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由之前的SARS-CoV-2暴露引发的儿科自身免疫甲状腺炎:一个过渡性哈希托毒性病例
Ligia Rodina1,2, Lavinia Georgeta Caplan2, Elena-Vanda Ciudin2
1Doctoral School of Medicine, Faculty of Medicine, Lucian Blaga University of Sibiu, Sibiu, Romania.
European journal of case reports in internal medicine
|January 15, 2026
概括
严重急性呼吸道综合征冠状病毒2 (SARS-CoV-2) 感染可能会在儿童中引发自身免疫性甲状腺炎,呈现过渡性甲状腺功能障碍 (hashitoxicosis) 和随后的甲状腺功能低下症. 这凸显了在病毒后炎症综合征中对甲状腺功能评估的必要性.
科学领域:
- 内分泌学 在内分泌学.
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
背景情况:
- 儿科甲状腺功能障碍往往表现为非特异性症状,使诊断复杂化.
- 包括SARS-CoV-2在内的病毒感染越来越多地与所有年龄段的自身免疫性甲状腺疾病有关.
- 病毒暴露后的免疫媒介机制可能会触发或恶化内分泌自身免疫.
研究的目的:
- 报告儿童患者在SARS-CoV-2感染后发生的带有哈希毒素的自身免疫甲状腺炎.
- 突出病毒感染诱导儿童内分泌自身免疫的潜力.
- 强调甲状腺功能评估在无法解释的病毒后系统性炎症中的重要性.
主要方法:
- 一个以前健康的13岁男孩在病毒感染后出现了全身症状的病例报告.
- 综合性感染检查,包括SARS-CoV-2抗体测试.
- 甲状腺功能测试 (TSH,甲状腺抗体) 和甲状腺超声波.
- 通过过渡性甲状腺过高和随后的甲状腺功能低下阶段监测甲状腺状况.
主要成果:
- 患者呈现出发烧,喘息,双细胞减退和肝细胞分解,除了鼻病毒外,常见的病毒感染呈阴性.
- 检测到高甲状腺刺激激素,阳性抗甲状腺抗体和高抗SARS-CoV-2抗体.
- 甲状腺超声波表明自身免疫性甲状腺炎;皮质类固醇治疗导致过渡性哈希托毒素症,随后是亚临床性甲状腺功能低下症.
结论:
- 病毒后自身免疫性甲状腺炎,包括哈希毒素症,在儿童感染SARS-CoV-2后可能发生.
- 甲状腺功能障碍应在长期发烧或炎症综合征病毒感染后的差异诊断中考虑.
- 系统性炎症,细胞分解或细胞衰竭可能伴随自身免疫性甲状腺炎,表明多器官免疫激活.
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