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[胺碘酮治疗患者中垂体对甲状腺激素的选择性抵抗]

[Selective pituitary resistance to thyroid hormone in a patient treated with amiodarone].

作者信息

Gómez Juan José López, Pomar María D Ballesteros, Casariego Alfonso Vidal, Rodríguez Isidoro Cano

机构信息

Sección de Endocrinología y Nutrición, Complejo Asistencial de León, León, España.

出版信息

Endocrinol Nutr. 2009 Oct;56(8):418-21. doi: 10.1016/S1575-0922(09)72712-3.

Abstract

Selective pituitary resistance to thyroid hormones is a syndrome that involves inadequate response of thyroid-stimulating hormone to changes in thyroid hormones. Unlike generalized resistance syndromes, this entity produces central hyperthyroidism and clinical thyrotoxicosis. Sometimes the disease may not be properly diagnosed and is treated with drugs with harmful effects on the thyroid, such as amiodarone, hampering diagnosis and possibly exacerbating the disorder. The treatment of this condition can be symptomatic, based on control of tachycardia and anxiety, or etiological, acting on the pituitary to regulate thyrotropin secretion or on the thyroid gland to control thyroid hormone production. We report the case of a patient with pituitary resistance to thyroid hormone, who was treated with amiodarone to control paroxysmal atrial fibrillation.

摘要

选择性垂体对甲状腺激素抵抗是一种综合征,其特征为促甲状腺激素对甲状腺激素变化的反应不足。与全身性抵抗综合征不同,该病症会导致中枢性甲状腺功能亢进和临床甲状腺毒症。有时,这种疾病可能无法得到正确诊断,并且会使用对甲状腺有不良影响的药物进行治疗,如胺碘酮,这会妨碍诊断并可能加重病情。这种病症的治疗可以是对症治疗,基于控制心动过速和焦虑,也可以是病因治疗,作用于垂体以调节促甲状腺激素分泌,或作用于甲状腺以控制甲状腺激素产生。我们报告了一例垂体对甲状腺激素抵抗的患者,该患者接受胺碘酮治疗以控制阵发性心房颤动。

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