Daffini Linda, Pirola Ilenia, Saccà Giovanni, Salvetti Massimo, Cappelli Carlo
Department of Clinical and Experimental Sciences, SSD Medicina ad indirizzo Endocrino-Metabolico, University of Brescia, ASST Spedali Civili di Brescia, Italy.
Department of Clinical and Experimental Sciences.
Caspian J Intern Med. 2021;12(Suppl 2):S371-S375. doi: 10.22088/cjim.12.0.371.
Thyroid storm is a rare, life-threatening condition characterized by severe clinical manifestations of thyrotoxicosis and can be precipitated by several factors. We described a thyroid storm precipitated by a long-term treatment using homeopathic medicine containing iodine.
A 55-year-old Italian woman was admitted to our Sub-Intensive Care Unit with the diagnosis of congestive heart failure and thyrotoxicosis. She has been diagnosed with Graves' disease two years before; she refused conventional therapy and in the preceding six months had been using phytotherapeutic and homeopathic medicine. We found serum and urine iodine levels consistent with severe intoxication by iodine (serum iodine: 42100 mcg/L and urinary iodine: 4223 mcg/L, respectively). After a few hours, the patient went into cardiac arrest. She was subjected to invasive ventilation, dialyzed with continuous veno-venous hemofiltration and treated with vasoactive amines.
The high level of iodemia manifested in our patient - around a thousand times greater than the normal range and itself associated with fatal outcomes - was caused by long-term homeopathic treatment. This long-term treatment has two consequences: first, iodine load-precipitated hyperthyroidism in thyroid storm, and secondly, it prevents us from treating patients with inorganic iodide.
甲状腺危象是一种罕见的、危及生命的疾病，其特征为甲状腺毒症的严重临床表现，可由多种因素诱发。我们描述了一例因长期使用含碘顺势疗法药物而引发的甲状腺危象。
一名55岁的意大利女性因充血性心力衰竭和甲状腺毒症被收入我们的亚重症监护病房。她两年前被诊断为格雷夫斯病；她拒绝接受传统治疗，在之前的六个月里一直在使用植物疗法和顺势疗法药物。我们发现血清和尿碘水平与碘严重中毒一致（血清碘分别为42100微克/升和尿碘为4223微克/升）。几小时后，患者发生心脏骤停。她接受了有创通气，采用持续静脉-静脉血液滤过进行透析，并使用血管活性胺进行治疗。
我们的患者出现的高碘血症——比正常范围高出约一千倍且本身与致命后果相关——是由长期顺势疗法治疗引起的。这种长期治疗有两个后果：第一，碘负荷引发甲状腺危象中的甲状腺功能亢进，第二，它使我们无法用无机碘治疗患者。
