診断の困難であつた橋本甲状腺炎

HASHIMOTO'S THYROIDITIS ACCOMPANIED WITH DIAGNOSTIC DIFFICULTIES

　I．はじめに

　橋本病は以前には，一般に比較的稀な疾患と考えられていた。かかる時代には耳鼻科医が橋本病を診断し，治療にあたる機会はほとんどなかつたであろうが，近年多くの橋本病患者がみつかるようになり，また瀰漫性の前頸部腫脹を主訴とする疾患であるので，耳鼻科医が初診にあたることも多くなつた。われわれは最近橋本病の2例を経験したが，いずれも診断に困難をきたしたものであつた。現在広く用いられている甲状腺疾患の診断法を，耳鼻科医も十分理解しておく必要性をつくづく感じたので，症例を報告し，診断法に重点をおいて考按を加えた。

　Two cases of Hashimoto's thyroiditis are reported with a special reference to the diagnostic method. In general considerations, Hashimoto's thyroiditis is, now, easily diagnosed which is aided by physical and immunological examinations. Diagnostic difficulties are, however, at times encountered in that in making a differentiation from malignancy. Examinations with serum thyroid hormone, BMR, thyroidal I¹³¹ uptake and scintigraphy are widely different in results and not altogether conclusive. A mere increase in circulating thyroid auto-anti-bodies alone does not point to Hashimoto's thyroiditis. Doubtful cases should be examined histopathologically.

　The principle mode of treatment usually rest with administration of thyroid hormone. Needs for surgical intervention are only exceptional.