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糖尿病酮症酸中毒和甲型流感诱发的甲状腺危象:一例报告及文献综述

Thyroid Storm Precipitated by Diabetic Ketoacidosis and Influenza A: A Case Report and Literature Review.

作者信息

Ikeoka Toshiyuki, Otsuka Hiroaki, Fujita Naruhiro, Masuda Yukiko, Maeda Shigeto, Horie Ichiro, Ando Takao, Abiru Norio, Kawakami Atsushi

机构信息

Department of Endocrinology and Metabolism, National Hospital Organization Nagasaki Medical Center, Japan.

出版信息

Intern Med. 2017;56(2):181-185. doi: 10.2169/internalmedicine.56.7593. Epub 2017 Jan 15.

Abstract

A 46-year-old woman with a history of Graves' disease presented with the chief complaints of appetite loss, weight loss, fatigue, nausea, and sweating. She was diagnosed with diabetic ketoacidosis (DKA), thyroid storm, and influenza A. She was treated with an intravenous insulin drip, intravenous fluid therapy, intravenous hydrocortisone, oral potassium iodine, and oral methimazole. As methimazole-induced neutropenia was suspected, the patient underwent thyroidectomy. It is important to maintain awareness that thyroid storm and DKA can coexist. Furthermore, even patients who have relatively preserved insulin secretion can develop DKA if thyroid storm and infection develop simultaneously.

摘要

一名有格雷夫斯病病史的46岁女性,以食欲减退、体重减轻、疲劳、恶心和出汗为主诉就诊。她被诊断为糖尿病酮症酸中毒(DKA)、甲状腺危象和甲型流感。她接受了静脉胰岛素滴注、静脉补液治疗、静脉注射氢化可的松、口服碘化钾和口服甲巯咪唑。由于怀疑甲巯咪唑引起中性粒细胞减少,患者接受了甲状腺切除术。重要的是要认识到甲状腺危象和DKA可能同时存在。此外,即使胰岛素分泌相对保留的患者,如果同时发生甲状腺危象和感染,也可能发生DKA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d9/5337464/c05bee8bd22c/1349-7235-56-0181-g001.jpg

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