Hayashi Masayuki, Onodera Kazunari, Suzuki Kengo, Kataoka Yuko, Tachikawa Kazushige, Riku Shigeo, Tanaka Hiroshi
Department of Endocrinology and Metabolism, Chukyo Hospital, Japan.
Intern Med. 2011;50(21):2627-32. doi: 10.2169/internalmedicine.50.5599. Epub 2011 Nov 1.
An 82-year-old Japanese man had consciousness disturbance due to severe hypothyroidism triggered by percutaneous absorption of iodine from an iodine-containing ointment used in diabetic gangrene treatment. Laboratory data revealed extremely high urinary iodine concentrations, and chronic thyroiditis-induced hypothyroidism. Excess iodine intake can also cause hypothyroidism. It was unlikely that iodine intoxication or Hashimoto's encephalopathy had caused the consciousness disturbance. The patient regained consciousness after discontinuing the use of the ointment and commencing thyroid hormone therapy. We conclude that consciousness disturbance resulted from severe hypothyroidism caused by chronic thyroiditis and excess iodine absorption.
一名82岁的日本男性因在糖尿病坏疽治疗中使用含碘药膏经皮吸收碘引发严重甲状腺功能减退而出现意识障碍。实验室检查数据显示尿碘浓度极高,且存在慢性甲状腺炎所致的甲状腺功能减退。碘摄入过量也可导致甲状腺功能减退。碘中毒或桥本脑病不太可能导致意识障碍。停用该药膏并开始甲状腺激素治疗后,患者恢复了意识。我们得出结论,意识障碍是由慢性甲状腺炎和碘吸收过量导致的严重甲状腺功能减退引起的。