Медицинская литература. Новинки

 

 

 

 

 

 

Тиреотоксический криз. Редкие проявления и трудности своевременной диагностики

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Тиреотоксический криз (ТК) - редко встречающееся жизнеугрожающее осложнение тиреотоксикоза. Провоцирующим фактором развития ТК могут быть бесконтрольное прекращение приема тиреостатиков, оперативное лечение как на щитовидной железе, так и на других органах, присоединение инфекции, роды, введение йодсодержащих веществ. Многообразие клинических проявлений нередко приводит к несвоевременной диагностике, а вследствие этого и высокой смертности при данном состоянии. В статье представлены типичные и редкие проявления тиреотоксического криза, обобщены подходы к диагностике и лечению; описан клинический случай тиреотоксического криза у молодого мужчины.

Ключевые слова:
thyroid storm, Burch-Wartovsky scale, treatment, тиреотоксический криз, шкала Бурха, Вартовского, лечение

Литература:
1.Burch H.B., Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. // Endocrinol Metab Clin N Am. 1993;22:263-277.
2.Akamizu T., Satoh T., Isozaki O., et al. Diagnostic Criteria, Clinical Features, and Incidence of Thyroid Storm Based on Nationwide Surveys. // Thyroid. 2012;22(7):661-679. doi: 10.1089/thy.2011.0334.
3.Burch H.B., Burman K.D., Cooper D.S. A 2011 Survey of Clinical Practice Patterns in the Management of Graves'' Disease. // J Clin Endocrinol Metab. 2012;97(12):4549-4558. doi: 10.1210/jc.2012-2802.
4.Nelson N.C., Becker W.F. Thyroid Crisis. // Ann Surg. 1969;170(2): 263-273. doi: 10.1097/00000658-196908000-00016.
5.Grossman A., Waldstein S.S. Apathetic thyroid storm in a 10-year-old child. // Pediatrics. 1961;28:447-451.
6.Lahey F.H. Apathetic Thyroidism. // Ann Surg. 1931;93(5):1026-1030. doi: 10.1097/00000658-193105000-00008.
7.Howton J.C. Thyroid storm presenting as coma. // Ann Emerg Med. 1988;17(4):343-345. doi: 10.1016/s0196-0644(88)80777-7.
8.Safe A.F., Griffiths K.D., Maxwell R.T. Thyrotoxic crisis presenting as status epilepticus. // Postgrad Med J. 1990;66(772):150-152. doi: 10.1136/pgmj.66.772.150.
9.Jarrett D.R., Hansell D.M., Zeegen R. Thyroid crisis complicated by cerebral infarction. // Br J Clin Pract. 1987;41:671-673.
10.Parker K.I., Loftley A., Charles C., Hermayer K. A case of apathetic thyroid storm with resultant hyperthyroidism-induced hypercalcemia. // Am J Med Sci. 2013;346(4):338-340. doi: 10.1097/MAJ.0b013e31828ffcbc.
11.Cansler C.L., Latham J.A., Brown P.M., et al. Duodenal Obstruction in Thyroid Storm. // South Med J. 1997;90(11):1143-1146. doi: 10.1097/00007611-199711000-00018.
12.Bennett W.R., Huston D.P. Rhabdomyolysis in thyroid storm. // Am J Med. 1984;77(4):733-735. doi: 10.1016/0002-9343(84)90375-9.
13.Ashkar F.S. Thyroid Storm Treatment With Blood Exchange and Plasmapheresis. // JAMA. 1970;214(7):1275. doi: 10.1001/jama.1970.03180070041007.
14.Mackin J.F, Canary J.J., Pittman C.S. Thyroid Storm and Its Management. // N Engl J Med. 1974;291(26):1396-1398. doi: 10.1056/nejm197412262912607.
15.Wartofsky L., Burman K.D. Alterations in Thyroid Function in Patients with Systemic Illness: The ''''Euthyroid Sick Syndrome''''. // Endocr Rev. 1982;3(2):164-217. doi: 10.1210/edrv-3-2-164.
