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一名青少年碘致甲状腺功能亢进症合并暴发性心肌炎:病例报告

Hyperthyroidism and fulminant myocarditis in an adolescent with iodine-induced hyperthyroidism: A case report.

作者信息

Lai Teng Fang, Liu ZhengJiang

机构信息

Department of Cardiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Baise, Guangxi, P.R. China.

出版信息

SAGE Open Med Case Rep. 2024 Dec 6;12:2050313X241305257. doi: 10.1177/2050313X241305257. eCollection 2024.

Abstract

This paper describes the case of a 15-year-old male patient who exhibited chest distress and pain following an upper respiratory tract infection. Upon admission, the patient exhibited elevated levels of myocardial enzymes and troponin I. Electrocardiography revealed an acute inferior myocardial infarction. Coronary computed tomography angiography ruled out coronary stenosis; however, cardiac magnetic resonance imaging revealed myocardial congestion and edema. Subsequent examinations revealed increased thyroid hormone levels and decreased thyroid-stimulating hormone levels, which is consistent with the manifestations of hyperthyroidism. The patient was diagnosed with acute fulminant myocarditis accompanied by iodine-induced hyperthyroidism. The patient received no pharmacologic treatment for hyperthyroidism but was prescribed a low-iodine diet, medication, and supportive treatment. His myocardial enzymes and troponin I levels gradually decreased, his electrocardiography and echocardiography results improved, and his cardiac function returned to normal. The patient was discharged and advised to maintain a low-iodine diet. At the 6-month follow-up, the patient's thyroid function and cardiac indicators had returned to normal. This case demonstrates that myocardial injury can result from myocarditis and iodine-induced hyperthyroidism and highlights the importance of closely monitoring and assessing thyroid function during treatment.

摘要

本文描述了一名15岁男性患者的病例,该患者在上呼吸道感染后出现胸部不适和疼痛。入院时,患者心肌酶和肌钙蛋白I水平升高。心电图显示急性下壁心肌梗死。冠状动脉计算机断层扫描血管造影排除了冠状动脉狭窄;然而,心脏磁共振成像显示心肌充血和水肿。随后的检查显示甲状腺激素水平升高,促甲状腺激素水平降低,这与甲状腺功能亢进的表现一致。该患者被诊断为急性暴发性心肌炎伴碘致甲状腺功能亢进。患者未接受甲状腺功能亢进的药物治疗,但被规定了低碘饮食、药物治疗和支持治疗。他的心肌酶和肌钙蛋白I水平逐渐下降,心电图和超声心动图结果改善,心脏功能恢复正常。患者出院并被建议维持低碘饮食。在6个月的随访中,患者的甲状腺功能和心脏指标已恢复正常。该病例表明,心肌炎和碘致甲状腺功能亢进可导致心肌损伤,并强调了在治疗期间密切监测和评估甲状腺功能的重要性。

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1
Hyperthyroidism: A Review.甲状腺功能亢进症:综述。
JAMA. 2023 Oct 17;330(15):1472-1483. doi: 10.1001/jama.2023.19052.
8
Hyperthyroidism.甲状腺功能亢进症
Lancet. 2016 Aug 27;388(10047):906-918. doi: 10.1016/S0140-6736(16)00278-6. Epub 2016 Mar 30.

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