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青少年因用碘塞罗宁增强抗抑郁治疗而导致的临床甲状腺毒症

Clinical Thyrotoxicosis Resulting from Liothyronine Augmentation of Antidepressant Therapy in an Adolescent.

作者信息

Pallant Benjamin A, Moore Claire E, Topor Lisa Swartz

机构信息

Warren Alpert Medical School of Brown University, Providence, RI, USA.

Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA.

出版信息

Case Rep Psychiatry. 2022 May 24;2022:2270202. doi: 10.1155/2022/2270202. eCollection 2022.

Abstract

. Thyrotoxicosis, a condition resulting from excessive peripheral thyroid hormone, is typically accompanied by thyroid function tests demonstrating a high free thyroxine (free T4) with appropriate suppression of thyroid-stimulating hormone (TSH). . We describe a 17-year-old female presenting with symptoms of thyrotoxicosis along with suppressed TSH and low free T4, a laboratory pattern concerning for central hypothyroidism. Further history revealed that she was prescribed liothyronine as an adjunct therapy for depression. . Due to the short half-life of liothyronine, clinical signs and symptoms of thyrotoxicosis may develop before detection by interval lab monitoring. . This case highlights the need for close monitoring and caution when treating adolescents with liothyronine and the importance of interpreting atypical laboratory findings within clinical context.

摘要

甲状腺毒症是一种由外周甲状腺激素过多引起的病症,通常伴有甲状腺功能检查显示游离甲状腺素(游离T4)升高且促甲状腺激素(TSH)受到适当抑制。我们描述了一名17岁女性,她出现甲状腺毒症症状,同时伴有TSH受抑制和游离T4降低,这种实验室检查结果提示存在中枢性甲状腺功能减退。进一步询问病史发现,她被开具了左甲状腺素钠作为抑郁症的辅助治疗药物。由于左甲状腺素钠半衰期短,在通过定期实验室监测发现之前,甲状腺毒症的临床体征和症状可能就已出现。该病例强调了在使用左甲状腺素钠治疗青少年时进行密切监测和谨慎用药的必要性,以及在临床背景下解读非典型实验室检查结果的重要性。

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