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[以急性肾衰竭为表现的自身免疫性甲状腺功能减退临床病例]

[Clinical case of acute renal failure revealing an autoimmune hypothyroidism].

作者信息

Montasser Dina Ibrahim, Hassani Mohamed, Zajjari Yassir, Bahadi Abdelali, Alayoud Ahmed, Hamzi Amine, Hassani Kawtar, Moujoud Omar, Asseraji Mohamed, Kadiri Moncif, Aatif Taoufik, El Kabbaj Driss, Benyahia Mohamed, Allam Mustapha, Akhmouch Ismail, Oualim Zouhir

机构信息

Service de néphrologie-dialyse et de transplantation rénale, hôpital militaire d'instruction Mohammed V, faculté de médecine et de pharmacie, Hay Riad, CP 10000 Rabat, Maroc.

出版信息

Nephrol Ther. 2010 Apr;6(2):128-31. doi: 10.1016/j.nephro.2009.12.005. Epub 2010 Feb 24.

Abstract

Although the clinic picture is often indicative of muscle manifestations in patients with hypothyroidism, signs and symptoms of this condition are variable from simple elevation of serum muscle enzymes with myalgia, muscle weakness, cramps to rhabdomyolysis with acute renal failure which remains a rare event. Thyroid hormones affect the function of almost every body organ, and thyroid dysfunction produces a wide range of metabolic disturbances. Hypothyroidism is associated with significant effects on the kidney which the pathophysiology seems to be multifactorial, but the exact mechanisms remain poorly understood. Hypothyroidism as a cause of renal impairment is usually overlooked, leading to unnecessary diagnostic procedures. The main objective of our observation is to report a case of acute renal failure revealing an autoimmune hypothyroidism in which thyroid hormone substitution led to a significant improvement in muscular, thyroid and renal disorders.

摘要

尽管临床症状常提示甲状腺功能减退患者存在肌肉表现,但该病症的体征和症状各不相同,从伴有肌痛、肌肉无力、痉挛的血清肌酶轻度升高到伴有急性肾衰竭的横纹肌溶解(这仍然是罕见事件)。甲状腺激素影响几乎每个身体器官的功能,甲状腺功能障碍会产生广泛的代谢紊乱。甲状腺功能减退对肾脏有显著影响,其病理生理学似乎是多因素的,但确切机制仍知之甚少。甲状腺功能减退作为肾功能损害的一个原因通常被忽视,导致不必要的诊断程序。我们观察的主要目的是报告一例急性肾衰竭病例,该病例揭示了自身免疫性甲状腺功能减退,其中甲状腺激素替代治疗使肌肉、甲状腺和肾脏疾病有了显著改善。

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