与甲状腺风暴相关的致命的复发性心血管血栓中风:一个病例报告
Chu-Fang Cheng1, Chih-Yang Liu1, Shinn-Kuang Lin1,2
1Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
Acta neurologica Taiwanica
|December 30, 2025
概括
甲状腺风暴是一种严重的甲状腺功能障碍并发症,可以模仿中风症状. 早期诊断和同时治疗甲状腺风暴和缺血性中风是至关重要的,但具有挑战性,正如一个复杂的案例所示.
科学领域:
- 内分泌学 在内分泌学.
- 神经学 神经学
- 心脏病学 心脏病学
背景情况:
- 甲状腺风暴是一种罕见的,危及生命的内分泌紧急情况.
- 甲状腺功能障碍会出现神经和心血管方面的并发症.
- 区分甲状腺风暴和急性中风是临床上具有挑战性的.
研究的目的:
- 报告一种甲状腺风暴病例,呈现出类似中风的症状.
- 突出诊断和治疗挑战在管理同时存在的甲状腺风暴和缺血性中风.
- 强调早期诊断和综合管理的重要性.
主要方法:
- 一个50岁的女性病例报告,她有甲状腺功能过高和心房动的病史.
- 临床表现急性左肢疲软和不清晰的语言.
- 诊断工作包括心电图,胸部放射,脑CT血管图,实验室测试 (甲状腺激素,TSH受体抗体) 和心声图.
- 治疗包括血栓消毒疗法,狄戈辛,醇和甲.
主要成果:
- 患者出现了模仿缺血性中风的症状.
- 实验室发现证实了甲状腺风暴 (FT4,FT3升高;TSH降低;TSH受体抗体阳性).
- 尽管初始的血栓解压疗法和随后的管理,患者出现了复发的双边半球心脏病发作,导致昏迷和四肢.
结论:
- 甲状腺风暴可以呈现神经缺陷,模仿急性缺血性中风.
- 同时治疗甲状腺风暴和缺血性中风带来了重大的临床挑战.
- 及时诊断和综合治疗策略对于改善患有并存疾病的患者的治疗结果至关重要.
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 I: Introduction
Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...
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...
Hypothyroidism II: Pathophysiology
Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...


