Galvan G
Acta Med Austriaca. 1983;10(2-3):79-81.
A 43 years old female was treated for 8 months with antithyroid drugs because of a difficult adjustable hyperthyroidism. In spite of this massive antithyroid therapy a threatening deterioration of the clinical picture occurred. The reason for it was the secret intermittent intake of up to 1200 micrograms lT4 daily motivated by private problems. The difficulties of a differential diagnosis between a thyrotoxicosis factitia and an endogenous hyperthyroidism is stressed. One should always consider a thyrotoxicosis factitia in the case of suggestion of a psychopathia and when thyroid hormone medication is used for suppressive thyroid hormone therapy or as a prophylaxis of goiter recurrence. In addition overweight, major personality disorders and resistance to antithyroid drugs are indicative for thyroid hormone abuse. Important indicators for the differentiation between a thyroid hormone abuse and an endogenous hyperthyroidism are a lack of technetium- or radioiodine-uptake in the thyroid and suppressed levels of thyroglobulin.
一名43岁女性因甲亢难以控制，接受了8个月的抗甲状腺药物治疗。尽管进行了大量的抗甲状腺治疗，但临床症状仍出现了威胁性的恶化。原因是由于个人问题，她每天秘密间断服用高达1200微克的左甲状腺素（LT4）。强调了鉴别人为性甲状腺毒症和内源性甲亢的困难。在存在精神疾病迹象以及甲状腺激素药物用于抑制性甲状腺激素治疗或预防甲状腺肿复发的情况下，应始终考虑人为性甲状腺毒症。此外，超重、严重人格障碍以及对抗甲状腺药物的抵抗提示甲状腺激素滥用。甲状腺激素滥用与内源性甲亢鉴别的重要指标是甲状腺缺乏锝或放射性碘摄取以及甲状腺球蛋白水平受抑制。
