Objective To summarize the advanced researchs of autoimmune thyroid disease(ATD) complicated with differentiated thyroid cancer (DTC). Methods The related literatures about concurrent ATD and DTC were consulted and reviewed. Results Hashimoto diseas (HD) complicated with DTC at home and abroad were reported more and more, whether merging with HD or other ATD disease could affect the prognosis of papillary thyroid cancer (PTC) was a controversial topic. HD and DTC (mainly PTC) had some same epidemiological and molecular features. Conclusion Better understanding of clinical pathology and characteristic of DTC concurrent with ATD can provide some new insights to immunotherapy for DTC.
Autoimmune uveitis (AU) and mood disorders, such as anxiety and depression, share a close bidirectional association. Visual impairment caused by AU and the side effects of glucocorticoid therapy significantly increase the incidence of anxiety and depression. Conversely, mood disorders disrupt immune homeostasis through neuro-endocrine-immune mechanisms, exacerbating inflammatory responses and elevating the risk of AU recurrence. The primary reasons for AU-induced mood disorders include visual impairment, unpredictable fluctuations in vision, long-term treatment, and glucocorticoid-related psychiatric reactions. Meanwhile, mood disorders not only trigger the onset and recurrence of AU but also interfere with treatment efficacy by reducing patient adherence. The underlying mechanisms involve psychological stress leading to hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, inflammatory factor-mediated “brain-eye axis” regulation, synergistic effects of the gut microbiota-brain-immune axis, and stage-specific immune regulatory characteristics of acute and chronic stress. Therefore, clinical management should emphasize the synergistic integration of psychological interventions and anti-inflammatory therapy to enable early detection and treatment of extramedullary lesions, optimize diagnostic and therapeutic protocols, and improve the prognosis of AU patients. Future research should further elucidate the molecular mechanisms underlying the interaction between mood and inflammation, establish multidisciplinary collaborative diagnosis and treatment systems, validate the efficacy of psychological interventions through large-scale clinical studies, and explore the development of neuroprotective anti-inflammatory drugs.
Objective To investigate the postoperative biochemical changes and the strategy of steroid treatment for autoimmune pancreatitis （AIP）. Methods Six patients with AIP from January 2007 to October 2011 in this hospital were included in this study. Four patients received pancreaticoduodenectomy or distal pancreatectomy for being preoperatively misdiagnosed as malignant tumors. Two patients avoided the unnecessary resection and received the internal drainage for obstructive jaundice and postoperative steroid medication because of a confirmation of AIP by intraoperative frozen biopsy. All the patients underwent routine examinations， including liver function， CA19-9 level， and imaging data. Measurement of serum IgG or IgG4 was performed for fewer patients after operation. Results CA19-9 levels were normal or slightly elevated in six AIP patients. For five patients with AIP in the head of pancreas， preoperative serum γ-GT levels were elevated. For these patients， whether pancreaticoduodenectomy or the internal drainage were performed， TB/DB levels were transiently elevated on day 1 or 4 after operation but dropped to below preoperative levelsor normal levels on day 7 after operation， and serum γ-GT levels among them presented a downward. Serum γ-globulin levels exhibited a downward trend among four AIP patients after resection， while a upward trend was found in another two AIP patients receiving internal drainage. From the limited data， elevated serum level of IgG in the AIP patients were found. As to IgG4， the only case was tested on month 7 after operation， the serum IgG4 level was elevated. CT showed that the swollen status of pancreas obviously reduced on month 3 after operation as compared with before operation.Conclusions Postoperative steroid therapy of AIP should be based on the serum γ-globulin level and operation method. CT or MRI imaging is used to evaluate the response to steroid treatment for the AIP patients.
Patients with autoimmune encephalitis are mainly characterized by behavioral, mental and motor abnormalities, neurological dysfunction, memory deficits and seizures. Different antibody types of autoimmune encephalitis its pathogenesis, clinical characteristics are different, in recent years found immune related epilepsy is closely related to autoimmune encephalitis, based on autoimmune encephalitis type is more, we choose more common autoimmune encephalitis, expounds its characteristics, to help clinical diagnosis.
