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继发于亚急性甲状腺炎的Graves病1例分析

1 case of Graves' disease following subacute thyoiditis

摘要:

目的 探讨继发于亚急性甲状腺炎的Graves病临床特点及诊疗中的注意事项.方法 报告1例继发于亚急性甲状腺炎的Graves病病例并进行相关文献复习.结果 患者39岁女性,因颈部疼痛、发热、心悸、消瘦20余天入院,人院后完善血常规、血生化、血沉、甲功、TRAb、甲状腺超声、甲状腺[3]I摄取率等检查,诊断为亚急性甲状腺炎、肝功异常,予泼尼松抗炎及控制心率、保肝等治疗,症状好转,2个月后因心慌、多汗再次入院,复查甲功、TRAb、甲状腺超声、甲状腺131I摄取率等,考虑诊断Graves病成立,因肝功异常,最终行131I治疗.结论 亚急性甲状腺炎后出现Graves病较罕见,其早期诊断尤为困难,需注意监测TRAb、甲功、血生化等,必要时完善甲状腺[3]I摄取率检查以明确.

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Objective To explore the clinical characteristics and therapeutic considerations of Graves' disease following subacute thyoiditis.Method A case of Graves' disease following subacute thyroiditis was reported and the related literatures were reviewed.Results The patient was a 39 years old female.She came to hospital because of neck pain,fever,palpitation,emaciation for more than 20 days.After being hospitalized,routine blood test,biochemical tests,blood sedimentation,thyroid function,thyrotropin receptor antibodies (TRAb),thyroid ultrasound,thyroid 131-iodine uptake rate test were taken,finally she was diagnosed as subacute thyroiditis and abnormal liver function.The main treatment included prednisone anti-inflammatory,heart rate control,and hepatoprotection,all symptoms were improved after the treatment.However,2 months later,she came to hospital again because of palpitation and hyperhidrosis.Thyroid function,TRAb,thyroid ultrasound,and thyroid 131-iodine uptake rate test were taken again,and Graves' disease was diagnosed.Because of liver damage,she finally chose 131-iodine treatment.Conclusions Graves' disease following subacute thyoiditis is rare,and the early diagnosis is very difficult.TRAb,thyroid function,biochemical tests should be taken,sometimes thyroid 131-iodine uptake rate test should be done if necessary.

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