南予医学雑誌 第18巻
41/91

南予医誌 Vol.18 No. 1 2017-40-Introduction Graves’ disease is an autoimmune thy-roid disease to develop thyrotoxicosis by thyroid stimulating hormone receptor anti-body(TRAb).Additionally, it is reported that other factors which modulate immune systems including the immunoglobulin E(IgE)are associated with the pathogenesis of Graves’ disease1-5).Serum IgE levels elevate in 29-38.3% of the patients with Graves’ disease2-4).The pollen allergy is one of the common allergic diseases which are related to IgE synthesis.The seasonal allergic rhinitis of cedar pollen occurs in the early spring in Ja-pan.After attack of seasonal allergic rhinitis with cedar pollen, onsets and recurrences of Graves’ thyrotoxicosis were observed1,6).To evaluate disease onset, treat-ment response and prognosis prediction in Graves’ disease, it is important to assess serum IgE levels appropriately.However, there is few report to focus to the rst visit season examined serum IgE levels in pa-tients with untreated Graves’ disease.The aim of this study was to investigate whether serum IgE levels are different be-tween the rst visit seasons in patients with Graves’ disease.Subjects and MethodsSubjectsWe studied 110 patients(27 males and 83 females, mean age 47.2±16.0 years, range 13-86 years)with Graves’ disease who visited at Uwajima City Hospital be-tween January 2009 and December 2012.Graves’ disease was diagnosed by clinical features such as diffuse goiter, exophthal-mos, tachycardia, tremor, weight loss and sweating, and laboratory data such as lower serum TSH, elevated levels of serum free tri-iodethyronine(FT3), free thyroxine(FT4) and TRAb, as well as by measuring thyroidal uptake of 99mTc and imaging of the 99mTc distribution pattern in the thy-roid.The patients were divided into four groups by the month when they had a diag-nosis as follows:spring(January-March), summer (April-June), autumn (July-Sep-tember), winter(October-December).Blood samples were obtained and examined at their rst visit.Serum TSH, FT3, FT4, TRAb and IgE levels were measured by us-ing the Elecsys ECLIA kit(Roche Diagnos-tics, Tokyo, Japan).Briefly, mean levels of TSH, FT3, FT4, TSH, TRAb and me-dian(interquartile range)of levels of IgE in Graves’ disease were 0.01±0.001 μIU/㎖, 15.6±8.2 pg/㎖, 4.7±2.1 ng/㎗, 15.7±12.1 IU/ℓ and 123(45-300.3)IU/㎖, respectively.This study was approved by the Instruction-al Review Board of Uwajima City Hospital.Informed consent was obtained from all pa-tients.Statistical analysisStatistical analyses were performed by Kruskal-Wallis test rstly to compare overall differences among four groups, and when there was a significant difference, Steel-

元のページ  ../index.html#41

このブックを見る