产后严重的甲状腺功能低下症引发精神病原性非性发作,肌肉病变和myxedema 昏迷
Brandon L Welborn1, Benjamin B Zwain2
1Neurology, Edward Via College of Osteopathic Medicine, Spartanburg, USA.
Cureus
|May 30, 2024
概括
严重的产后甲状腺功能低下症可以模仿心理非性发作 (PNES) 并导致肌性昏迷. 及时的甲状腺激素替代疗法对于在女性中管理这些复杂的神经精神病症状至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 神经学 神经学
- 精神病学是一个精神病学.
背景情况:
- 产后期对妇女健康构成独特的挑战.
- 甲状腺功能障碍可以表现为各种神经精神症状.
- 心理非发作 (PNES) 的诊断可能具有挑战性.
研究的目的:
- 详细介绍一个患有严重产后甲状腺功能低下症的病例,该病例加剧了PNES并导致结核炎昏迷.
- 强调内分泌评估在产后神经精神病学陈述中的重要性.
- 为了强调甲状腺功能障碍和PNES之间的潜在联系.
主要方法:
- 一个29岁的女性患有分娩后并发症的病例报告.
- 临床表现:困惑,失语,腿部,类似发作的情节.
- 实验室检查:肌酸激酶 (CK),甲状腺刺激激素 (TSH) 的升高,以及自由甲状腺素 (T4) 的低水平.
主要成果:
- 诊断出严重的产后甲状腺功能低下症与肌肉病和PNES.
- 在重新引入Levothyroxine后,症状迅速消失.
- 在TSH (216 mIU/L) 和CK (2083 U/L) 中显著升高,具有临界低的T4 (0.2 ng/dL).
结论:
- 严重的产后甲状腺功能低下症可以呈现为PNES和myxedema昏迷.
- 内分泌评估对于产后神经精神症状至关重要.
- 建议采用多学科的方法来管理复杂的产后病例.
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