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Autoimmune thyroid diseases : Hashimoto's thyroiditis and Graves' disease Nobuyuki Takasu 1,2 1University of the Ryukyus 2Aizawa Hospital Keyword: Basedow病 , 橋本病 , TSH受容体抗体(TRAb) , 甲状腺刺激抗体(TSAb) , ブロッキング抗体(TSBAb) , 抗サイログロブリン抗体(TGAb) , 抗甲状腺ペルオキシダーゼ抗体(TPOAb) pp.1272-1279
Published Date 2011/10/30
DOI https://doi.org/10.11477/mf.1542102813
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Autoimmune thyroid diseases (Hashimoto's thyroiditis and Graves' disease) occur when the thyroid is attacked by the immune system. Hashimoto's causes hypothyroidism. Graves' causes hyperthyroidism. These diseases occur more in women than in men. Hashimoto's and Graves' have a genetic component because they sometimes run in families. The immune system mistakes thyroid tissue for a foreign and potentially dangerous invader of the body and attacks it. Hypothyroidism is the hallmark of Hashimoto's. Hypothyroidism results in a slowing of the body's chemical processes and metabolism (weight gain, fatigue, and depression). Hyperthyroidism is the hallmark of Graves' disease. Hyperthyroidism results in increases of metabolism (nervousness, anxiety, and palpitation). Making a diagnosis begins with taking the history, including symptoms, and completing a physical examination. A goiter in the neck may be detected. A blood test is performed to determine levels of TSH and T4 and T3. High TSH levels and low T4 levels indicate hypothyroidism and may indicate a diagnosis of Hashimoto's. Low TSH levels and high T4 levels indicate hyperthyroidism and may indicate a diagnosis of Graves'. Hashimoto's is characterized by the destruction of thyroid follicle cells by various cell- and antibody-mediated immune processes. Hashimoto's patients have TPOAb, TGAb, and TSH-stimulation blocking Ab (TSBAb). Graves' is an autoimmune disease characterized by hyperthyroidism due to TSAb. TSAb is TRAb, which stimulates the thyroid. There are two types of TRAb ; TSAb and TSBAb. TSAb causes Graves' hyperthyroidism. TSBAb causes hypothyroidism. MMI is used for the treàtment of Graves' hyperthyroidism, and T4 for that of hypothyroidism.


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電子版ISSN 1882-1367 印刷版ISSN 0485-1420 医学書院

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