Dave Anjalee, Ludlow Jason, Malaty John
Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA.
University of Florida, Gainesville, Florida, USA.
BMJ Case Rep. 2015 May 20;2015:bcr2014208119. doi: 10.1136/bcr-2014-208119.
A 53-year-old woman presented for evaluation of dizziness, shortness of breath and chest pain. She was found to be in atrial fibrillation with rapid ventricular response that was determined to be caused by iodine-induced thyrotoxicosis (from a CT scan with intravenous contrast 2 months prior to presentation). Jod-Basedow syndrome (iodine-induced hyperthyroidism) is infrequently considered as a cause of thyrotoxicosis, even when typical risk factors are present. However, this patient did not have typical risk factors: she did not reside in an iodine deficient area, did not have a prior diagnosis of thyroid disorder or goitre, had never been treated with thyroid medications or medications known to cause thyroid dysfunction and she presented later than is typical with this syndrome (2 months after receiving iodinated contrast). She had complete resolution of hyperthyroidism and atrial fibrillation 2 weeks later with no recurrence over the following 7 months.
一名53岁女性因头晕、气短和胸痛前来评估。她被发现处于房颤伴快速心室反应状态，经诊断是由碘诱发的甲状腺毒症（起因于就诊前2个月进行的静脉注射造影剂CT扫描）所致。即使存在典型危险因素，碘致巴塞多综合征（碘诱发的甲状腺功能亢进）也很少被视为甲状腺毒症的病因。然而，该患者并无典型危险因素：她不住在碘缺乏地区，既往没有甲状腺疾病或甲状腺肿的诊断，从未接受过甲状腺药物治疗或已知会导致甲状腺功能障碍的药物治疗，而且她出现症状的时间比该综合征的典型发病时间晚（在接受碘化造影剂2个月后）。两周后她的甲状腺功能亢进和房颤完全缓解，在接下来的7个月里未再复发。
