problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl13132problendo-13132Research ArticleКлиническая эндокринологияClinical endocrinologyТиреотоксикоз у пациентки с синдромом Шерешевского–Тернера: терапия радиоактивным йодомThyrotoxicosis in a patient with Turner syndrome: radioactive iodine therapyhttps://orcid.org/0000-0002-8694-2474ГусейноваР. М.GuseinovaR. M.

Гусейнова Раисат Магомедкамиловна

117036, Москва, ул. Дм. Ульянова, д. 11

Raisat M. Guseinova

11 Dm. Ulyanova street, 117036 Moscow

rasgus-9@mail.ruhttps://orcid.org/0000-0002-4877-8124ПросвирнинаА. А.ProsvirninaA. A.

Просвирнина Анна Александровна

117036, Москва, ул. Дм. Ульянова, д. 11

Anna A. Prosvirnina - resident

11 Dm. Ulyanova street, 117036 Moscow

anna.shi96@mail.ruhttps://orcid.org/0000-0002-6954-1126КорчагинаМ. О.KorchaginaM. O.

Корчагина Мария Олеговна

Москва

SPIN-код:7834-5652

Maria O. Korchagina

Moscow

SPIN-код:7834-5652

mashulia96@list.ruhttps://orcid.org/0000-0001-5592-4727ТрухинА. А.TrukhinA. A.

Трухин Алексей Андреевич

117036, Москва, ул. Дм. Ульянова, д. 11

SPIN-код: 4398-9536

Alexey A. Trukhin

11 Dm. Ulyanova street, 117036 Moscow

SPIN-код: 4398-9536

alexey.trukhin12@gmail.comhttps://orcid.org/0000-0003-3785-0335ШереметаМ. С.SheremetaM. S.

Шеремета Марина Сергеевна - к.м.н.

117036, Москва, ул. Дм. Ульянова, д. 11

SPIN-код: 7845-2194

Marina S. Sheremeta - PhD

11 Dm. Ulyanova street, 117036 Moscow

SPIN-код: 7845-2194

marina888@yandex.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation2022201220226864958Copyright © Гусейнова Р.М., Просвирнина А.А., Корчагина М.О., Трухин А.А., Шеремета М.С., 20222022Гусейнова Р.М., Просвирнина А.А., Корчагина М.О., Трухин А.А., Шеремета М.С.Guseinova R.M., Prosvirnina A.A., Korchagina M.O., Trukhin A.A., Sheremeta M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/13132

Синдромом Шерешевского–Тернера (СШТ) - хромосомное заболевание, при котором в клетках женского организма одна Х-хромосома нормальная, а другая отсутствует или структурно изменена. Данные генетические аберрации приводят к появлению ряда отклонений в росте и развитии и повышают риск развития аутоиммунных заболеваний, в том числе затрагивающих щитовидную железу (ЩЖ). Патология ЩЖ при СШТ может быть представлена аутоиммунным тиреоидитом (АИТ), гипотиреозом или тиреотоксикозом различного генеза (болезнь Грейвса (БГ), АИТ в стадии тиреотоксикоза).Тиреотоксикоз — синдром, обусловленный избытком циркулирующих в крови гормонов ЩЖ. Одна из основных причин тиреотоксикоза — БГ, органоспецифичное аутоиммунное заболевание, обусловленное выработкой стимулирующих антител к рецепторам тиреотропного гормона. Существует три варианта лечения тиреотоксикоза при БГ: консервативный, хирургический, радионуклидный. Персонализированный подход к лечению особенно важен при наличии у пациента сопутствующих фоновых заболеваний, затрагивающих генотип.Мы представляем клинический случай пациентки Б. с СШТ и БГ, которая направлена к радиологу в отделение радионуклидной терапии ФГБУ «НМИЦ эндокринологии» Минздрава России. Особенности анамнеза: на этапе неонатального скрининга у пациентки диагностирован врожденный гипотиреоз, в возрасте 3 лет инициирована терапия тиреоидными гормонами. В возрасте 21 года у пациентки манифестировал тиреотоксикоз, причиной которого была БГ. На фоне тиреостатической терапии развился токсический гепатит. С учетом непереносимости консервативной терапии рекомендована терапия радиоактивным йодом 131I, в результате которой развился гипотиреоз.

Turner syndrome (TS) is a chromosomal disorder affecting female and characterized by complete or partial monosomy of the X chromosome. These genetic changes lead to the abnormalities in growth and development and increase the risk of autoimmune diseases, including those affecting the thyroid. Thyroid pathology in TS may include autoimmune thyroiditis, hypothyroidism, thyrotoxicosis (Graves disease, AIT in the hyperthyroid state).Thyrotoxicosis is the clinical syndrome of excess circulating thyroid hormones. One of the main causes of thyrotoxicosis is Graves’ disease (GD), an organ-specific autoimmune disease caused by the production of stimulating thyrotropin receptor antibodies. There are three treatment options for thyrotoxicosis: anti-thyroid drugs, radioactive iodine and thyroidectomy. A personalized approach to disease management is especially important in cases of genetic diseases.We present a clinical case of a patient with TS and GD, who has been referred to a radiologist at the Department of Radionuclide Therapy of Endocrinology Research Center. The patient was diagnosed with congenital hypothyroidism at neonatal screening, but thyroid hormones therapy was initiated aged three. Based on the survey, GD was diagnosed aged twenty one. Anti-thyroid drug therapy was started, which resulted in toxic hepatitis. Taking into account intolerance to anti-thyroid drugs, radioiodine therapy has been recommended, which led to hypothyroidism.

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The authors declare that there are no conflicts of interest present.