格雷夫斯病的罕见表现：心室颤动。
Unusual Manifestation of Graves' Disease: Ventricular Fibrillation.
作者信息
Kobayashi Hiroki, Haketa Akira, Abe Masanori, Tahira Kazunobu, Hatanaka Yoshinari, Tanaka Sho, Ueno Takahiro, Soma Masayoshi
机构信息
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
出版信息
Eur Thyroid J. 2015 Sep;4(3):207-12. doi: 10.1159/000437225. Epub 2015 Aug 26.
BACKGROUND
It is well known that thyrotoxicosis causes rhythm disorders including sinus tachycardia, atrial fibrillation, and atrial flutter. Atrial fibrillation is the most common arrhythmia in thyrotoxicosis, occurring in 5-15% of patients over 60 years of age, whereas ventricular arrhythmia is an unusual manifestation.
CASE REPORT
An 18-year-old Japanese woman was admitted to our emergency department because of loss of consciousness caused by ventricular fibrillation. She had been diagnosed with Graves' disease only 5 days earlier and had no other past medical history. Blood examination showed no obvious abnormality except thyrotoxicosis, and coronary angiography revealed patent coronary arteries. She was diagnosed with thyroid storm due to Graves' disease and is currently healthy during outpatient follow-up.
CONCLUSION
This case highlights that thyrotoxicosis can, albeit extremely rarely, cause ventricular fibrillation even in the absence of hypokalemia or underlying cardiovascular disease.
背景
众所周知，甲状腺毒症会引发节律紊乱，包括窦性心动过速、心房颤动和心房扑动。心房颤动是甲状腺毒症中最常见的心律失常，在60岁以上患者中发生率为5% - 15%，而室性心律失常则是一种不常见的表现。
病例报告
一名18岁日本女性因室颤导致意识丧失被收入我院急诊科。她5天前刚被诊断为格雷夫斯病，无其他既往病史。血液检查除甲状腺毒症外无明显异常，冠状动脉造影显示冠状动脉通畅。她被诊断为格雷夫斯病所致的甲状腺危象，目前门诊随访期间身体健康。
结论
本病例表明，即使在没有低钾血症或潜在心血管疾病的情况下，甲状腺毒症也可能极其罕见地导致室颤。
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