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자료유형
학술저널
저자정보
Duncan J. Topliss (Monash University)
저널정보
대한내분비학회 Endocrinology and Metabolism Endocrinology and Metabolism Vol.31 No.4
발행연도
2016.1
수록면
493 - 499 (7page)

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초록· 키워드

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Aspects of autoimmune thyroid disease updated in this review include: immunoglobulin G4 (IgG4)-related thyroid disease (Riedel’sthyroiditis, fibrosing variant of Hashimoto’s thyroiditis, IgG4-related Hashimoto’s thyroiditis, and Graves’ disease with elevatedIgG4 levels); recent epidemiological studies from China and Denmark indicating that excess iodine increases the incidence of Hashimoto’sthyroiditis and hypothyroidism; immunomodulatory agents (ipilimumab, pembrolizumab, nivolumab) activate immune responseby inhibiting T-cell surface receptors which down-regulate immune response, i.e., cytotoxic T-lymphocyte antigen 4 and programmedcell death protein 1 pathways; alemtuzumab is a humanised monoclonal antibody to CD52 which causes immune depletionand thyroid autoimmune disease especially Graves’ hyperthyroidism; small molecule ligand (SML) agonists which activate receptors,SML neutral antagonists, which inhibit receptor activation by agonists, and SML inverse agonists which inhibit receptor activationby agonists and inhibit constitutive agonist independent signaling have been identified. SML antagonism of thyroid-stimulatinghormone-receptor stimulatory antibody could treat Graves’ hyperthyroidism and Graves’ ophthalmopathy; and thyroxinetreatment of subclinical hypothyroidism can produce iatrogenic subclinical hyperthyroidism with the risk of atrial fibrillation and osteoporosis. The increased risk of harm from subclinical hyperthyroidism may be stronger than the potential benefit from treatment ofsubclinical hypothyroidism.

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