1例抗甲状腺药物致妊娠合并甲亢患者关节炎综合征的案例分析  

A case of arthritis syndrome induced by antithyroid drugs in a pregnant patient with hyperthyroidism

作　　者：张倩影 靳玉倩 李慧颖 刘坤 王洪民[4] ZHANG Qian-ying;JIN Yu-qian;LI Hui-ying;LIU Kun;WANG Hong-min(Department of Pharmacy,the Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China;Department of Endocrinology,the Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China;Department of Pharmacy,Fengrun District People's Hospital,Tangshan 063000,China;Department of Pharmacy,Tangshan Maternal and Child Health Hospital,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院药学部,河北唐山063000 [2]华北理工大学附属医院内分泌科,河北唐山063000 [3]丰润区人民医院药剂科,河北唐山063000 [4]唐山市妇幼保健院药剂科,河北唐山063000

出　　处：《中国药物应用与监测》2022年第4期274-276,共3页Chinese Journal of Drug Application and Monitoring

基　　金：河北省医学科学研究课题计划项目(20191148)。

摘　　要：1例25岁妊娠女性,因甲状腺功能亢进于孕10周服用丙硫氧嘧啶片(50 mg,tid),7 d后出现双膝关节、左腕关节、左小臂疼痛,关节处疼痛在行动时尤为严重,活动轻微受限,停药后症状缓解。孕12周因甲亢控制不佳换用甲巯咪唑片(10 mg,qd),4 d后再次出现双膝关节疼痛,症状同前,停药后症状减轻。经查系统性血管炎相关自身抗体谱(4项)、抗核抗体谱阴性,类风湿因子、红细胞沉降率、C反应蛋白、补体2项、免疫球蛋白3项、抗链球菌溶血素O均未见异常,考虑为抗甲状腺药物所致关节炎综合征。患者因怀孕初期无法实施手术和放射性碘治疗甲亢,服用抗甲状腺药物后又出现关节炎综合征,完善相关检查后于孕16周行引产手术,术后1个月行放射性碘治疗,甲亢预后良好。A 25-year-old pregnant woman with hyperthyroidism was treated with propylthiouracil tablets(50 mg,tid)at 10 weeks of gestation.7 days later,she developed pain in both knees,left wrist and left forearm,which was more severe especially during action.Her activities were slightly limited,and the symptoms were relieved after drug withdrawal.At 12 weeks of pregnancy,propylthiouracil was replaced by methimazole(10 mg,qd)due to the poor effect.4 days later,the above symptoms appeared again which were alleviated after withdrawal.The results of autoantibody profile associated with systemic vasculitis(4 items),antinuclear antibody profiles were negative.No abnormalities were observed in rheumatoid factor,erythrocyte sedimentation rate,C-reactive protein,complement(2 items),immunoglobulin(3 items)and anti-streptococcal hemolysin O.She received induction of labor at 16 weeks of gestation after completing the relevant laboratory examinations because radioactive iodine therapy and thyroidectomy were not suitable for her due to pregancy and she developed arthritis syndrome induced by antithyroid drugs.Radioactive iodine therapy was implemented 1 month later and the hyperthyroidism had a good prognosis.

关 键 词：妊娠 甲状腺功能亢进 关节炎综合征 抗甲状腺药物 药品不良反应 

分 类 号：R977.14[医药卫生—药品]