Paiaulla Santosh, Venkategowda Pradeep Marur, Rao S Manimala, Balaraju Banda
Department of Critical Care Medicine, Yashoda Multi-Speciality Hospital, Somajiguda, Hyderabad, Telangana, India.
Indian J Crit Care Med. 2015 Aug;19(8):484-6. doi: 10.4103/0972-5229.162471.
Hyperthyroidism is a condition characterized by excessive production of thyroid hormones. Propylthiouracil (PTU) is commonly used as first line drug in the management of hyperthyroidism. This is a case report of 24-year-old female, a known case of hyperthyroidism since 4 years, who came with a history of fever and myalgia since 3 days and dyspnea with coughing out of blood since 1 day. Patient was taking PTU (100 mg per day) since 4 years for hyperthyroidism. Patient was immediately intubated for type-II respiratory failure. Diagnosed to be having PTU-induced autoimmune disease. PTU was stopped and treated with methylprednisolone and cyclophosphamide. Clinical features improved over a period of 8 days and discharged home successfully. Having a high suspicion for the onset of autoimmune disease in hyperthyroidism patients who are on PTU therapy and timely treatment with immunosuppressants and supportive care along with the withdrawal of the drug can make a difference in morbidity and mortality.
甲状腺功能亢进症是一种以甲状腺激素过度分泌为特征的病症。丙硫氧嘧啶(PTU)通常作为治疗甲状腺功能亢进症的一线药物。这是一例24岁女性的病例报告,该女性4年来一直患有甲状腺功能亢进症,3天来出现发热和肌痛病史,1天来出现呼吸困难并咯血。患者因甲状腺功能亢进症服用PTU(每日100毫克)已有4年。患者因II型呼吸衰竭立即插管。诊断为PTU诱导的自身免疫性疾病。停用PTU,并用甲泼尼龙和环磷酰胺治疗。临床症状在8天内有所改善,并成功出院。对于接受PTU治疗的甲状腺功能亢进症患者,高度怀疑自身免疫性疾病的发作,并及时使用免疫抑制剂和支持性护理以及停药,可对发病率和死亡率产生影响。