甲状腺功能减退性肌病并发横纹肌溶解致急性肾损伤一例  

Acute kidney injury caused by hypothyroid myopathy complicated by rhabdomyolysis: a case report

作　　者：史玉萍 朱楠[1] 戎殳[1] Shi Yuping;Zhu Nan;Rong Shu(Department of Nephrology, Shanghai General Hospital, Shanghai Jiao TongUniversity School of Medicine, Shanghai 200080, China)

机构地区：[1]上海交通大学附属第一人民医院肾内科

出　　处：《新医学》2019年第10期793-796,共4页Journal of New Medicine

摘　　要：甲状腺功能减退性肌病(HM)是继发于甲状腺功能减退的肌肉病变,起病隐匿,临床上易漏诊或误诊,此文报道一例HM合并横纹肌溶解致急性肾损伤患者的诊疗经过。该患者因眼睑浮肿就诊发现急性肾损伤,病程中出现双下肢乏力,肌电图未见明显异常,患者既往有甲状腺功能减退病史,排查横纹肌溶解时发现肌酶增高,予甲状腺激素治疗后,肌酶水平下降,病情缓解,最终确诊HM。该例诊治提示,对于甲状腺功能减退的患者,尤其是老年患者,需提高警惕,及时发现、治疗,这对避免HM患者潜在并发症至关重要。Hypothyroid myopathy (HM) is a clinical feature of muscle lesions secondary to hypothyroidism. With an insidious onset, HM is likely to be missed diagnosis or misdiagnosed in clinical practice. In this article, the diagnosis and treatment of one case of acute kidney injury caused by HM complicated with rhabdomyolysis were reported. The patient was diagnosed with acute kidney injury due to orbital edema. During the course of the disease, the patient developed fatigue in both lower limbs, whereas electromyography (EMG) revealed no obvious abnormality. The patient had a history of hypothyroidism. The muscle enzyme level was increased during the detection of rhabdomyolysis. After thyroid hormone treatment was given, the muscle enzyme level was decreased, and the disease condition was relieved. The patient was eventually diagnosed with HM. The diagnosis and treatment of this case prompt that it is necessary to be vigilant for patients with hypothyroidism, especially elderly patients, to deliver corresponding treatment in a timely manner, which is essential to avoid potential complications of HM patients.

关 键 词：急性肾损伤 甲状腺功能减退 横纹肌溶解 甲状腺功能减退性肌病 

分 类 号：R581.2[医药卫生—内分泌]