Mizuno Haruo, Sugiyama Yukari, Nishi Yoshikazu, Ueda Noriko, Ohro Yoichiro, Togari Hajime
Department of Paediatrics, Neonatology and Congenital Disorders, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Acta Paediatr. 2006 Feb;95(2):243-5. doi: 10.1080/08035250500341444.
We describe two cases of increases in serum creatine kinase (CK) concentrations in children undergoing treatment of Graves' disease with antithyroid medications. Presenting complaints consisted of myalgias and muscle cramping in both patients, and increases in serum CK levels were noted 1 mo after initiation of antithyroid drugs. Both patients were euthyroid at the time of CK elevation. While the mechanisms for this process are not clear, it is likely that the acute decrease of thyroid hormones in tissues following a state of chronic hyperthyroidism may result in relative hypothyroid states and subsequent alterations in CK concentrations.
Although this side effect has been reported in adults, it is a novel finding in children. Clinicians should be aware of the rare potential for elevations in serum CK when initiating treatment for Graves' disease in children.
我们描述了两例接受抗甲状腺药物治疗格雷夫斯病的儿童血清肌酸激酶(CK)浓度升高的病例。两名患者的主要症状均为肌痛和肌肉痉挛,在开始使用抗甲状腺药物1个月后血清CK水平升高。CK升高时两名患者甲状腺功能均正常。虽然这一过程的机制尚不清楚,但慢性甲状腺功能亢进状态后组织中甲状腺激素的急性减少可能导致相对甲状腺功能减退状态,进而引起CK浓度改变。
虽然这种副作用在成人中已有报道,但在儿童中却是一个新发现。临床医生在开始治疗儿童格雷夫斯病时应意识到血清CK升高这种罕见的可能性。