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由甲状腺功能亢进引起的胆囊壁水肿增厚:一例报告。

Edematous wall thickening of the gallbladder induced by hyperthyroidism: A case report.

机构信息

Department of General Internal Medicine 1, Kawasaki Medical School, Okayama, Japan.

Department of General Internal Medicine 2, Kawasaki Medical School, Okayama, Japan.

出版信息

Medicine (Baltimore). 2022 Jan 28;101(4):e28720. doi: 10.1097/MD.0000000000028720.

Abstract

RATIONALE

Hyperthyroidism, such as Basedow disease, causes fluid retention, although the common cause is volume overload due to congestive heart failure. In addition, hyperthyroidism and Basedow disease are known to cause pulmonary hypertension. Edematous thickening of the gallbladder wall is caused by venous blood congestion. The feature of edematous wall thickening of the gallbladder on abdominal computed tomography (CT) is subserosal edema and is often accompanied by a periportal collar sign.

PATIENT CONCERNS

A 30-year-old woman was referred to our hospital because of liver dysfunction, edematous gallbladder wall thickening, and fluid retention. In addition, the patient developed hyperthyroidism and heart failure. Enhanced abdominal CT revealed edematous wall thickening of the gallbladder and a periportal collar sign.

DIAGNOSIS

We suspected that fluid retention and congestion were caused by hyperthyroidism and Basedow disease.

INTERVENTIONS

On admission, we started thiamazole therapy for Basedow disease, and her thyroid hormone levels normalized.

OUTCOMES

Abdominal CT revealed disappearance of edematous wall thickening of the gallbladder, which was likely associated with an improvement in thyroid function. The patient was discharged 10 days after admission.

LESSONS

We encountered a case of hyperthyroidism and Basedow disease accompanied by edematous wall thickening of the gallbladder and various fluid retentions as the first symptoms. Such edematous wall thickening of the gallbladder and various fluid retentions were reduced, together with the improvement of hyperthyroidism.

摘要

背景

甲状腺功能亢进症(如 Basedow 病)可引起体液潴留,尽管常见原因是充血性心力衰竭引起的容量超负荷。此外,甲状腺功能亢进症和 Basedow 病已知可引起肺动脉高压。胆囊壁水肿性增厚是由静脉血液淤滞引起的。腹部计算机断层扫描(CT)上胆囊水肿性壁增厚的特征是胆囊壁的浆膜下水肿,常伴有门脉周围领圈征。

病例介绍

一名 30 岁女性因肝功能障碍、胆囊壁水肿性增厚和体液潴留被转至我院。此外,该患者还患有甲状腺功能亢进症和心力衰竭。增强腹部 CT 显示胆囊壁水肿性增厚和门脉周围领圈征。

诊断

我们怀疑体液潴留和充血是由甲状腺功能亢进症和 Basedow 病引起的。

治疗

入院时,我们开始用甲巯咪唑治疗 Basedow 病,患者的甲状腺激素水平恢复正常。

治疗结果

腹部 CT 显示胆囊壁水肿性增厚消失,这可能与甲状腺功能的改善有关。患者在入院后 10 天出院。

经验教训

我们遇到了一例以水肿性胆囊壁增厚和各种体液潴留为首发症状的甲状腺功能亢进症和 Basedow 病病例。随着甲状腺功能亢进症的改善,这种水肿性胆囊壁增厚和各种体液潴留得到了缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7394/8797480/0d9fc9fd963a/medi-101-e28720-g001.jpg

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