Li Anxin, Jiang Xiaoyan, Zhong Miao, Li Ning, Tao Yang, Wu Wenxun, Yang Cheng, Wang Hongyan, Min Le, Ma Yu, Deng Wuquan
Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Hospital, Chongqing, China.
Department of Intensive Care Unit, Chongqing University Central Hospital, Chongqing Emergency Medical Hospital, Chongqing, China.
Ther Adv Endocrinol Metab. 2020 Jun 20;11:2042018820934307. doi: 10.1177/2042018820934307. eCollection 2020.
Diabetic ketoacidosis (DKA) and thyroid storm (TS) are severe metabolic and endocrine disorders. Both usually manifest with multiple systemic clinical signs and symptoms, and digestive symptoms, such as nausea and vomiting, are most common in these patients. Moreover, the presence of a concurrent severe or rare complication may worsen the condition or even cause death due to misdiagnosis, delayed diagnosis, or inappropriate treatment. The identification of these symptoms is usually closely related to the severity and prognosis of the disease. Although clinical prognosis might be improved by prompt diagnosis and aggressive treatment, some rare and insidious metabolic complications are difficult to identify early. Moreover, life-threatening gastrointestinal symptoms are very rare in patients with DKA and TS. Here, we report an inpatient diagnosed with DKA and Graves' disease who developed life-threatening intractable hiccups resulting in TS and respiratory failure during the treatment of DKA. In addition, we review the literature to discuss the possible underlying mechanism of intractable hiccups in the development of TS.
糖尿病酮症酸中毒（DKA）和甲状腺危象（TS）是严重的代谢和内分泌紊乱疾病。两者通常都表现为多种全身临床体征和症状，而恶心、呕吐等消化系统症状在这些患者中最为常见。此外，并发严重或罕见并发症可能会使病情恶化，甚至因误诊、诊断延迟或治疗不当而导致死亡。这些症状的识别通常与疾病的严重程度和预后密切相关。尽管及时诊断和积极治疗可能会改善临床预后，但一些罕见且隐匿的代谢并发症很难早期识别。此外，危及生命的胃肠道症状在DKA和TS患者中非常罕见。在此，我们报告一名住院患者，诊断为DKA和格雷夫斯病，在DKA治疗期间出现危及生命的顽固性呃逆，导致甲状腺危象和呼吸衰竭。此外，我们回顾文献以讨论顽固性呃逆在甲状腺危象发生过程中可能的潜在机制。
