七、甲状腺炎

七、甲状腺炎

1.亚急性甲状腺炎。1895年,Mygind[41]报道了18名患有亚急性甲状腺炎的患者,他将该病称为“Thyroiditis Acuta”,意为“急性甲状腺炎”。9年后,瑞士医生Quervain[42]描述了相似症状患者的组织病理学并称之为“非化脓性甲状腺炎”。这两者报道的都是我们今天所熟知的亚急性甲状腺炎。

2.慢性侵袭性纤维性甲状腺炎。1896年,德国外科医生Riedel[43]报道了一种今天非常罕见的甲状腺炎——慢性侵袭性纤维性甲状腺炎,并且以他的名字命名。

3.桥本甲状腺炎。1912年,日本医生Hashimoto描述了今天最常见的甲状腺炎——桥本甲状腺炎。Hashimoto报道了4名患有甲状腺肿的女性,她们的甲状腺病理标本都伴有淋巴细胞浸润、实质性萎缩和纤维化[44]

1956年,来自美国的免疫学家Rose和他的导师Witebsky解释了桥本甲状腺炎的发病机制(图1-9)。他们证明了使用同源甲状腺提取物进行免疫的兔子会产生针对甲状腺球蛋白的自身抗体,并且这些兔子的甲状腺伴有淋巴细胞浸润[45]。同年,来自英国的Doniach等[46]证实了桥本甲状腺炎患者血清中含有甲状腺球蛋白的自身抗体。

图示

图1-9 1956年,美国的Rose报告桥本甲状腺炎的发病机制

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