PDF(Pubmed)
Abstract：
Thyroid Hemiagenesis (THA) is an uncommon, congenital anomaly defined by the absence of one thyroid lobe with or without the isthmus. Reports suggest it may be found more often in regions endemic for hypothyroidism. Genetic abnormalities are thought to have a role based on findings in monozygotic twins. Most cases are sporadic, however familiar clusters have also been documented. It is found more frequently in females. A majority of patients report no symptoms and THA is found incidentally during investigations or intraoperatively. THA is usually associated with normal thyroid function, but it can present with thyroid hypofunction. Since a majority of patients are asymptomatic, there are no specific recommendations for management. Ultrasound imaging and thyroid scintigraphy using technetium or iodine are useful in diagnosis. Its clinical importance occurs when the remnant thyroid lobe requires excision leading to the lifelong requirement for thyroxine supplementation. Published English literature (Medline, PubMed, and Embase databases) was searched. Medical subject headings (MeSH) terms used were \"thyroid hemiagenesis,\" \"one thyroid lobe,\" and \"thyroid aplasia\". Case reports, case series, and original articles were selected to provide a framework for this review. Articles reviewed were published in the past 20 years. The association of THA with thyroid cancer was explored. In this group, the F:M ratio was 3.25:1. Left THA constituted 53% of cases, right THA in 29.4%, and isthmus absence in 17.6% of cases. Also, the authors investigated the link between THA and hyperparathyroidism, both left and right THA are seen in an equal number of cases in the hyperparathyroidism subgroup. In patients with THA and Grave\'s disease, left THA was seen in a majority of cases (86.7%), while an equal number of left and right THA was observed in patients with Hashimoto\'s thyroiditis. In addition, congenital abnormalities associated with THA were observed, the left THA was seen in 60% and right THA in 40% of cases of this subgroup. The summative review provided a detailed insight into the epidemiology, aetiopathogenesis, genetics, symptomatology, diagnosis, and treatment for THA by combining findings and results from almost a hundred research papers from around the world. THA remains a poorly understood, often incidentally detected, abnormality in euthyroid patients undergoing investigations and treatment for other thyroid disorders.
摘要：
甲状腺发育不全（THA）是一种罕见的，先天性异常定义为没有一个甲状腺叶，有或没有峡部。报告表明，在甲状腺功能减退症的地方性地区可能更常见。根据单卵双胞胎的发现，遗传异常被认为具有作用。大多数病例是零星的，然而，熟悉的集群也被记录下来。在女性中更常见。大多数患者报告没有症状，并且在检查期间或术中偶然发现了THA。THA通常与正常的甲状腺功能有关，但它可以表现为甲状腺功能减退。由于大多数患者无症状，没有具体的管理建议。使用tech或碘进行超声成像和甲状腺闪烁显像可用于诊断。当残余甲状腺叶需要切除导致终生需要补充甲状腺素时，其临床重要性就发生了。出版的英国文学(Medline，PubMed,和Embase数据库)进行了搜索。使用的医学主题词(MeSH)术语是“甲状腺发育不全”，一个甲状腺叶,\"和\"甲状腺发育不全\"。病例报告,案例系列,并选择了原始文章来为本次审查提供框架。回顾的文章发表在过去的20年。探讨了THA与甲状腺癌的相关性。在这个群体中,F:M比为3.25:1。左THA占病例的53%，右THA在29.4%，和峡部缺失的病例占17.6%。此外，作者研究了THA和甲状旁腺功能亢进之间的联系，在甲状旁腺功能亢进症亚组中，左THA和右THA的数量相等。在患有THA和Grave病的患者中，在大多数情况下（86.7％）可见左THA，而桥本甲状腺炎患者的左、右THA数量相等。此外,观察到与THA相关的先天性异常，在本亚组中,左侧THA占60%,右侧THA占40%.总结性审查提供了对流行病学的详细了解，病因，遗传学,症状学，诊断,通过结合来自世界各地的近百篇研究论文的发现和结果来治疗THA。THA仍然知之甚少，经常被偶然发现，正在接受其他甲状腺疾病调查和治疗的甲状腺功能正常患者的异常。
