Study On Clinical Characteristics Of IgG4 Positive Hashimoto’s Thyroiditis

【Purpose】To investigate the characteristics of immunoglobulin G4 in patients with Hashimoto’s thyroiditis,and to analyze the differences of clinical,biochemical and imaging features between IgG4 related HT and non IgG4 related HT.To improve the understanding of IgG4 related HT and provide basis for correct diagnosis and reasonable treatment of IgG4 related HT.【Methods】60 patients with Hashimoto’s thyroiditis were randomly selected.The serum IgG4 level was determined by immune turbidimetry.The patients were divided into two groups:IgG4 related HT(IgG4≥864mg/l)and non IgG4 related HT(IgG4≥864mg/l)according to the serum IgG4 level.The difference of IgG4 concentration,IgG4/IgG,age,sex,FT3,FT4,TSH,TPOAb,TgAb,TRAb,thyroid volume,thyroid nodule,degree of hypoechoic thyroid and clinical recurrence were compared between the two groups.【Results】(1)There was a positive correlation between serum IgG4 and serum TRAb、TPOAb、TgAb in patients with IgG4-HT(The r values were 0.463、0.541、0.381;and the P values were 0.00655、0.00078、0.003).(2)The level of IgG4/IgG、TPOAb、TgAb,thyroid volume,the ratio of recurrence in IgG4-HT group was higher than that in non-IgG4-HT group,and the difference was statistically significant(The P values were 0.0001,0.0037,0.0134,0.023,0.009),it has no difference in FT3、FT4、TSH、TRAb、thyroid nodule,degree of hypoechoic thyroid,age and sex between the two groups.(3)There was a positive correlation between the fluctuation of clinical condition and serum IgG4、IgG4/IgG、thyroid volume level in HT patients(The r values were 0.353、0.022、0.256;and the P values were 0.006,0.022,0.049).【Conclusions】(1)IgG4-HT is a unique subtype of Hashimoto ’ s disease。(2)The serological,Imaging and Clinical Features of IgG4-HT : the level of IgG4/IgG 、TPOAb、TgAb,the thyroid volume,the ratio of recurrence was higher than that in non-IgG4-HT group.The serum IgG4,IgG4/IgG,TSH,TGAb,TPOAb,TRAb have not obvious contact with prone to recurrent.