Objective To sum up experiences in diagnosis and treatment for Hashimoto′s disease (HD). Methods Clinical records of 78 patients who underwent operations and were diagnosed as Hashimoto′s disease by histologic examination in our hospital from Jan. 1988 to Dec. 1998 were analyzed. Results Seventy females and 8 males, aged 9 to 70 years (average of 41.6 years). HD was coexistent with 10.3% of thyroid gland malignant tumor, 23.1% of adenoma and 30.8% of other thhroid gland diseases. The misdiagnosis rate was 35.9% and missed diagnosis rate was 46.2%. The clinical feature of HD and most common cause of misdiagnosis and missed diagnosis have been discussed. Conclusion It is emphasized that patients with diffuse goiter, palpable nodules, lighty color on scintillation scintigraphy, elevation of antimicosomiaux and antithyroglobuline but no finding on Bus should be highly suspected of having Hashimoto′s disease.
ObjectivesTo systematically review the efficacy of Bailing capsule for autoimmune antibodies in Hashimoto thyroiditis (HT).MethodsPubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI databases were electronically searched to collect the randomized controlled trials (RCTs) on Bailing capsule in treatment of HT from inception to January 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs involving 428 patients were included. The results of meta-analysis showed that the changes of TGAb and TPOAb in Bailing capsule combined with Euthyrox group were higher than that in control group (MD=?228.91, 95%CI ?398.61 to ?59.20, P=0.008; MD=?158.19, 95%CI ?222.44 to ?93.94, P<0.000 01); the changes of TGAb and TPOAb in Bailing capsule combined with Iodine modification diet group were higher than that in control group(MD=?499.27, 95%CI ?540.39 to ?458.15, P<0.000 01; MD=?407.37, 95%CI ?448.60 to ?366.14, P<0.000 01).ConclusionsCurrent evidence shows that Bailing capsule combined with other therapies can decrease the levels of TGAb and TPOAb in HT patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
Autoimmune ocular diseases are a type of inflammatory eye condition characterized by the involvement of the immune response. This includes various types disease such as autoimmune uveitis, thyroid-associated eye disease, and primary Sj?gren's syndrome. In recent years, breakthroughs have been achieved in inducing transplant tolerance, understanding tumor immune evasion, and preventing autoimmune diseases using immune checkpoint molecules. Negative immune checkpoints effectively control disease progression by inhibiting T cell proliferation, reducing inflammatory cytokine levels, and ultimately regulating autoimmune balance. Therefore, the negative immune checkpoint molecules are expected to be used as a new therapeutic target in the future, and the combination therapy through the combination of negative immune checkpoint drugs is expected to become an important direction to improve the efficacy of the treatment of autoimmune diseases.
ObjectiveTo summarize the clinical characteristic of IgG4 related lung disease.
MethodsThe clinical manifestation,laboratory examination,imaging,diagnosis and treatment data of 2 patients with IgG4 related lung disease admitted in the PLA General Hospital from January 2000 to January 2014 were collected and analyzed retrospectively.Related literatures were also reviewed.
ResultsThe serum IgG level of IgG4 related lung disease might be normal and the levels of IgG1,2,3 and 4 might increase.Some autoantibodies were positive.IgG4 related lung disease could be easily misdiagnosed as Sjogren's syndrome associated with interstitial pneumonia when the lacrimal gland and salivary gland were involved,and the chest CT occasionally showed multiple vesicles.The immunochemical staining of lung tissues revealed the increase of IgG4/IgG and the number of IgG4 positive lymphatic plasma cells >10/HP.The combination of clinical manifestation,laboratory examination,imaging and pathology results was more conducive for the diagnosis of IgG4 related lung disease.After the treatment of glucocorticoid,the clinical symptoms were relieved and the serum IgG4 level obviously decreased.
ConclusionIgG4 related lung disease is rare in clinic,which can involve the lung alone or multiple organs.The increase of IgG4/IgG indicated by the immunochemical staining of lung tissues is the gold standard for diagnosis.Glucocorticoid has good treatment effect in IgG4 related lung disease.
