由于饥饿和格雷夫斯病导致的严重非糖尿病酸性酸症
Koki Yamamoto1, Yuki Honda2,3, Kazuhito Saito2
1Department of General Internal Medicine, Seirei Hamamatsu General Hospital Epilepsy Center, Hamamatsu, Japan driveflareon130@gmail.com.
BMJ case reports
|September 25, 2025
概括
饥饿可以导致非糖尿病酸性脂肪酸症 (NDKA),但轻度甲状腺功能障碍症可以危险地使这种情况恶化. 早期诊断和治疗甲状腺功能障碍症对于管理严重的NDKA至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
- 关键护理医学 关键护理医学
背景情况:
- 饥饿诱导的非糖尿病酸性酸症 (NDKA) 通常是一种轻微的代谢障碍.
- 甲状腺功能障碍症可以影响代谢过程,但其在加剧NDKA中的作用尚不清楚.
研究的目的:
- 报告一个危及生命的NDKA病例,原因是先前未被诊断的甲状腺功能障碍症患者的饥饿.
- 强调同时存在的甲状腺功能障碍可能显著恶化NDKA的可能性.
主要方法:
- 一个病人的病例报告呈现出严重的代谢酸症,子水平升高和正常的葡萄糖.
- 诊断工作显示了轻度至中度甲状腺功能障碍 (格雷夫斯病).
- 治疗涉及密集护理,包括血液透析,含葡萄糖的液体,抗甲状腺药物和β-抑制剂.
主要成果:
- 由于饥饿,该患者患有严重的高阴离子间隙代谢酸性化症.
- 未被诊断的格雷夫斯病被确定为一个促成因素.
- 干预措施成功地解决了酸性和正常化了甲状腺功能.
结论:
- 轻度至中度甲状腺功能障碍症可以大大加剧饥饿引起的NDKA.
- 临床医生应考虑在患有严重酸性脂肪酸症的患者中查甲状腺功能过高症,特别是当怀疑NDKA时.
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