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甲亢未得到控制时:1例罕见的格雷夫斯病急性心包炎诱发心脏压塞病例

When hyperthyroidism goes unchecked: A rare case of cardiac tamponade induced by acute pericarditis in Graves' disease.

作者信息

Jabri Meryem, Ismaili Nabila, Ouafi Noha El, Bazid Zakaria

机构信息

Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco.

Department of Cardiology Mohammed VI University Hospital Mohammed I University Oujda Morocco.

出版信息

Radiol Case Rep. 2024 Oct 23;20(1):221-227. doi: 10.1016/j.radcr.2024.09.126. eCollection 2025 Jan.

Abstract

Graves' disease, the most prevalent cause of hyperthyroidism, is an autoimmune disorder associated with several cardiovascular complications. The occurrence of acute pericarditis within the context of Graves' disease, is very rare. We present an uncommon case of cardiac tamponade in a patient diagnosed with Graves' disease. A female patient, was admitted with symptoms of dyspnea and palpitations. Clinical examination revealed Beck's triad. Transthoracic echocardiography showed a large pericardial effusion with significative respiratory variations, indicating an urgent pericardiocentesis. Thyroid function tests revealed hyperthyroidism with positive TSH-receptor antibodies, and elevated anti-TPO antibodies. Cardiac tamponade, induced by acute pericarditis in Graves' disease is an uncommon entity. Typically, the diagnosis is established on a detailed history and physical examination, supported by specific investigations, including suppressed levels of TSH along with elevated free T4 levels and thyroid receptor antibodies. Pericardiocentesis, NSAIDs, betablockers, associated with antithyroid medications constitute the mainstay of treatment.

摘要

格雷夫斯病是甲状腺功能亢进最常见的病因,是一种与多种心血管并发症相关的自身免疫性疾病。格雷夫斯病患者发生急性心包炎的情况非常罕见。我们报告一例诊断为格雷夫斯病的患者发生心脏压塞的罕见病例。一名女性患者因呼吸困难和心悸症状入院。临床检查发现贝克三联征。经胸超声心动图显示大量心包积液且有明显的呼吸变化,提示需紧急进行心包穿刺术。甲状腺功能检查显示甲状腺功能亢进,促甲状腺激素受体抗体阳性,抗甲状腺过氧化物酶抗体升高。格雷夫斯病急性心包炎所致心脏压塞是一种罕见情况。通常,根据详细的病史和体格检查,并辅以包括促甲状腺激素水平降低、游离甲状腺素水平升高以及甲状腺受体抗体等特定检查来确诊。心包穿刺术、非甾体抗炎药、β受体阻滞剂以及抗甲状腺药物构成了主要治疗手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/650a/11539356/89c1668127c0/gr1.jpg

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