一名患有甲状腺风暴的儿童出现QT间期延长。
QT prolongation in a child with thyroid storm.
作者信息
Albert Benjamin B, Eckersley Luke Gerard, Skinner Jonathan Robert, Jefferies Craig
机构信息
Liggins Institute, University of Auckland, Auckland, New Zealand.
出版信息
BMJ Case Rep. 2014 Apr 12;2014:bcr2013202595. doi: 10.1136/bcr-2013-202595.
A 12-year-old girl presented with an acute confusional state and a 2-year history of weight loss, anxiety, agitation and recurrent fever. Thyroid function tests confirmed severe hyperthyroidism, and a diagnosis of thyroid storm was made (Burch and Wartofsky score=75). ECG showed a prolonged QTc interval of 506 ms. Acute treatment for thyroid storm consisted of Lugol's iodine, prednisolone, carbimazole and propranolol. She made a steady recovery and by 3 months her thyroid function had normalised; a repeat ECG showed a QTc within the normal range (430 ms). There was no relevant family history. This is a case of QTc prolongation with hyperthyroidism and normalisation with euthyroidism. It is not commonly recognised that hyperthyroidism in children may be associated with QTc prolongation. QTc measurement should be incorporated into management protocols for hyperthyroidism.
一名12岁女孩出现急性意识模糊状态，并有2年体重减轻、焦虑、烦躁和反复发热病史。甲状腺功能检查证实为严重甲亢，诊断为甲状腺危象（伯奇和瓦尔托夫斯基评分=75）。心电图显示QTc间期延长至506毫秒。甲状腺危象的急性治疗包括卢戈氏碘、泼尼松龙、卡比马唑和普萘洛尔。她病情稳步恢复，3个月后甲状腺功能恢复正常；复查心电图显示QTc在正常范围内（430毫秒）。无相关家族史。这是一例甲亢伴QTc延长、甲功正常后QTc恢复正常的病例。儿童甲亢可能与QTc延长相关这一点尚未得到普遍认识。QTc测量应纳入甲亢的管理方案中。
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