Prosser Jennifer S, Quan Dan K
Department of Emergency Medicine, Maricopa Medical Center, Phoenix, Arizona, USA.
J Emerg Trauma Shock. 2015 Oct-Dec;8(4):232-4. doi: 10.4103/0974-2700.161656.
Thyrotoxic crisis (TC) is defined as a life-threatening exacerbation of the hyperthyroid state that causes multiple autonomic and metabolic disturbances. It is considered to be an endocrine emergency that must be urgently diagnosed and treated. We describe a case of TC precipitated by trauma with a resultant lactic acidosis. The patient is a 24-year-old male with a history of hyperthyroidism who presented to the emergency department following a motor vehicle accident. The patient was initially tachycardic and hypertensive, however, was afebrile. Initial laboratory analysis showed an anion gap of 26, lactic acid 7.6, free T4 5.61 and thyroid stimulating hormone < 0.015. A diagnosis of TC was made, and he was treated with intravenous fluids, propranolol, and methimazole with improvement of tachycardia and lactic acidosis. We discuss the features of this case, which reviews the presentations of TC as well as its metabolic sequelae.
甲状腺毒症危象（TC）被定义为甲状腺功能亢进状态的危及生命的加重，可导致多种自主神经和代谢紊乱。它被认为是一种必须紧急诊断和治疗的内分泌急症。我们描述了一例因创伤引发乳酸酸中毒的甲状腺毒症危象病例。患者为一名24岁男性，有甲状腺功能亢进病史，在机动车事故后被送往急诊科。患者最初心率过速且血压升高，但无发热。初步实验室分析显示阴离子间隙为26，乳酸为7.6，游离甲状腺素为5.61，促甲状腺激素<0.015。诊断为甲状腺毒症危象，给予静脉补液、普萘洛尔和甲巯咪唑治疗后，心动过速和乳酸酸中毒有所改善。我们讨论了该病例的特点，回顾了甲状腺毒症危象的表现及其代谢后遗症。
