Ho S C, Eng P H, Ding Z P, Fok A C, Khoo D H
Department of Endocrinology, Singapore General Hospital, Singapore.
Ann Acad Med Singap. 1998 Sep;27(5):748-51.
Thyroid storm is a difficult diagnosis in "apathetic" variant of hyperthyroidism. The clinical features may not be evident. Abnormal atrioventricular (AV) conduction, such as complete heart block, in thyrotoxicosis is uncommon. We report a case of a 16-year-old girl presenting with fever, jaundice, heart failure and complete heart block in whom the diagnosis of thyroid storm was initially missed because of the unusual presenting features. Prompt resolution of the conduction abnormality occurred when treatment with carbimazole, intravenous iodide and dexamethasone was instituted.
甲状腺危象在甲状腺功能亢进症的“淡漠型”变体中是一种难以诊断的疾病。临床特征可能不明显。甲状腺毒症中出现异常的房室传导，如完全性心脏传导阻滞，并不常见。我们报告一例16岁女孩，表现为发热、黄疸、心力衰竭和完全性心脏传导阻滞，因其不寻常的临床表现，最初漏诊了甲状腺危象。在开始使用卡比马唑、静脉注射碘化物和地塞米松治疗后，传导异常迅速得到缓解。
