一名46岁女性因吸入性暴露出现呼吸困难，引发甲状腺风暴及随后的多器官系统衰竭。
A 46-Year-Old Woman With Dyspnea From an Inhalational Exposure, Triggering Thyroid Storm and Subsequent Multi-Organ System Failure.
作者信息
Moraco Andrew H, Banauch Gisela, Kopec Scott
机构信息
UMass Memorial Medical Center, Department of Pulmonary, Allergy and Critical Care, Worcester, MA, USA
UMass Memorial Medical Center, Department of Pulmonary, Allergy and Critical Care, Worcester, MA, USA.
出版信息
J Intensive Care Med. 2015 Dec;30(8):518-20. doi: 10.1177/0885066615571527. Epub 2015 Feb 12.
BACKGROUND
Thyroid storm is a rare, life-threatening condition which arises in patients with thyrotoxicosis, with an annual incidence of 2 patients per 1,000,000 and a mortality rate of 11%.
CASE
We present the case of a 46-year-old-female with a medical history of controlled mild intermittent asthma, who presented with a severe asthma exacerbation, that triggered thyroid storm after exposure to polyurethane fumes.
CONCLUSION
This patient represents, to the best of our knowledge, the first patient in whom the stress related to a severe asthma attack triggered the development of thyroid storm. She also is the first patient with no indication of cardiac dysfunction who developed fatal cardiac arrest after initiation of b-blockade for treatment of thyroid storm.
背景
甲状腺危象是一种罕见的、危及生命的疾病，发生于甲状腺毒症患者中，年发病率为每100万人中有2例，死亡率为11%。
病例
我们报告一例46岁女性病例，该患者有轻度间歇性哮喘且病情得到控制的病史，此次因严重哮喘发作就诊，在接触聚氨酯烟雾后引发了甲状腺危象。
结论
据我们所知，该患者是首例因严重哮喘发作相关应激引发甲状腺危象的患者。她也是首例在无心脏功能障碍迹象的情况下，在开始使用β受体阻滞剂治疗甲状腺危象后发生致命性心脏骤停的患者。
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