Jaroudi Sarah, Gavin Meredith, Boylan Kathryn, Peiris Alan N
Texas Tech University Health Sciences Center, School of MedicineLubbockTexas.
Texas Tech University Health Sciences Center, Clinical Research Institute and Department of Internal MedicineLubbockTexas.
Proc (Bayl Univ Med Cent). 2018 Oct 19;32(1):80-81. doi: 10.1080/08998280.2018.1503480. eCollection 2019 Jan.
In its early course, Hashimoto's disease may present as thyrotoxicosis (Hashitoxicosis). This usually manifests as elevated free T4 and suppressed thyroid-stimulating hormone (TSH). We report the unusual occurrence of an elevated T3 level in a patient with Hashimoto's disease. A 27-year-old woman presented with an incidental finding of elevated free T3 levels, normal free T4 levels, and low TSH levels, which were confirmed with follow-up testing. Her only medication was a birth control pill. There was no family history of thyroid disease. Physical examination was normal. She tested positive for thyroid peroxidase and thyroglobulin antibodies. Thyroid heterogeneity was noted on ultrasound. Two months later, her TSH, free T3, and free T4 were normal and remained normal on subsequent testing. No treatment was administered due to spontaneous resolution of her T3 toxicosis. This case highlights a novel presentation of T3 toxicosis in the setting of Hashimoto's disease with spontaneous resolution.
在桥本氏病的早期病程中，可能会表现为甲状腺毒症（桥本甲状腺毒症）。这通常表现为游离T4升高和促甲状腺激素（TSH）受抑制。我们报告了一例桥本氏病患者出现T3水平升高的不寻常情况。一名27岁女性偶然发现游离T3水平升高、游离T4水平正常以及TSH水平降低，后续检查证实了这些结果。她仅服用避孕药。无甲状腺疾病家族史。体格检查正常。她的甲状腺过氧化物酶和甲状腺球蛋白抗体检测呈阳性。超声检查发现甲状腺不均质。两个月后，她的TSH、游离T3和游离T4恢复正常，后续检查也一直保持正常。由于其T3毒症自行缓解，未给予治疗。该病例突出了在桥本氏病背景下T3毒症的一种新表现形式且可自行缓解。
