Subscribe to RSS
DOI: 10.1055/s-0029-1243053
© Georg Thieme Verlag KG Stuttgart · New York
Autoimmunthyreoiditis: Diagnostik und Therapie
Autoimmune thyroiditis: diagnosis and treatmentPublication History
eingereicht: 12.9.2009
akzeptiert: 12.11.2009
Publication Date:
25 November 2009 (online)

Zusammenfassung
Die Autoimunthyreoiditis ist eine Autoimmunerkrankung mit familiär gehäuftem Auftreten und Bevorzugung des weiblichen Geschlechts. Im Erwachsenenalter ist die AIT die häufigste Ursache für eine Hypothyreose. Vermutlich spielt bei der Genese das zytotoxische T-Lymphozytenantigen 4 (CTL-4) eine wichtige Rolle. Die Diagnose wird durch eine Erhöhung der Antikörper gegen thyreoidale Peroxidase und gegen Thyreoglobulin und eine typische Echoarmut im Sonogrammm gestellt. Bei hypothyreoter Stoffwechsellage muss L-Thyroxin substitutiert werden. Die AIT kann als Sonderform postpartal auftreten sowie als Folge einer Zytokintherapie.
Summary
Autoimmune thyroiditis (AIT) is an autoimmune disease with genetic background. Women are more likely to develop AIT. In adulthood, AIT is the most frequent cause for aquired hypothyroidism. Cytotoxic T-lyphocyte antigen (CTL-4) may play a role in the etiology of the disease. Diagnosis is made by determination of elevated antibodies against thyroid peroxidase and thyroglobulin, and a hypoechoic pattern in ultrasound. In case of hypothyroidism a substitutive therapy with levothyrooxine is necessary. AIT may occur as postpartum thyroiditis or as a special entity as consequence of therapy with zytokines.
Schlüsselwörter
Thyreoiditis - Autoimmunthyreoiditis - Hashimoto-Thyreoiditis - Hypothyreose - Postpartum-Thyreoiditis
Keywords
thyroiditis - autoimmune thyroiditis - Hashimoto’s thyreoiditis - hypothyroidism - postpartum thyreoiditis
Literatur
- 1
Braun B, Blank W.
Die Sonographie der Schilddrüse
und Nebenschildrüsen.
Der Internist.
2006;
47
1432-1289
Reference Ris Wihthout Link
- 2
Brix T H, Kyvik K O, Hegedüs L.
A population-based study of chronic autoimmune
hypothyroidism in Danish twins.
J Clin Endocrinol Metab.
2000;
85
536-539
Reference Ris Wihthout Link
- 3
Brown T R, Zhao G, Palmer K C, Sundick P S.
Thyroid injury,
autoantigen availability, and the initiation of autoimmune thyroiditis.
Autoimmunity.
1998;
27
1-12
Reference Ris Wihthout Link
- 4
Caraccio N, Cuccato S, Pratesi F. et al .
Effect of type I interferon(s) on cell
viability and apoptosis in primary human thyrocyte cultures.
Thyroid.
2009;
19
149-55
Reference Ris Wihthout Link
- 5
Carlé A, Bülow Pedersen I, Knudsen N. et al .
Thyroid volume in hypothyroidism
due to autoimmune disease follows a unimodal distribution: evidence
against primary thyroid atrophy and autoimmune thyroiditis being
distinct diseases.
J Clin Endocrinol Metab.
2009;
94
833-839
Reference Ris Wihthout Link
- 6
Friedrich N, Schwarz S, Thonack T, John U, Wallaschofski H, Völzke H.
Association
between parity and autoimmune thyroiditis in a general female population.
Autoimmunity.
2008;
41
174-80
Reference Ris Wihthout Link
- 7
Gärtner R, Gasnier B C, Dietrich J W, Krebs B, Angstwurm M W.
Selenium supplementation in patients
with autoimmune thyroiditis decreases thyroid peroxidase antibodies
concentrations.
J Clin Endocrinol Metab.
2002;
87
1687-91
Reference Ris Wihthout Link
- 8
Grozinsky-Glasberg S, Fraser A, Nahshoni E, Weizman A, Leibovici L.
Thyroxine-triiodothyronine combination therapy versus thyroxine monotherapy
for clinical hypothyroidism: meta-analysis of randomized controlled
trials.
J Clin Endocrinol Metab.
2006;
91
2592-9
Reference Ris Wihthout Link
- 9
Hampel R, Bennöhr G, Gordalla A, Below H.
Jodidurie bei Ewachsenen in
Deutschland 2005 im WHO-Zielbereich.
Med Klinik.
2009;
104
425-428
Reference Ris Wihthout Link
- 10
Hashimoto H.
Zur Kenntnis der lymphomatösen Veränderung
der Schilddrüse (Struma lymphomatosa).
Arch Klin
Chir.
1912;
97
219
Reference Ris Wihthout Link
- 11
Hemminki K, Li X, Sundquist J, Sundquist K.
Familial associations
of rheumatoid arthritis with autoimmune diseases and related conditions.
Arthritis Rheum.
2009;
60
661-668
Reference Ris Wihthout Link
- 12
Köhrle J, Jakob F, Contempré B, Dumont J F.
Selenium, the
thyroid, and the endocrine system.
Endocrine Rev.
2005;
26
944-84 Epub
2005 Sep 20
Reference Ris Wihthout Link
- 13
Marhawa R K, Tandon N, Karak A K. et al .
Hashimoto’s thyroiditis: countrywide
screening of goitrous healthy young girls in postiodination phase
in India.
J Clin Endocrinol Metab.
