亜急性甲状腺炎における下垂体甲状腺系に関する研究

抄録

In eighteen patients with subacute thyroiditis, serum triiodothyronine (T₃), thyroxine (T₄), thyrotropin (TSH) and 4-hour ¹³¹I-uptake were measured during the course of the illness. In the acute stage, serum T₃ and T₄were markedly elevated, (T₃ : 343±36 ng/dl, T₄ : 11.0±0.9 ug/dl) and ¹³¹I-uptake was low. (2.9 ±0.6%) Serum TSH was undetectable in 14 patients out of 18.
In five cases, TRH test was performed.There was no significant response in serum TSH in the acute stage.
This indicates that in the acute stage of subacute thyroiditis, the thyroid hormone level is increased sufficiently to inhibit TSH release. The mean value of an increment in serum TSH was only 1.8μU/ml during the recovery phase when ¹³¹I-uptake was normal or hypernormal. In addition, an elevated ¹³¹I-uptake was not necessarily associated with an immediate increase in serum T₃ and T₄.
These observation suggests that the resumption of the iodide pump is more important than an increment in serum TSH in producing normal or hypernormal ¹³¹I-uptake during the recovery phase.
There appears to be dissociation between the reestablishment of ¹³¹I-uptake and the resumption of hormone synthesis and secretion in the thyroid.