Le Cosquer P, Guerin-Robardey A M, Ossart M
Département d'anesthésie-réanimation B, CHU hôpital Nord, Amiens, France.
Ann Fr Anesth Reanim. 1996;15(7):1092-4. doi: 10.1016/s0750-7658(96)89481-0.
We report a case of amiodarone-induced thyrotoxicosis, diagnosed with a systematic laboratory investigation in a 64-year-old patient, for haematuria. Despite the interruption of amiodarone, hyperthyroidism and a goiter occurred. Conventional therapy betablockers, antithyroid agents, prednisone, potassium perchlorate) did not result in any clinical improvement. The development of a malignant thyrotoxicosis with neurologic disturbances and acute respiratory insufficiency required mechanical ventilation and a subtotal thyroidectomy. The patient's status improved progressively and he was discharged without sequelae. The respective roles of medical therapy and thyroidectomy in amiodarone-induced thyrotoxicosis are discussed.
我们报告一例胺碘酮诱发的甲状腺毒症，该病例是在一名64岁因血尿接受系统实验室检查的患者中诊断出来的。尽管停用了胺碘酮，但仍出现了甲状腺功能亢进和甲状腺肿。常规治疗（β受体阻滞剂、抗甲状腺药物、泼尼松、高氯酸钾）并未带来任何临床改善。伴有神经功能障碍和急性呼吸功能不全的恶性甲状腺毒症的发展需要机械通气和甲状腺次全切除术。患者的状况逐渐改善，出院时无后遗症。本文讨论了药物治疗和甲状腺切除术在胺碘酮诱发的甲状腺毒症中的各自作用。
