大量摄入左甲状腺素后发生甲状腺毒症：一例报告
Thyrotoxicosis after a massive levothyroxine ingestion: A case report.
作者信息
Du Fang, Liu Shi-Wei, Yang Hua, Duan Rui-Xue, Ren Wen-Xia
机构信息
Department of Endocrinology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan 030009, Shanxi Province, China.
Department of Endocrinology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China.
出版信息
World J Clin Cases. 2022 Apr 16;10(11):3624-3629. doi: 10.12998/wjcc.v10.i11.3624.
BACKGROUND
The literature on thyrotoxicosis caused by excessive ingestion of exogenous thyroid hormone is limited, and most cases reported have involved pediatric clinical studies.
CASE SUMMARY
A 21-year-old woman initially presented with palpitation and chest tightness after an overdose of levothyroxine (10 mg). The patient transiently lost consciousness and developed atrial fibrillation during hospitalization. We used propylthiouracil to decrease the peripheral conversion of T4 to T3 and inhibit the synthesis of endogenous thyroxine, propranolol to control heart rate, hydrocortisone to correct severe thyrotoxicosis, and hemoperfusion to increase levothyroxine clearance. The patient recovered and was discharged.
CONCLUSION
For patients with thyrotoxicosis after taking excess levothyroxine, it is critical to monitor vital signs and initiate effective treatment.
背景
关于因过量摄入外源性甲状腺激素导致甲状腺毒症的文献有限，且大多数报道的病例涉及儿科临床研究。
病例摘要
一名21岁女性在过量服用左甲状腺素（10毫克）后最初出现心悸和胸闷。患者在住院期间短暂失去意识并发生房颤。我们使用丙硫氧嘧啶减少T4向T3的外周转化并抑制内源性甲状腺素的合成，普萘洛尔控制心率，氢化可的松纠正严重甲状腺毒症，血液灌流增加左甲状腺素清除率。患者康复出院。
结论
对于服用过量左甲状腺素后发生甲状腺毒症的患者，监测生命体征并启动有效治疗至关重要。
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