论文部分内容阅读
作者发现1例有TSH增高的原发性甲状腺功能减退(甲减)老年患者,用放射免疫法测定其血清中fT_4、TT_4、TT_3始终增高。即使用甲醇提取排除血清高滴度的内源性IgG干扰后,TT_3、TT_4仍增高。只有靠基础TSH值及用平衡透析法测fT_4及fT_3才符合甲减。患者为84岁女性。无甲状腺疾病家族史。1958年开始出现突眼,左眼尤甚。1962年两眼出现纵向复视,发现左眼为内分泌性突眼伴上下睑收缩,眼眶组织水肿,眼球向上注视受限,配戴棱镜后可纠正复视。1965年首次行甲状腺功能检查,无异常,眼部症状未加剧。5年中体重增加9kg,无甲状腺肿,但毛发稀少,踝反射消失。蛋白结合碘(PBI)3.8(正常
The authors found that in elderly patients with elevated thyroid TSH (hypothyroidism), the levels of fT_4, TT_4 and TT_3 in the serum were always increased by radioimmunoassay. TT_3 and TT_4 are still elevated even after methanol extraction removes the high titer of serum from endogenous IgG. Only by basal TSH value and the use of equilibrium dialysis fT_4 and fT_3 in line with hypothyroidism. The patient is 84 years old. No family history of thyroid disease. Exophthalmus began to appear in 1958, especially in the left eye. In 1962 two eyes appeared diplopia and found that the left eye for endocrine exophthalmos accompanied by the lower eyelid contraction, orbital tissue edema, eye upwards restricted, wear prism to correct diplopia. 1965 thyroid function tests for the first time, no abnormalities, ocular symptoms not aggravated. 5 years weight gain 9kg, no goiter, but rare hair, ankle reflex disappears. Protein bound iodine (PBI) 3.8 (normal