van Velzen D M, Krul-Poel Y H, den Heijer M, Simsek S
Department of Internal Medicine, Northwest Clinics, location Alkmaar, the Netherlands.
Neth J Med. 2018 Sep;76(7):339-342.
Severe hypothyroidism is known to cause elevation of creatinine and this phenomenon has been reported in clinical settings in the past. Screening for hypothyroidism is not regularly performed in the differential workup for acute kidney injury due to its rare presentation. Therefore, to most physicians hypothyroidism is not known as a cause of acute kidney injury. In this clinical case report, we describe a case of subacute kidney injury in a patient with severe hypothyroidism prior to iodine-131 ablation therapy. Hypothyroidism was not recognized as the cause of elevated creatinine, which in this case led to unnecessary hospital admission and diagnostics. This case report serves as a reminder for clinicians to consider hypothyroidism in the differential diagnosis of (sub)acute kidney injury.
已知严重甲状腺功能减退会导致肌酐升高，过去临床环境中已有相关报道。由于甲状腺功能减退表现罕见，在急性肾损伤的鉴别检查中通常不会常规筛查。因此，大多数医生并不认为甲状腺功能减退是急性肾损伤的病因。在本临床病例报告中，我们描述了一例在碘 - 131消融治疗前患有严重甲状腺功能减退的患者发生亚急性肾损伤的病例。甲状腺功能减退未被识别为肌酐升高的原因，在此病例中这导致了不必要的住院和诊断检查。本病例报告提醒临床医生在（亚）急性肾损伤的鉴别诊断中考虑甲状腺功能减退。
