Bhasin S, Wallace W, Lawrence J B, Lesch M
Am J Med. 1981 Nov;71(5):887-90. doi: 10.1016/0002-9343(81)90392-2.
Three patients with hyperthyroidism due to deliberate intake of excessive amounts of L-thyroxine are described wherein death was "instantaneous" and presumably due to ventricular fibrillation. Hyperthyroidism was not recognized on admission in two of these patients because of atypical presentations. Autopsy was performed in two patients. In one patient no coronary disease was present and focal myocarditis with leukocytic infiltration was noted. The second patient had an acute posterior myocardial infarction due to acute coronary thrombosis, but focal areas of leukocytic infiltration and fibrosis were also seen in the anterior wall not involved in the process of infarction. Factitious hyperthyroidism due to L-thyroxine abuse can be associated with sudden death in the absence of coronary artery disease and may be related to a drug induced myocarditis.
本文描述了3例因故意过量摄入左甲状腺素导致甲状腺功能亢进的患者，其死亡为“瞬间性”，推测是由于心室颤动所致。其中2例患者入院时因表现不典型未被诊断为甲状腺功能亢进。2例患者进行了尸检。1例患者无冠状动脉疾病，但发现有局灶性心肌炎伴白细胞浸润。第2例患者因急性冠状动脉血栓形成导致急性后壁心肌梗死，但在前壁未发生梗死的区域也可见到局灶性白细胞浸润和纤维化。滥用左甲状腺素所致的人为性甲状腺功能亢进可在无冠状动脉疾病的情况下与猝死相关，可能与药物性心肌炎有关。
