Nomoto N, Araki Y, Fujioka T, Kurihara T, Wakata N
Fourth Department of Internal Medicine, Toho University School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokoy 153-8515, Japan.
No To Shinkei. 2001 Mar;53(3):271-4.
We report a patient with thyrotoxic myopathy associated with unusual muscle symptoms. A 29-year-old man developed hyperhidrosis, diarrhea, increase in appetite, and excitability in July, 1999. In August, he experienced muscle stiffness in bilateral lower extremities after maintaining postures such as driving a car or sitting on a chair. He was admitted to our hospital, in January, 2000. On physical examination, goiter was noted. Neurological examination was normal except for proximal muscle weakness. Laboratory test showed elevated free T3 and free T4, decreased TSH. TSH receptor antibody was increased. MRI of lower extremities revealed atrophy of bilateral biceps femoris. Muscle strength increased gradually after an oral administration of thiamazole 30 mg/day, and muscle stiffness disappeared. The clinical features of this patient and differential diagnosis were discussed.
我们报告了一例伴有不寻常肌肉症状的甲状腺毒症性肌病患者。一名29岁男性于1999年7月出现多汗、腹泻、食欲增加和易激惹症状。8月，他在保持如开车或坐在椅子上的姿势后，双侧下肢出现肌肉僵硬。2000年1月他入住我院。体格检查发现甲状腺肿大。除近端肌无力外，神经学检查正常。实验室检查显示游离T3和游离T4升高，促甲状腺激素（TSH）降低。TSH受体抗体升高。下肢MRI显示双侧股二头肌萎缩。口服30mg/天甲巯咪唑后肌力逐渐增加，肌肉僵硬消失。对该患者的临床特征及鉴别诊断进行了讨论。
