耐火性二次性甲状腺功能增强症呈现与逆轨道棕色瘤:一个病例报告
Cihan Uysal1, Tugba Yilmaz2, Hamiyet Ozkan3
1Department of Nephrology, Erciyes University School of Medicine, Dede Efendi Street, Köşk District, Kayseri, Melikgazi, 38030, Turkey. drcihanuysal@hotmail.com.
BMC nephrology
|January 5, 2024
概括
这一案例突出了长期透析患者的严重,耐治疗的三级甲状腺功能增强症,呈现出具有破坏性的棕色瘤和不寻常的腺瘤位置. 在慢性病中治疗二次性甲状腺功能障碍仍然具有挑战性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
背景情况:
- 三级性甲状腺功能增强症在慢性病 (CKD) 中长期的二次性甲状腺功能增强症后涉及自主甲状腺激素 (PTH) 分泌.
- 棕色瘤是无法控制的副甲状腺功能障碍症的迹象.
- 这份报告详细介绍了一例耐火性,具有非典型表现和腺瘤位置的破坏性甲状腺功能增强症病例.
研究的目的:
- 在长期透析患者中呈现一种具有严重并发症的三级甲状腺功能障碍症的独特病例.
- 为了强调管理耐火性二次性甲状腺功能增强症的挑战.
主要方法:
- 一名37岁的末期脏病患者在透析治疗22年后出现了轨道质量.
- 诊断成像 (MRI,CT) 显示了一个轨道质量和一个状翼骨损伤.
- 骨质的手术切除证实了棕色瘤;进行了广泛的甲状腺评估.
主要成果:
- 病理学证实了棕色瘤,这是甲状腺功能障碍症的表现.
- 该患者表现出极高的完整PTH水平 (4557 pg/mL).
- 尽管先前进行了手术和修订了医疗/透析方案,但PTH水平仍然很高,副甲状腺扫描显示了多种腺瘤,其中包括一个在中.
结论:
- 这一案例说明了抗治疗的三级甲状腺功能障碍症,导致慢性透析患者的严重并发症.
- 在CKD中治疗二次性甲状腺功能障碍症是复杂的,并且可能很难控制.
相关概念视频
Hyperthyroidism I: Introduction
Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Hyperthyroidism II: Pathophysiology
Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Graves Disease II: Pathophysiology
Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...


