Chen Yi-Hsien, Lin Hung-Jung, Chen Kuo-Tai
Emergency Department, Chi-Mei Medical Center, Tainan, Yungkang 710, Taiwan.
Am J Emerg Med. 2009 Feb;27(2):258.e1-2. doi: 10.1016/j.ajem.2008.06.038.
Typical presentations of hyperthyroidism are palpitation, nervousness, tremor, malaise, and weight loss. Hyperthyroidism affects nearly every system in the body, and some patients may manifest neurologic or hematologic symptoms. Atypical presentations of hyperthyroidism often pose a great challenge in diagnosis and treatment. We report a case of Basedow's paraplegia and pancytopenia that was precipitated by hyperthyroidism. The unusual manifestations led to unnecessary examinations and delayed the treatment of hyperthyroidism. The classical symptoms of Basedow's paraplegia are subacute symmetric weakness of the lower extremities with areflexia and sparing sensation or sphincter involvement. Control of the hyperthyroidism mitigated the neurologic and hematologic complications and prevented unnecessary studies.
甲状腺功能亢进的典型表现为心悸、紧张、震颤、不适和体重减轻。甲状腺功能亢进几乎影响身体的每个系统,一些患者可能表现出神经或血液学症状。甲状腺功能亢进的非典型表现常常给诊断和治疗带来巨大挑战。我们报告一例由甲状腺功能亢进引发的巴塞多氏截瘫和全血细胞减少症病例。这些不寻常的表现导致了不必要的检查,并延误了甲状腺功能亢进的治疗。巴塞多氏截瘫的典型症状是下肢亚急性对称性无力,伴有反射消失,感觉或括约肌功能未受累。控制甲状腺功能亢进减轻了神经和血液学并发症,并避免了不必要的检查。