弥漫性毒性甲状腺肿患者白细胞减少/缺乏的机制及治疗

doi:10.3969/j.issn.1004-583X.2016.03.004

临床荟萃 ›› 2016, Vol. 31 ›› Issue (3): 246-249.doi: 10.3969/j.issn.1004-583X.2016.03.004

弥漫性毒性甲状腺肿患者白细胞减少/缺乏的机制及治疗

张荣金,郝咏梅

河北医科大学第二医院内分泌科,河北石家庄 050000

收稿日期:2015-11-25 出版日期:2016-03-05 发布日期:2016-04-18
通讯作者: 郝咏梅,Email:Hym8601@126.com
作者简介:郝咏梅，河北医科大学第二医院内分泌科副主任医师，副教授，博士，硕士研究生导师，大内科副主任，内科教研室副主任。兼任中国医师协会内分泌代谢科医师分会青年委员、中国医师协会男科医师分会内分泌组委员、河北省血管健康与技术协会常务理事、河北省医学会糖尿病分会青年委员、石家庄市医学会糖尿病分会副主任委员、石家庄市医学会内分泌分会常务委员兼秘书长等职务。长期从事内分泌临床诊治工作，曾获河北省科学进步奖一、二等奖各1项，主研河北省自然基金1项，发表论文数十篇，SCI 3篇，参编著作6部。

Pathogenesis and treatment of patients with Graves disease presenting with leucopenia or agranulocytosis

Zhang Rongjin,Hao Yongmei

Department of Endocrinology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China

Received:2015-11-25 Online:2016-03-05 Published:2016-04-18
Contact: Hao Yongmei,Email:Hym8601@126.com

摘要/Abstract

摘要： 弥漫性毒性甲状腺肿(Graves病)是内分泌常见疾病,白细胞减少/缺乏是Graves病常见的合并症之一,可以发生在治疗之前和抗甲状腺药物治疗之后,在临床上经常被延误诊断和治疗,有时导致严重感染而使病情加重。本文就近几年来的研究进展,主要对其诊断、发病机制和治疗方面进行综述,着重论述临床如何早期发现与及时治疗。

关键词: 糖尿病, 2型；阿卡波糖, 甲状腺功能亢进症, 白细胞减少, 粒细胞缺乏

Abstract: Graves disease is one of the most common endocrine diseases. Leucopenia or agranulocytosis can be coexistent with Graves' disease in some patients.It can be seen in patients before treatment and after anti-thyroid medication. This phenomenon is often delayed in clinical diagnosis and treatment,which sometimes causes serious infections and makes the disease worse. According to the research progress in the recent years, including the diagnosis, pathogenesis and treatment about the desease, the authors aim to show early discovery and timely treatment in patients with Graves’ disease presenting with leucopenia or agranulocytosis.

Key words: diabetes mellitus, type 2, acarbose, hyperthyroidism, leukopenia, agranulocytosis

中图分类号:

R581.1

张荣金,郝咏梅. 弥漫性毒性甲状腺肿患者白细胞减少/缺乏的机制及治疗[J]. 临床荟萃, 2016, 31(3): 246-249.

Zhang Rongjin,Hao Yongmei. Pathogenesis and treatment of patients with Graves disease presenting with leucopenia or agranulocytosis[J]. Clinical Focus, 2016, 31(3): 246-249.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2016.03.004

