Simon H B, Daniels G H
Am J Med. 1979 Feb;66(2):257-63. doi: 10.1016/0002-9343(79)90542-4.
Although hyperthermia is a component of many endocrine diseases, it is uncommon for fever to be the presenting manifestation of hormonal disorders. During a four year period we encountered six patients, hospitalized principally because of fever, who were found to have endocrine causes for the fever. In all, the admitting diagnosis was infection; three were suspected of having tuberculosis, two of gram-negative bacteremia and one of endocarditis. Except for asymptomatic bacteriuria in one patient (who remained febrile despite appropriate antibiotic therapy) infection was ruled out in all cases, and fever was attributed to "masked" thyrotoxicosis, triiodothyronine (T3) toxicosis, subacute thyroiditis, primary adrenal insufficiency, secondary adrenal insufficiency and pheochromocytoma. In a seventh patient, extreme pyrexia developed in the setting of the thyroid storm. The importance of hormonal mechanisms in thermoregulation is discussed.
尽管体温过高是许多内分泌疾病的一个组成部分，但发热作为激素紊乱的首要表现并不常见。在四年期间，我们遇到了6例主要因发热住院的患者，他们被发现发热存在内分泌原因。总体而言，入院诊断均为感染；3例怀疑患有结核病，2例怀疑革兰氏阴性菌血症，1例怀疑心内膜炎。除1例患者有无症状菌尿（尽管接受了适当的抗生素治疗仍持续发热）外，所有病例均排除了感染，发热归因于“隐匿性”甲状腺毒症、三碘甲状腺原氨酸（T3）中毒、亚急性甲状腺炎、原发性肾上腺功能不全、继发性肾上腺功能不全和嗜铬细胞瘤。在第7例患者中，在甲状腺危象的情况下出现了极高热。本文讨论了激素机制在体温调节中的重要性。