ObjectiveTo study the diagnosis value of anti-SSa (including anti-Ro52 and anti-Ro60). MethodsAntibodies of ENA (including Sm, Ro52, Ro60, SSb, RNP, Scl-70, Jo-1 and Rib-P) from 23145 patients with positive antinuclear antibody (ANA) were retrospected from January 2009 to December 2013. The relationship between anti-Ro52, anti-Ro60 and other test results and the diagnosis or symptomatic information of patients was also analyzed. ResultsThe anti-Ro60 positive rate was 35.19% (8 145/23 145), and the anti-Ro52 was 13.16% (3 046/23 145) in 23145 ANA positive cases (P<0.05). The positive percentage of anti-Ro60 was higher in anti-SSb, anti-RNP, anti-Sm and anti-Rib-P positive cases than anti-Ro52 (P<0.05); the results of anti-Ro52 negative and anti-Ro60 positive (Ro52-Ro60+) had a higher percentage in autoimmune diseases, non-autoimmune disease and symptoms groups than anti-Ro52 positive and anti-Ro60 negative (Ro52+Ro60-) results (P<0.05). ConclusionThe anti-Ro60 has higher positive rate than anti-Ro52, and the sensitivity and prediction value of autoimmune diseases of anti-Ro60 are better than anti-Ro52. But both anti-Ro60 and anti-Ro52 have poor specificity for disease diagnosis.
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.
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.
ObjectiveTo retrospectively analyze patients taking Bacteroides fragilis (BF839) alone for their "possible autoimmune-related epilepsy" to find new treatments for epilepsy. Methods15 newly diagnosed patients who were not treated with standard Anti-seizure medications were diagnosed with "possible autoimmune-related epilepsy" and were given oral BF839 to initiate treatment. Seizure changes, self-reported improvement of comorbidities, EEG, adverse reactions and other information were reviewed. ResultsDuring the follow-up period of 14~33 months, 73.33% (11/15) patients achieved 1-year remission during the follow-up period, 7 patients had a remission time of more than 24 months, and 4 patients had a remission time of more than 30 months. 73.33% (11/15) of the patients reported that their comorbidities improved, and the EEG improvement rate was 57.14% (4/7). No patients withdrew due to adverse reactions, and the 12-month retention rate was 73.33% (11/15).ConclusionIt is the first report that the early application of intestinal flora preparation alone can effectively treat “possible autoimmune-related epilepsy”, and it can also be used as a diagnostic treatment tool due to its lower adverse reactions and improvement of comorbidities. This is not only of great significance to significantly improve the early diagnosis rate and remission rate of autoimmune-related epilepsy, and to prevent patients from developing refractory epilepsy, but also refreshes our understanding of the etiology of epilepsy.
Serum anti-retinal autoantibodies (ARA) are a group of autoantibodies that bind to retinal auto-antigens with significant biological importance in pathological processes such as retinal degeneration, inflammatory microenvironment formation, and tissue destruction. In recent years, the expression of serum anti-retinal antibodies has been found to be upregulated in patients with various blinding retinal diseases such as age-related macular degeneration, autoimmune retinopathy, and retinitis pigmentosa, closely correlated with the progression of diseases. However, current researches on ARA are incomplete, lacking animal experiments and large randomized controlled clinical trials. As a result, the exact mechanism of ARA is not well understood. Although several studies have demonstrated that serum ARA has an important diagnostic value in hereditary, autoimmune, and degenerative retinal diseases, there still lacks recognized laboratory tests and laboratory indicators with high specificity and sensitivity. Clinical symptoms should be considered when making definitive diagnosis of the diseases. Therefore, clarifying the mechanisms of ARA in retinal dystrophies provides new ideas in early diagnosis and treatments of retinal diseases, which is clinically and scientifically important for the maintenance of visual functions.