甲状腺功能亢进危象伴复杂性全血细胞减少1例  

Hyperthyroidism crisis and complex pancytopenia:A case report

作　　者：雷小添 冷蔚玲 隆敏 谢来平 陈刘 LEI Xiaotian;LENG Weiling;LONG Min;XIE Laiping;CHEN Liu(Department of Endocrinology,First Affiliated Hospital of Army Medical University,Chongqing 400038;Department of Nuclear Medicine,First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院内分泌科,重庆400038 [2]陆军军医大学第一附属医院核医学科,重庆400038

出　　处：《中南大学学报（医学版）》2024年第7期1089-1094,共6页Journal of Central South University ：Medical Science

摘　　要：甲状腺功能亢进症(以下简称“甲亢”)治疗中所用抗甲亢药物可导致粒细胞减少或缺乏,全血细胞减少罕见。粒细胞缺乏或全血细胞减少合并甲亢危象时,病情复杂,治疗难度大,严重危及患者生命。陆军军医大学第一附属医院收治1例甲巯咪唑导致粒细胞缺乏伴感染,继发甲亢危象、全血细胞减少,同时合并系统性红斑狼疮相关抗体异常的甲亢患者。通过完善检查检验鉴别病因,及时给予抗感染、促粒细胞生成、复方碘溶液控制甲状腺功能等治疗,挽救了患者的生命。对于甲亢合并严重全血细胞减少的患者,早发现和鉴别全血细胞减少的可能病因,动态调整治疗方案意义重大。Antithyroid drugs can cause neutropenia or agranulocytosis,rarely pancytopenia in hyperthyroidism therapy.The treatment is difficult and lethality is high when granulocytopenia or pancytopenia combined with hyperthyroidism crisis.First Affiliated Hospital of Army Medical University treated a patient who had pancytopenia caused by methimazole with systemic lupus erythematosus,secondary hyperthyroidism crisis and agranulocytosis.We gave the reasonable treatment in time,such as anti-infection,stimulating granulocyopoiesis,compound iodine solution to control thyroid function,controlled the disease effectively and saved the patient’s life.Early detection and identification of possible causes of pancytopenia and dynamic adjustment of treatment plan show great significance for patients with hyperthyroidism and severe pancytopenia.

关 键 词：甲状腺功能亢进症 甲状腺功能亢进危象 全血细胞减少 免疫相关血小板减少 

分 类 号：R581.1[医药卫生—内分泌]