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挺过风暴:两例成功采用血浆置换治疗的甲状腺风暴病例

Surviving the storm: two cases of thyroid storm successfully treated with plasmapheresis.

作者信息

Carhill Aubrey, Gutierrez Absalon, Lakhia Ronak, Nalini Ramaswami

机构信息

Department of Medicine/Endocrinology, Baylor College of Medicine, Houston, Texas, USA.

出版信息

BMJ Case Rep. 2012 Oct 19;2012:bcr2012006696. doi: 10.1136/bcr-2012-006696.

Abstract

Thyroid storm is a rare, but critical, illness that can lead to multiorgan failure and carries a high death rate. The following case series describes two adult men with Graves' disease who presented in thyroid storm and either failed or could not tolerate conventional medical management. However, both patients responded well to plasmapheresis, which resulted in clinical and biochemical stabilisation of their disease processes. The treatment option of plasmapheresis should be considered as a stabilising measure, especially when patients have failed or cannot tolerate conventional therapy. Plasmapheresis leads to amelioration of symptoms and a significant decline in thyroid hormone levels, providing a window to treat definitively with thyroidectomy.

摘要

甲状腺危象是一种罕见但严重的疾病,可导致多器官功能衰竭,死亡率很高。以下病例系列描述了两名患有格雷夫斯病的成年男性,他们出现了甲状腺危象,传统药物治疗无效或无法耐受。然而,两名患者对血浆置换反应良好,这使他们的疾病过程在临床和生化方面得到了稳定。血浆置换这种治疗选择应被视为一种稳定措施,尤其是当患者传统治疗无效或无法耐受时。血浆置换可改善症状并使甲状腺激素水平显著下降,为通过甲状腺切除术进行确定性治疗提供了时机。

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