Autoimmune Thyroid Disease-Associated Nephropathy
Introduction
Introduction to autoimmune thyroid disease related nephropathy Autoimmunethyroid disease (AITD) includes Graves' disease, thyroiditis, and primary hypothyroidism. According to domestic and foreign scholars, the incidence of proteinuria in AITD patients is 11% to 40%, so it is also called AITD nephropathy. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: hypothyroidism, thyroid adenoma
Cause
Causes of autoimmune thyroid disease related nephropathy
Causes:
Autoimmune thyroid disease (AITD) is a thyroid disease caused by autoimmune disorders. Autoantibodies against thyroid antigens, including thyroglobulin antibodies and thyroid microsomal antibodies, can be detected in patients' blood. Patients may be accompanied by mild proteins. Urine, a small number of patients with nephrotic syndrome, there have been reports in 85 cases of AITD patients, found that proteinuria up to 40%, the study suggests that the occurrence of such proteinuria may be related to autoimmunity, many kidney biopsy related to AITD combined with proteinuria Reports indicate that there is deposition of thyroid antigen in the kidney tissue, and it is thought that the thyroid antigen-antibody complex may be deposited in the renal tissue via the blood circulation to cause immune complex nephritis.
Pathogenesis:
Foreign scholars believe that the mechanism of AITD membranous nephropathy may be the formation of in situ immune complexes in the deposition of thyroid globulin and thyroid microsomal antigen in the glomerular basement membrane. In some cases, there may be a mechanism of circulating immune complexes.
Prevention
Autoimmune thyroid disease related nephropathy prevention
There is no report on the prevention of AITD, but in the topical discussion of autoimmunity and pregnancy, some scholars have suggested that taking selenium during pregnancy can prevent postpartum thyroiditis. In the case of autoimmune thyroid disease-related nephropathy, attention should be paid to low-salt and light diets to avoid spicy and irritating foods. Vegetables, fruits, and soy products are indispensable.
Complication
Autoimmune thyroid disease related nephropathy complications Complications hypothyroidism thyroid adenoma
Hypothyroidism.
Symptom
Symptoms of nephropathy associated with autoimmune thyroid disease Common symptoms Hypothyroidism proteinuria
Mainly AITD clinical manifestations and proteinuria, proteinuria is mild, but sometimes can even be manifested as nephrotic syndrome, AITD and proteinuria can occur simultaneously or sequentially, sometimes AITD is first, sometimes proteinuria is first, The interval between the two can be more than 10 years.
Examine
Examination of autoimmune thyroid disease-related nephropathy
There may be laboratory manifestations of nephrotic syndrome, proteinuria and AITD may occur simultaneously or sequentially, with microscopic hematuria, and no hypertensive or renal impairment.
Renal biopsy AITD-related nephrotic syndrome patients, the most common pathological type is membranous nephropathy, may also have mesangial proliferative nephritis, focal glomerular sclerosis changes, specific changes for renal tissue biopsy with thyroid antigen Deposition.
Diagnosis
Diagnosis and diagnosis of autoimmune thyroid disease related nephropathy
AITD should be considered when combining proteinuria, but it should be noted whether the two are independent of each other. The diagnosis of proteinuria caused by AITD depends on renal biopsy to find thyroid antigen deposition in kidney tissue, due to AITD and protein. Urine does not necessarily occur at the same time, so you should pay attention to check for proteinuria when diagnosing AITD. In turn, all kinds of immune complex nephritis should be excluded to rule out AITD.
AITD should be distinguished from various immune complex nephritis.
