南予医学雑誌 第18巻
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宮内、他:Seasonal differences of serum Immunoglobulin E levels at the first visit in patients with Graves' disease南予医誌 Vol.18 No. 1 2017-43-daka et al.reported that onset of Graves’ disease after attacks of allergic rhinitis were due to Japanese cedar pollen with el-evation of serum antigen-specific IgE and recurrence of thyrotoxicosis after attack of allergic rhinitis1,6).An allergic rhinitis of cedar pollen in early spring is one of the most common diseases associated with the synthesis of IgE.These reports suggest that the elevation of serum IgE levels have seasonality in patients with Graves’ dis-ease.In spring and autumn group of female Graves’ patients, serum IgE levels signi-cantly increased than that of summer group of female Graves’ disease patients although serum IgE levels in male Graves’ disease patients were not increased signicantly in each season.In spring group, the cause of the elevation of IgE levels might be al-lergic response to cedar pollen.In autumn group, the cause of the elevation of IgE levels might be allergic response to autumn allergens such as ragweed, mugwort and orchard grass7-9).To our knowledge, this is the first report to suggest positive rela-tion between Graves’ disease and allergens in autumn.However, the relationship be-tween Graves’ disease and other seasonal allergens has still been unclear, although allergens in autumn are the main causes of other allergy related diseases such as aller-gic conjunctivitis and asthma in Japan.Un-fortunately, we have not examined specic serum IgE levels of the patients yet in the present study.In addition, it has not been clear that the causes of the difference of serum IgE levels between female Graves’ disease patients and male Graves’ disease patients.The causes might be the differ-ence of susceptibility to allergen between female and male.The elevation of serum IgE levels have im-portant implications for evaluating disease onset, treatment response and prognosis prediction in Graves’ disease.Several liter-atures reported that elevation of serum IgE levels was found in 29%-38.3% patients with Graves’ disease.Sato et al. reported that 29% patients with Graves’ disease had elevations of serum IgE levels, 58% of whom had hereditary and/or allergic condi-tions1).Komiya et al.reported that remis-sion rates of Graves’ patient with elevated IgE levels was less than patients with nor-mal IgE levels4).However, these studies do not provide the meaning about seasonal differences of the first visit in elevation of IgE in patients with Graves’ disease.It is suggested that female Graves’ disease pa-tients onset in spring or autumn might have the possibility for resistance to treatment.In addition, signicant differences in serum thyroid hormone levels were found between spring group and summer group in all pa-tients and female patients.The causes of these differences in each season are still unknown.Further investigations are re-quired.This study has limitations such as relatively small sample size and a study in a local area in Japan.Since distribution periods of seasonal allergens differ in each area, the effects of seasonal allergens to the Graves’

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