2000;
85
3798-3802
Reference Ris Wihthout Link
- 14
Mariotti S, Caturegl P, Piccolo P, Barbesino G, Pinchera A.
Antithyroid peroxidase autoantibodies in thyroid diseases.
J Clin Endocrinol Metab.
1990;
71
661-9
Reference Ris Wihthout Link
- 15
McGrogan A, Seaman H E, Wright J W, De Vries C S.
The
incidence of autoimmune thyroid disease: a systematic review of
the literature.
Clin Endocrinol.
2008;
69
687-697
Reference Ris Wihthout Link
- 16
Negro R, Greco G, Mangieri T, Pezzarossa A, Dazzi D, Hassan A.
The influence of selenium
supplementation on postpartum thyroid status in pregnant women with
thyroid peroxidase autoantibodies.
J Clin Endocrinol Metab.
2007;
92
1263-8
Epub 2007 Feb 6
Reference Ris Wihthout Link
- 17
Nygaard B, Jensen E, Kvetny J, Jarlov A, Faber J.
Effect of combination therapy with thyroxine (T4) and 3,5,3-triiodothyronine
(T3) versus T4 monotherapy in patients with hypothyroidism, a double
blind, randomized cross-over study.
Eur J Endocrinol.
2009; Aug 7. [Epub ahead of print];
Reference Ris Wihthout Link
- 18
Ord W M.
On myxoedema, a term proposed to be applied to an essential
condition in the „cretinoid” affection, occasionally
observed in middle-aged women.
Medico-chirurgical transactions.
1878;
61
57-78
Reference Ris Wihthout Link
- 19
Rink T, Schroth H -J, Holle L -H, Garth H.
Effekte
von Iodid und Schilddrüsenhormonen bei der Induktion und
Therapie einer Thyreoiditis Hashimoto.
Nuklearmedizin.
1999;
38
144-149
Reference Ris Wihthout Link
- 20
Schmidt M, Voell M, Rahlff I.
Long-term follow-up of antithyroid peroxidase antibodies in
patients with chronic autoimmune thyroiditis (Hashimoto’s
thyroiditis) treated with levothyroxine.
Thyroid.
2008;
18
755-60
Reference Ris Wihthout Link
- 21
Stagnaro-Green A.
Clinical Review 152: Postpartum Thyreoiditis.
J Clin
Endocrinol Metab.
2002;
87
4042-7
Reference Ris Wihthout Link
- 22
Stranges S, Marshall J R, Natarajan R.
Effects of long-term selenium supplementation
on the incidence of type 2 diabetes: a randomized trial.
Ann
Intern Med.
2007;
147
217-23
Reference Ris Wihthout Link
- 23
Strieder T GA, Tijssen J GP, Wenzel B E, Endert E, Wirsinga W M.
Prediction of progression to overt
hypothyroidism or hyperthyroidism in female relatives of patients
with autoimmune thyroid disease using the Thyroid Events Amsterdam
(THEA) Score.
Arch Intern Med.
2008;
168
1657-1663
Reference Ris Wihthout Link
- 24
Tan L, Sun W, Sang Z N, Zhang W Q.
The effect of
selenium on the expression of Fas/FasL in experimental
autoimmune thyroiditis rats’ thyroid with adequate iodine.
Zhonghua Yu Fang Yi Xue Za Zhi.
2008;
42
640-3
Reference Ris Wihthout Link
- 25
Teng W, Shan Z, Teng X. et
al .
Effekt of iodine intake on thyroid diseases in
China.
New Engl J Med.
2006;
354
2783-2793
Reference Ris Wihthout Link
- 26
Thamm M, Ellert U, Thierfelder W, Liesenkötter K -P, Völzke H.
Jodversorgung in Deutschland.
Ergebnisse
des Jodmonitorings im Kinder- und Jugendgesundheitssurvey (KiGGS)
Bundesgesundheitsbl- Gesundheitsforsch- Gesundheitsschutz.
2007;
50
744-749
Reference Ris Wihthout Link
- 27
Tomer Y, Davies T F.
Searching for the
autoimmune thyroid disease susceptibility genes: from gene mapping
to gene function.
Endocr Rev.
2003;
24
694-717
Reference Ris Wihthout Link
- 28
Tomer Y, Blackard J T, Akeno N.
Interferon alpha treatment and thyroid dysfunction.
Endocrinol
Metab Clin North Am.
2007;
36
1051-66
Reference Ris Wihthout Link
- 29
Tunbridge W MG, Brewis M, French J M. et al .
Natural history of autoimmune thyroiditis.
Brit Med J.
1981;
282
258-262
Reference Ris Wihthout Link
- 30
Völzke H, Lüdemann J, Robinson D M.
The prevalence of undiagnosed thyroid disorders
in a previously iodine-deficient area.
Thyroid.
2003;
13
803-810
Reference Ris Wihthout Link
- 31 Weissenrieder N, Stier B.
Jugendgesundheitsuntersuchung J1. In: Stier B, Weissenrieder N Jugendmedizin Gesundheit und Gesellschaft. Berlin; Springer 2006: 132-138Reference Ris Wihthout Link - 32
Yoshida A, Hisatome I, Taniguchi S. et al .
Pendrin is a novel autoantigen recognized
by patients with autoimmune thyroid diseases.
J Clin Endocrinol
Metab.
2009;
94
442-448
Reference Ris Wihthout Link
PD Dr. Joachim Feldkamp
Medizinische Klinik I, Klinikum Bielefeld
Teutoburger Str. 50
33604 Bielefeld
Phone: 0521/581-3500
Fax: 0521/581-3599
Email: joachim.feldkamp@klinikumbielefeld.de