库欣综合征术后继发于亚急性甲状腺炎的甲状腺危象1例报道

Thyroid storm caused by subacute thyroiditis after Cushing's syndrome remission:one case report

患者为46岁女性,因库欣综合征5月前行肾上腺腺瘤切除术,予糖皮质激素替代逐步减量中,3周前因咽痛、饮水呛咳、恶心、呕吐自行停药。之后出现高热及意识障碍,化验提示甲状腺功能亢进,予丙硫氧嘧啶及β受体阻滞剂后意识障碍进行性加重,结合炎性指标升高、TSH受体抗体阴性及摄碘率低平考虑为亚急性甲状腺炎,加用糖皮质激素治疗后病情好转,甲亢缓解。

A 46-year-old female was subjected to unilateral left adrenalectomy due to Cushing's syndrome 5 months ago.After surgery,she was placed on glucocorticoid substitution and discontinued the treatment due to nausea and vomiting 3 weeks ago.Then she developed subacute thyroiditis and progressed to thyroidstorm.Her condition worsened after administration of propylthiouracil andβ-blockers,but was'soon relieved by administration of glucocorticoids.