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胺碘酮所致甲状腺毒症伴心肺骤停

Amiodarone-induced Thyrotoxicosis with Cardiopulmonary Arrest.

作者信息

Inoue Kosuke, Saito Jun, Kondo Tetsuo, Miki Kaoru, Sugisawa Chiho, Tsurutani Yuya, Hasegawa Naoki, Kowase Shinya, Kakuta Yukio, Omura Masao, Nishikawa Tetsuo

机构信息

Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan.

Department of Human Pathology, University of Yamanashi Interdisciplinary Graduate School of Medicine and Engineering, Japan.

出版信息

Intern Med. 2018 Jan 1;57(1):59-63. doi: 10.2169/internalmedicine.9177-17. Epub 2017 Oct 16.

DOI:10.2169/internalmedicine.9177-17
PMID:29033440
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5799058/
Abstract

We describe a case of amiodarone-induced thyrotoxicosis (AIT) with cardiopulmonary arrest (CPA) in a 49-year-old woman. The patient had been treated with amiodarone for non-sustained ventricular tachycardia. Two weeks prior to her admission, she developed thyrotoxicosis and prednisolone (PSL, 30 mg daily) was administered with the continuation of amiodarone. However, she was admitted to our hospital for CPA. We performed total thyroidectomy to control her thyrotoxicosis and the pathological findings were consistent with type 2 AIT. She gradually improved and was discharged on day 84. This case demonstrates the importance of considering immediate total thyroidectomy for patients with uncontrollable AIT.

摘要

我们描述了一例49岁女性因胺碘酮诱发甲状腺毒症(AIT)并发生心肺骤停(CPA)的病例。该患者因非持续性室性心动过速接受胺碘酮治疗。入院前两周,她出现甲状腺毒症,在继续使用胺碘酮的同时给予泼尼松龙(PSL,每日30 mg)治疗。然而,她因心肺骤停入住我院。我们进行了甲状腺全切除术以控制她的甲状腺毒症,病理结果与2型AIT一致。她逐渐康复,并于第84天出院。该病例表明,对于无法控制的AIT患者,考虑立即进行甲状腺全切除术具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4180/5799058/3e0342bb06cf/1349-7235-57-0059-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4180/5799058/a0eb7a8cc6d5/1349-7235-57-0059-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4180/5799058/e0a0ba2e3371/1349-7235-57-0059-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4180/5799058/3e0342bb06cf/1349-7235-57-0059-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4180/5799058/a0eb7a8cc6d5/1349-7235-57-0059-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4180/5799058/e0a0ba2e3371/1349-7235-57-0059-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4180/5799058/3e0342bb06cf/1349-7235-57-0059-g003.jpg

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本文引用的文献

1
A Case of Type 2 Amiodarone-Induced Thyrotoxicosis That Underwent Total Thyroidectomy under High-Dose Steroid Administration.1例2型胺碘酮所致甲状腺毒症患者在大剂量类固醇激素治疗下接受了甲状腺全切除术。
Case Rep Endocrinol. 2015;2015:416145. doi: 10.1155/2015/416145. Epub 2015 Jan 13.
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Prevalence of amiodarone-induced thyrotoxicosis and associated risk factors in Japanese patients.在日本患者中,胺碘酮诱导的甲状腺功能亢进症的流行情况及其相关危险因素。
Int J Endocrinol. 2014;2014:534904. doi: 10.1155/2014/534904. Epub 2014 Jun 25.
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Amiodarone-induced destructive thyroiditis associated with coronary artery vasospasm and recurrent ventricular fibrillation.
胺碘酮致破坏性甲状腺炎伴冠状动脉痉挛和反复性室颤。
Eur Thyroid J. 2013 Mar;2(1):65-7. doi: 10.1159/000345528. Epub 2012 Nov 30.
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Amiodarone and the thyroid: a 2012 update.胺碘酮与甲状腺:2012 年更新
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Treatment of amiodarone-induced thyrotoxicosis type 2: a randomized clinical trial.胺碘酮致 2 型甲状腺毒性的治疗:一项随机临床试验。
J Clin Endocrinol Metab. 2012 Feb;97(2):499-506. doi: 10.1210/jc.2011-2390. Epub 2011 Nov 30.
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Graves' disease complicated by ventricular fibrillation in three men who were smokers.Graves 病并发心室颤动在三名吸烟者中。
Thyroid. 2011 Sep;21(9):1021-5. doi: 10.1089/thy.2010.0368. Epub 2011 Aug 11.
7
Hypokalemic thyrotoxic periodic paralysis with thyrotoxic psychosis and hypercapnic respiratory failure.低血钾型甲状腺毒症周期性瘫痪伴甲状腺毒症性精神病和高碳酸血症性呼吸衰竭。
Am J Med Sci. 2010 Aug;340(2):147-53. doi: 10.1097/MAJ.0b013e3181cbf567.
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Approach to the patient with amiodarone-induced thyrotoxicosis.胺碘酮相关性甲状腺毒症患者的处理方法。
J Clin Endocrinol Metab. 2010 Jun;95(6):2529-35. doi: 10.1210/jc.2010-0180.
9
Glucocorticoids are preferable to thionamides as first-line treatment for amiodarone-induced thyrotoxicosis due to destructive thyroiditis: a matched retrospective cohort study.对于胺碘酮所致破坏性甲状腺炎引起的甲状腺毒症,糖皮质激素作为一线治疗优于硫代酰胺类药物:一项配对回顾性队列研究。
J Clin Endocrinol Metab. 2009 Oct;94(10):3757-62. doi: 10.1210/jc.2009-0940. Epub 2009 Jul 21.
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Thyrotoxic periodic paralysis complicated by acute hypercapnic respiratory failure and ventricular tachycardia.甲状腺毒症性周期性瘫痪并发急性高碳酸血症性呼吸衰竭和室性心动过速。
Thyroid. 2008 Dec;18(12):1321-4. doi: 10.1089/thy.2008.0232.