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[来氟米特联合聚维酮碘治疗类风湿关节炎期间甲状腺功能减退转变为甲状腺功能亢进]

[The conversion of hypothyroidism into hyperthyroidism during leflunomide with povidone iodine treatment of rheumatoid arthritis].

作者信息

Grzywa Marek, Kadziela Małgorzata

机构信息

Gabinet Lekarski Internistyczno-Endokrynologiczny w Rzeszowie.

出版信息

Pol Merkur Lekarski. 2013 Jun;34(204):348-50.

Abstract

Till now there has not been reported data related to the influence of leflunomide on the thyroid gland function of the treated person. The authors described the case of woman with rheumathoid arthritis and hypothyroidism who revealed hyperthyroidism in 7 months after starting leflunomide tablets treatment containing povidone iodine as well. Also both autonomical tissue area in thyroid right lobe and hight TSHRAb level were found. Leflunomid tablets containing povidone iodine in its structure can cause hyperthyroidism in the person with previous hypothyroidism and nodular goiter, probably as a result of immunological reconversion and tissue nodular functional autonomisation. In persons with nodular goitre one should prefer free of povidone iodine leflunomide treatment and also monitor serum thyroid hormone contents and thyroid antibodies as well.

摘要

迄今为止,尚未有关于来氟米特对接受治疗者甲状腺功能影响的相关数据报道。作者描述了一名患有类风湿关节炎和甲状腺功能减退症的女性病例,该患者在开始服用含聚维酮碘的来氟米特片治疗7个月后出现甲状腺功能亢进。同时还发现甲状腺右叶的自主组织区域以及促甲状腺素受体抗体(TSHRAb)水平升高。结构中含有聚维酮碘的来氟米特片可能会导致既往患有甲状腺功能减退症和结节性甲状腺肿的患者出现甲状腺功能亢进,这可能是免疫再转换和组织结节性功能自主化的结果。对于患有结节性甲状腺肿的患者,应优先选择不含聚维酮碘的来氟米特治疗,同时监测血清甲状腺激素含量和甲状腺抗体。

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