胸膜增生是准确检测新发的Graves'甲状腺功能障碍症,并在恢复甲状腺功能障碍症后得到解决
L Scappaticcio1,2, P Caruso1,2, N Di Martino2
1Unit of Endocrinology and Metabolic Diseases, AOU University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.
Journal of endocrinological investigation
|March 30, 2024
概括
胸膜增生 (TH) 是格雷夫斯病 (GD) 的新指标. 在诊断GD时,TH显示出高准确度,大多数病例在治疗甲状腺功能障碍后得到解决.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
- 放射学 放射学是一门学科.
背景情况:
- 格雷夫斯病 (GD) 是一种自身免疫性疾病,其特征是甲状腺功能障碍.
- 新的甲状腺外表现,包括胸膜增生 (TH),异常肝血检 (ALBTs),中性质衰竭 (NEU) 和Graves'轨道病变 (GO),在GD中越来越多地被识别出来.
- 对于区分GD与甲状腺毒的其他原因,TH的诊断效用需要进一步研究.
研究的目的:
- 为了评估胸膜增生 (TH) 在区分格雷夫斯病 (GD) 与非GD发炎毒性病的准确性.
- 为了比较TH的诊断性能与其他甲状腺外表现:ALBTs,NEU和GO.
- 调查与GD相关的TH和非GD相关的TH的临床结果和解决模式.
主要方法:
- 对264名新诊断为甲状腺毒性病的成年患者进行前性分析 (2018年1月 - 2023年6月).
- 通过部超声波 (nUS) 检测胸膜增生 (TH) 并通过磁共振成像 (MRI) 进行确认/随访.
- 对GO,TH,ALBT和NEU进行敏感性,特异性,准确性,正预测值 (PPV) 和负预测值 (NPV) 的计算,以区分GD与非GD.
主要成果:
- 胸膜增生 (TH) 在格雷夫斯病 (GD) (16.4%) 中的患病率明显高于非GD 甲状腺毒性病 (1.4%) (p < 0.001).
- 对于GD,TH的诊断准确性很高,其特异性为98%和积极预测值 (PPV) 为91%.
- 在20名GD患者中,TH在12个月内在18名GD患者中消失;在GD患者中,thymus也在euthyroidism中消失.
结论:
- 胸膜增生 (TH) 是一种具有高正预测值 (PPV) 的有价值指标,用于诊断甲状腺功能高的患者的格雷夫斯病 (GD).
- 建议对与甲状腺毒性相关的TH采取保守的管理方法.
- 在高甲状腺症的成功治疗后,TH的解决表明其可逆性质和与潜在的甲状腺状况的关联.
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