https://huicui.hebmu.edu.cn/CN/Y2016/V31/I3/246

参考文献

[1] 中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南[J].中华内科杂志,2007,46(10):876-882.
[2] 关晓燕,包建玲,李巍.初诊Graves′甲亢患者合并白细胞减少的研究[J].国际检验医学杂志,2015,36(6):835-837.
[3] Cooper DS, Goldminz D, Levin AA, et al. Agranulocytosis associated with antithyroid drugs[J]. Ann Intern Med,1983,98(1):26-29.
[4] Young GAR, Vincent PC. Drug-induced agranulocytosis[J]. Clin Haematol,1980,9(3): 483-504.
[5] Tajiri J, Noguchi S, Murakami T,et al. Antithyroid drug-induced agranulocytosis. The usefulness of routine white blood cell count monitoring[J]. Arch Intern Med,1990, 150(3):621.
[6] Tamai H, Takaichi Y, Morita T, et al. Methimazole-induced agranulocytosis in Japanese patients with Graves' disease[J]. Clin Endocrinol,1989,30(5): 525-530.
[7] Guffy MM, Goeken NE, Bruno CP. Granulocytotoxic antibodies in a patient with propylthiouracil-induced agranulocytosis[J]. Arch Intern Med, 1984, 144(8): 1687-1688.
[8] Weitzman SA,Stossel TP, Harmon DC,et al. Antineutrophil autoantibodies in Graves′disease. Implications of thyrotropin binding to neutrophils[J].J Clin Invest,1985,75(1): 119-123.
[9] Yamada T,Sato A,Aizawa T,et al.An elevation of stem cell factor in patients with hyperthyroid Graves′disease[J]. Thyroid,1998, 8(6): 499-504.
[10] Diez S,Banias H,Diez-Martin JL,et al.Apparent cure of Graves-Basedow disease after sibling allogeneic bone marrow transplantation[J].Clin Endocrinol,1999,50(2):267-270.
[11] 李梅,邱明才,李欣,等.Graves病合并白细胞减少患者血清对骨髓细胞粒-单核细胞系集落形成单位生长的影响[J].中华实用医学杂志,2002,82(9):643-645.
[12] 邹大进,李娟.甲状腺功能亢进症伴粒细胞减少的诊断与处理[J].中国实用内科杂志,2006,26(9):645-646.
[13] 田竹芳,华郁.Graves病患者血液学异常的特点及相关因素分[J]析.中国全科医学,2010,13(3B):855-856.
[14] 刘迎见,施秉银,李娟.Graves甲亢合并白细胞减少与甲状腺自身抗体相关性研究[J].山东医药,2010,50(17):58-59.
[15] Takata K,Kubota S,Fukata S,et al.Methimazole-induced agranulocytosis in patients with Graves′ disease is more frequent with an initial dose of 30 mg daily than with 15 mg daily[J].Thyroid,2009,19(6):559-563.
[16] Shiran A, Shechner C, Dickstein G. Propylthiouracil-induced agranulocytosis in four patients previously treated with the drug[J]. JAMA,1991,266(22):3129-3130.
[17] 吴嘉俐.甲状腺功能亢进症合并白细胞减少60例临床观察[J].华中医学杂志,2008,32(5):367.
[18] Tamai H, Sodo T, Kimura A, et al.Association between the DRB1＊08032 histocompatibility antigen and methimazole-induced agranulocytosis in Japanese patients with Graves disease[J]. Am Intern Med, 1996, 124(5): 490-494.
[19] Douer D, Eisenstein Z. Methimazole-induced agranulocytosis: growth inhibition of myeloid progenitor cells by the patient ′s serum[J]. Eur J Haematol, 1988, 40(1):91-94.
[20] 高云明,汤建雷,周萍,等.ATD对GD患者粒细胞分布的影响[J].医学研究杂志,2013,42(8):130-132.
[21] Fukata S,Murakami Y,Kuma K,et al. G-CSF levels during spontaneous recovery from drug-induced agranulocytosis[J]. Lancet,1993,342(8885):1495.
[22] Tajiri J,Noguchi S,Murakami N. Usefulness of granulocyte count measurement four hours after injection of granulocyte colony-stimulating factor for detecting recovery from antithyroid drug-induced granulocytopenia[J].Thyroid,1997,7(4): 575-578.
[23] Vyas AA,Vyas P,Fillipon NL,et al.Successful treatment of thyroid storm with plasmapheresis in a patient with methimazole-induced agranulocytosis[J]. Endocr Pract,2010,16(4): 673-676.

弥漫性毒性甲状腺肿患者白细胞减少/缺乏的机制及治疗

Pathogenesis and treatment of patients with Graves disease presenting with leucopenia or agranulocytosis

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	吕莎莎, 宋金兰, 石健. m.3243A>G突变相关线粒体糖尿病1例并文献复习[J]. 临床荟萃, 2024, 39(2): 160-163.
[2]	张佳楠, 孙琳琳, 詹潇燕, 李冰. 血清维生素B₁₂与老年2型糖尿病轻度认知功能障碍的关系[J]. 临床荟萃, 2024, 39(1): 34-37.
[3]	位增, 曹灵, 佘敦敏, 刘彦, 王艳, 张真稳. 54例2型糖尿病患者合并新型冠状病毒感染的死亡原因分析[J]. 临床荟萃, 2023, 38(9): 806-812.
[4]	张娜文, 黄少敏, 田利民. 2型糖尿病与帕金森病相关性研究的进展[J]. 临床荟萃, 2023, 38(9): 845-850.
[5]	杨鑫, 许华娇. 基于Web of Science糖尿病患者心理干预研究的文献计量学分析[J]. 临床荟萃, 2023, 38(8): 731-736.
[6]	马光宇, 罗慧娟, 王冬菊, 肖小敏. 黄芩苷治疗糖尿病及其并发症的研究进展[J]. 临床荟萃, 2023, 38(8): 757-762.
[7]	张欣欣, 刘国庆, 王蓓蓓. 糖尿病酮症酸中毒引起极度血小板增多症1例并文献复习[J]. 临床荟萃, 2023, 38(8): 719-721.
[8]	金家辉, 杨阳, 秦铜, 何雨欣, 苏美华. 补充益生菌对2型糖尿病患者糖代谢改善的meta分析[J]. 临床荟萃, 2023, 38(7): 581-587.
[9]	贾丽娜, 吴美妮, 尹昌浩. 2型糖尿病认知功能障碍发病机制的研究进展[J]. 临床荟萃, 2023, 38(6): 554-558.
[10]	陈婷, 刘金彦. 中药靶向PI3K/Akt/mTOR通路调节自噬在糖尿病肾脏病中的研究进展[J]. 临床荟萃, 2023, 38(6): 564-568.
[11]	苏晨蓓, 王富军. 糖尿病下肢动脉疾病介入治疗疗效的研究进展[J]. 临床荟萃, 2023, 38(6): 569-572.
[12]	吴亚楠, 延天美, 梁鹏, 魏立民. 中老年糖尿病患者抑郁症状的高危识别[J]. 临床荟萃, 2023, 38(6): 516-520.
[13]	吕丽丽, 翟满满, 丁小艳, 陈永清. 线粒体转录因子A介导的线粒体功能障碍在糖尿病心肌病中的作用[J]. 临床荟萃, 2023, 38(5): 465-468.
[14]	易静静, 圈启芳, 马婕. 调节小胶质细胞反应性:糖尿病视网膜病变新见解[J]. 临床荟萃, 2023, 38(4): 364-368.
[15]	杨旻星, 孙璐, 叶赟, 徐文东, 黄小琳, 张海云, 徐英蕾. 中青年2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征患者认知功能特点及其影响因素[J]. 临床荟萃, 2023, 38(3): 216-220.