ObjectiveTo explore changes on Electroencephalograph (EEG) and Evoked Potential (EP) changes in autoimmune encephalitis.MethodsEight cases with autoimmune encephalitis from Sichuan people's hospital during July 18th 2014 to July 18th 2016 were recruited. The inclusion criteria included:① The blood and cerebral spinal fluid (CSF) of patients were sent to Neurology Lab of Peking Union Medical College Hospital for autoimmunerelated antibody analysis and confirmed as autoimmune encephalitis.2 Patient had done at least 2 or more times of routine EEG or video EEG (VEEG). 1 or more times of auditory brainstem response (ABR), Visual evoked potential (VEP) and Somatosensory evoked potential (SEP) for both upper and lower limbs. 3 Patients had classical clinical manifestation of autoimmune encephalitis as abnormal psychomotor behaviors, seizures, memory loss, fever, headache, and even disturbance of consciousness or decreased ventilate function.ResulstOf 8 patients in this study, 5 were anti NMDA-R encephalitis, 2 were anti GABABR encephalitis, and 1 was positive for both antibodies. The EEG profile of 5 anti NMDA-R encephalitis:2 of them had β wave in early stage (about 10th day) and δ wave with fast wave even appeared as δ brush in middle stage (about 20th day). They all had severe symptoms and long hospitalization but negative MRI. Another 2 of them could be seen sparsely distributed sharp wave and sharp-slow wave in their EEG. Their EEG gradually turned to normal when their symptoms gradually disappeared. The last one had normal EEG during the whole disease course. The EEG profile of anti GABAB-R encephalitis as following. 1 was dominant by slow wave and EEG went normal after effective treatment and the other showed generalized α wave especially α wave in frontal region. The latter patient withdraw treatment. For the only 1 both antibodies positive patient, EEG showed slow wave and it turned to normal when symptoms disappeared. EP showed some abnormalities with wave amplitude and latency changes in some patients.EP (SEP、VEP) turned to normal when symptoms disappeared.ConclusionThe EEG present differently in different types of autoimmune encephalitis and change with stages of disease. EEG may be used as an indicator for prognosis as well. When EEG shows fast wave with the history of patient points to encephalitis, blood and CSF antibodies for NMDA-R should be checked routinely. Generalized α wave on EEG should also be an indicator for checking GABAB-R. More researches should be done for EP changes in autoimmune encephalitis for our study was based on a small patient number.
Objective To investigate the MRI features of the autoimmune pancreatitis （AlP）. Methods MRI data of 8 patients with AIP were retrospectively analyzed. Results MRI showed that diffuse swelling of the pancreas in 8 cases. T1WI signal intensity homogeneous or inhomogeneous decreased， and T2WI signals intensity homogeneous or inhomogeneous increased. In arterial phase the enhancement of the lesion was not obviously，in portal venous phase there was gradual increase of enhancement. There was coated sample annular enhancement around pancreas， and the degree of enhancement was slightly lower than the pancreatic parenchyma. Pancreatic duct was irregular narrow. Conclusion AIP is a special kind of chronic pancreatitis，MRI features of AIP are helpful for the diagnosis and treatment of AIP．
【Abstract】Objective To study the relation between iodine and experimental autoimmune thyroiditis(EAT). Methods Establishment of animal model was performed with iodine and thyroglobulin(TG).The rats were randomly divided into 5 groups: normal control group(NC), low iodine group (LI,500 μg/L), high iodine group(HI,500 mg/L), TG+Freund adjuvant group(TG) and TG+Freund adjuvant+HI group(TG+HI). The rats in TG group and TG+HI group were rejected hypodermically with TG emulsified by complete Freund adjuvant, and strengthen immunity was conducted with TG emulsified by incomplete Freund adjuvant on 15 days. After that, strengthen immunity was done weekly till the end of the experiment. Serum TGAb and TPOAb were measured by radioimmunoassay. Observation of the pathological changes of thyroid gland was also done. Results Thyroid follicular destruction and lymphocytic infiltration in the TG+HI group (3.83±1.72) and HI group (3.00±0.89) were significantly higher than that of the NC group(0.67±0.82)，P＜0.05. The results of the TG group were higher compared with the NC group, but there were no significant differences between them（Pgt;0.05）. The levels of TGAb in the TG+HI (4.990±1.505)，HI (3.589±1.240) and TG group (4.883±1.198) were significant higher than those of the NC group (0.642±0.454) and the LI group (0.707±0.240)，P＜0.01. The levels of TPOAb in TG+HI group (1.475±0.523) and TG group (1.316±0.606) were significantly higher than those of the NC group (0.365±0.196) and the LI group（P＜0.01）. Serum TGAb and TPOAb levels were positively correlated with the histological grades of lymphocytic thyroiditis(r=0.9,P＜0.05）. Conclusion Excessive iodine intake may induce the occurrence of EAT. The induction of EAT with excessive iodine and TG may be more efficient.
ObjectiveThe purpose of this study was to investigate the autoimmune encephalitis (AE) seizure types and EEG characteristics and the value of diagnosis.
MethodsFifteen AE patients were hospitalized in the Department of Neurology at the First Hospital of Jilin University from November 2012 to July 2014. Data from their clinical manifestations, seizure types, EEG characteristics and laboratory investigation were analyzed.
