中国甲状腺疾诊病断指南.ppt

《中国甲状腺疾病诊治指南》中华医学会内分泌学分会;慢性淋巴细胞性甲状腺炎(Chronic lymphocytic thyroiditis);内容;内容;Dr. Hakaru Hashimoto ;概 述;;分型;;内容;流行病学;流行病学;内容;病因和发病机制;Figure?1.?The TAZ10 transgenic mouse model10 and the immunological basis for Hashimoto thyroiditis.(a) Thyroid follicle and the location of the major thyroid autoantigens: thyroid peroxidase (TPO), thyroglobulin (Tg) and the thyroid-stimulating hormone receptor (TSHR). (b) Immunological mechanisms leading to the spectrum of human autoimmunity with differing pathological and clinical characteristics. Graves hyperthyroidism is caused directly by TSHR autoantibodies that activate the TSHR. Hypothyroidism in Hashimoto thyroiditis is associated with autoantibodies to TPO (and less commonly to Tg), but the relative contributions to thyrocyte damage by autoantibodies, TPO-specific T cells and/or cytokines is unknown. The TAZ10 model of Quaratino et al. shows that TPO-specific T cells are sufficient to induce the histopathological and clinical features of Hashimoto disease. However, how CD8+ T cells and cytokines secreted by CD4+ T cells contribute to destruction has yet to be determined. T3, triiodothyronine.;内容;病理;;;The specimen in Panel A shows typical changes of Hashimotos thyroiditis, including lymphoid follicles with germinal centers (G), small lymphocytes and plasma cells (P), thyroid follicles with Hürthle-cell metaplasia (H), and minimal colloid material (C). ;内容;临床表现;GRETINISM : 呆小症; MYEXEDEMA : 粘液性水肿;;Identical male twins with Hashimotos thyroiditis were photographed at age 12. At age 8, they had the same height and appearance. During the intervening 4 years, small goiters developed and the growth of the twin on the right almost stopped. Biopsy indicated Hashimotos thyroiditis in each twins thyroid. ;内容;实验室检查和辅助检查;甲状腺超声;Pathology of Hashimotos thyroiditis. In this typical view of severe Hashimotos thyroiditis, the normal thyroid follicles are small and greatly reduced in number, and with the hematoxylin and eosin stain are seen t