs和其他与抗肿瘤分子药物相关的炎性甲状腺疾病更为常见。近年来,与SARS-CoV-2感染相关的自身免疫性甲状腺炎是一个新的实体。Graves病和AIT可能从甲状腺功能亢进转变为甲状腺功能减退,这可能使鉴别诊断和进一步的治疗策略复杂化。此外,所有AITDs都可能表现为甲状腺毒症(一种以血清甲状腺激素水平高为特征的临床症状),由于治疗方法不同,必须将其与甲状腺功能亢进(甲状腺功能亢进导致甲状腺激素产生和分泌增加)区分开来。核医学技术,如放射性碘摄取(RAIU)和甲状腺显像,使用99mTc-高技术酸盐(Na[99mTc]TcO4)或123-碘(Na[123I]I),在鉴别诊断中具有至关重要的作用。甲状腺抗体的测定,如甲状腺过氧化物酶抗体(TPO)和促甲状腺素受体抗体(TRAb),以及甲状腺超声,是评估甲状腺疾病的补充方法。
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来源期刊
Seminars in nuclear medicine
Seminars in nuclear medicine 医学-核医学
CiteScore
9.80
自引率
6.10%
发文量
86
审稿时长
14 days
期刊介绍: Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.
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