ResultA total of 15 patients, 5 males and 10 females, aged 19-75 years were included. Eight cases of anti-NMDA receptor encephalitis, five cases of LGI1 receptor encephalitis and two cases of anti-Hu antibody encephalitis were diagnosed clinically.①Anti-NMDA receptor encephalitis:seven patients had seizures, which inclued complex partial seizure, generalized tonic-clonic seizure, simple partial seizure and status epilepticus.Three patients had extreme delta brush.②LGI1 receptor encephalitis:two cases had seizures, while four cases with FBDS. Sharp and slow waves with irregular delta waves appeared in bilateral temporal areas in EEG of three cases, while one case showed clinical seizure. Two cases detected "limb shaking and others" attack, but the corresponding EEG showed no abnormalities.③Anti-Hu antibody encephalitis:one case showed seizures, the EEG showed a lot of sharp and slow waves with irregular delta waves in bilateral temporal areas, while one case showed sharp and slow waves.
ConclusionAnti-NMDA receptor encephalitis can present with various types of seizures and non-convulsive status epilepticus, interictal extreme delta brush is more specific. It has important value. LGI1 receptor encephalitis is characterized by FBDS, it has important clinical significance.Anti-Hu antibody encephalitis lesions diffuse distribution, clinical manifestations are different. It may be associated with seizures, seizure types are not-specific.It may have slow waves or sharp and slow waves.
Objective〓〖WTBZ〗To observe the clinical features of autoimmune optic neuropathy (AON). 〖WTHZ〗Methods〓 〖WTBZ〗The clinical data of 58 patients with AON from Jan. 2006 to Dec. 2007 were retrospectively analyzed. The patients had undergone routine ophthalmological, neurological examination, visual field test, all set of autoimmune antibody test, brain MRI. 〖WTHZ〗Results〓〖WTBZ〗In 93 eyes of 58 patients with AON, the lowest best corrected visual acuity (BCVA) was lt;01 in 68 eyes (731%), 10 patients (172%) had other symptoms of nervous system, 14 patients (241%) had lesions of nonneurological system. Positive antinuclear antibody was found in 43 patients (796%); other abnormal antibodies were also found, including antiSSA/SSB, antidsDNA, antihistonic, anticardiolipin, and antihuman leukocyte antigen B27 antibodies. Systematic connective tissue disease presented in 20 patients (345%), such as sicca syndrome, systemic lupus erythematosus, and Behcet disease. 32 patients (552%) had abnormal brain MRI, and the BCVA of 49 eyes (777%) improved significantly after hospitalization. 〖WTHZ〗Conclusion〓〖WTBZ〗Patients with AON always have poor visual function, some of whom associate with other systems, as well as damages to other parts of the nervous system. While some AON patients are secondary to systemic connective tissue disease involving the optic nerve, the majority of these patients are isolated autoimmune optic neuropathy.
ObjectiveTo explore the epidemiological and clinical features of hepatic hemangioma.
MethodsThe clinical data of patients with hepatic hemangioma who were diagnosed in the First Affiliated Hospital of Guangxi Medical University from 2003 to 2011 were retrospectively analyzed, and then analyzed the epidemiological and clinical characteristics of hepatic hemangioma.
ResultsEight hundreds and eighteen patients with hepatic hemangioma were included in the study.Among them, 398 cases (48.7%) were male, 420 cases (51.3%) were female, and there were no significant differences in constitute of gender for each year (χ2=9.912, P=0.271), but there were significant differences in constitute of gender between different age groups (χ2=18.791, P=0.000 1), male patients were more than female in the group of aged over 60 years old.There was no special clinical manifestations of hepatic hemangioma.There were 75 patients (9.2%) combined autoimmune diseases in this group.The size of hepatic hemangioma ranged from 0.5-39.0 cm, the median diameter was 3.0 cm.There were significant differences between different gender, the tumor size of female patients were larger than male's (P < 0.05).The tumor happened mostly in the right hepatic lobe (57.2%), and there were no significant differences of the tumor location in different gender (P > 0.05).Hepatic hemangioma with a single lesion was most common (70.0%), and the right lobe lesions were more common than the left lobe lesions in single lesion group, multiple lesions in double lobes were most common in multiple lesion group.
ConclusionsHepatic hemangioma has a certain distribution pattern in gender, age, size, position, and so on, further research in prevention and controlled strategy need to be carried out in the future.At the same time, more in-depth research in the related factors participated in occurrence and development of hepatic hemangioma also need to be carried out, especially for the relationship between gender, age, autoimmune diseases, and hepatic hemangioma, which is worthy to be discussed.
