아급성 갑상선염 환자에서 Prednisolone 투여 후 혈청 Interleukin-6치의 변화에 관한 연구

Abstract

Recent studies have shown that increased serum IL-6 concentrations in patients with thyroid cell damage induced by inflammatory and noninflammatory processes are associated with leakage of IL-6 from thyrocytes. To investigate the changes in serum IL-6 concentrations, we evaluated serum levels of T4, thyroglobulin and ESR in subacute thyroiditis during treatment with corticosteroid. Six female patients were evaluated within 10days after the onset of fever, palpitation and pain in the thyroid. Serum samples were obtained to measure serum T4, TSH, Tg, TSH-receptor antibody(TRAb), IL-6 by RIA and ESR. These parameters except for TRAb were measured before predinisolone treatment, 7 days, 14 days, 42 days after prednisolone treatment. The dose of prediniolone administerd was started at 30mg/day, and tapered greadullay at intervals of 7days. 1) The serum T4 concentration was increased above normal in the untreated condition (13.63±1.38ug/dl) and decreased progressively with time after prenisolone(PDN) treatment (12.68±1.07g/dl, 11.04±0.90ug(P<0.05), 9.87±1.17ug/dl(P<0.05). 2) The serum thyroglobulin(Tg) concentration was increased above normal in the untreated condition (170.67±107.99ng/dl) and decreased progressively with time after PDN treatment (86.83±23.19ng/ml(P<0.05), 55.48±21.08ng/ml(P<0.05), 11.79±7.83ng/ml(P<0.05)). 3) Levels of ESR was increased above normal in the untreated condition(41.83±7.31mm/hr) and decreased rapidly after PDN treatment (12.00±6.07mm/hr(P<0.05), 17.00±4.90mm/hr (P<0.05), 16.50±12.24mm/hr(P<o..05)). No rebound elevation of serum T4, Tg or ESR levels was found during PDN treatment. 4) The serum IL-6 concentration was increased in all six patients in the untreated on the seventh day after PDN treatment (161.93±49.53fmol/ml). However, the serum IL-6 concentration was not changed on the 14th and 42th day after PDN treatment (80.38±15.31fmol/ml(P<0.05), 34.30±10.78fmol/ml(P<0.05). The different changes between serum IL-6 concentration and levels of T4, Tg and ESR on the 7th day after PDN treatment could only reflect the persistent release of IL-6 from thyroid cells disrupted by viral aggression. Therefore, the serum IL-6 concentration dose not seem to be a good index for response of early PDN treatment in the subacute thyroiditis, although the serum IL-6 concentration is a good index for the thyroid destruction.