TY -的A2矶Osamu AU - Lithgow Kirstie AU -西蒙兹,克里斯托弗PY - 2017 DA - 2017/08/24 TI -严重的甲状腺毒症继发于聚乙烯吡咯酮碘从腹膜透析SP - 2683120六世- 2017 AB - 73岁的男性在家庭腹膜透析(PD)与最近诊断为房颤出现疲劳和呼吸困难。甲状腺功能亢进，TSH < 0.01 mIU/L, FT4 > 100 pmol/L。他没有个人或家族甲状腺病史。患者未接触CT造影剂、胺碘酮或碘。甲状腺锝扫描显示弥漫性摄取减低。他被推定为甲状腺炎而出院。三周后，他的病情出现了恶化。再次回顾了可能的碘源，并确定了聚维酮碘溶液用于每个PD循环。甲巯咪唑25 mg / d;然而，他难以忍受药物，并继续恶化临床。 He was readmitted to hospital where methimazole was restarted at 20 mg bid with high dose prednisone 25 mg and daily plasma exchange (PLEX) therapy. Biochemical improvement was observed with FT4 dropping to 48.5 pmol/L by day 10, but FT4 rebounded to 67.8 pmol/L after PLEX was discontinued. PLEX was restarted and thyroidectomy was performed. Pathology revealed nodular hyperplasia with no evidence of thyroiditis. Preoperative plasma iodine levels were greater than 5 times the upper limit of normal range. We hypothesize that the patient had underlying autonomous thyroid hormone production exacerbated by exogenous iodine exposure from a previously unreported PD-related source. SN - 2090-6501 UR - https://doi.org/10.1155/2017/2683120 DO - 10.1155/2017/2683120 JF - Case Reports in Endocrinology PB - Hindawi KW - ER -