16.Ghobrial M.W., Ruby E.B. Coma and Thyroid Storm in Apathetic Thyrotoxicosis. // South Med J. 2002;95(5):552-554. doi: 10.1097/00007611-200295050-00020.
17.Bahn R.S., Burch H.B., Cooper D.S., et al. Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. // Thyroid. 2011;21(6):593-646. doi: 10.1089/thy.2010.0417.
18.Hodak S.P., Huang C., Clarke D., et al. Intravenous Methimazole in the Treatment of Refractory Hyperthyroidism. // Thyroid. 2006;16(7):691-695. doi: 10.1089/thy.2006.16.691.
19.Nabil N., Miner D.J., Amatrudaf J.M. Methimazole: An Alternative Route of Administration. // J Clin Endocrinol Metab. 1982;54(1): 180-181. doi: 10.1210/jcem-54-1-180.
20.Alfadhli E., Gianoukakis A.G. Management of Severe Thyrotoxicosis When the Gastrointestinal Tract Is Compromised. // Thyroid. 2011;21(3):215-220. doi: 10.1089/thy.2010.0159.
21.Myung Park J., Seok Lee I., Young Kang J., et al. Acute esophageal and gastric injury: Complication of Lugol''s solution. // Scand J Gastroenterol. 2007;42(1):135-137. doi: 10.1080/00365520600825141.
22.Nayak B., Burman K. Thyrotoxicosis and Thyroid Storm. // Endocrinol Metab Clin N Am. 2006;35(4):663-686. doi: 10.1016/j.ecl.2006.09.008.
23.Scholz G.H., Hagemann E., Arkenau C., et al. Is There a Place for Thyroidectomy in Older Patients with Thyrotoxic Storm and Cardiorespiratory Failure? // Thyroid. 2003;13(10):933-940. doi: 10.1089/105072503322511337.
24.Mintz G.U.Y., Pizzarello R.O.Y., Klein I. Enhanced Left Ventricular Diastolic Function in Hyperthyroidism: Noninvasive Assessment and Response to Treatment. // J Clin Endocrinol Metab. 1991;73(1):146-150. doi: 10.1210/jcem-73-1-146.
25.Das G. Treatment of Thyrotoxic Storm with Intravenous Administration of Propranolol. // Ann Intern Med. 1969;70(5):985. doi: 10.7326/0003-4819-70-5-985.
26.Shenfield G.M. Influence of Thyroid Dysfunction on Drug Pharmacokinetics. // Clin Pharmacokinet. 1981;6(4):275-297. doi: 10.2165/00003088-198106040-00003.
27.Jha S., Waghdhare S., Reddi R., Bhattacharya P. Thyroid Storm Due to Inappropriate Administration of a Compounded Thyroid Hormone Preparation Successfully Treated with Plasmapheresis. // Thyroid. 2012;22(12):1283-1286. doi: 10.1089/thy.2011.0353.
28.Langley R.W., Burch H.B. Perioperative management of the thyrotoxic patient. // Endocrinol Metab Clin North Am. 2003;32(2): 519-534. doi: 10.1016/s0889-8529(03)00010-0.
29.Dalan R., Leow M.K. Cardiovascular collapse associated with beta blockade in thyroid storm. // Exp Clin Endocrinol Diabetes. 2007;115(6):392-396. doi: 10.1055/s-2007-971065.
30.Duggal J., Singh S., Kuchinic P., et al. Utility of esmolol in thyroid crisis. // Can J Clin Pharmacol. 2006;13(3):e292-295.
31.Fadel B.M., Ellahham S., Lindsay J., et al. Hyperthyroid heart disease. // Clin Cardiol. 2000;23(6):402-408. doi: 10.1002/clc.4960230605.
32.Mazzaferri E.L. Thyroid Storm. // Arch Intern Med. 1969;124(6):684. doi: 10.1001/archinte.1969.00300220036006.
33.Urbanic R.C., Mazzaferri E.L. Thyrotoxic crisis and myxedema coma. // Heart Lung. 1978;7(3):435-447.
34.Burch H.B., Solomon B.L,. Cooper D.S., et al. The effect of antithyroid drug pretreatment on acute changes in thyroid hormone levels after (131)I ablation for Graves'' disease. // J Clin Endocrinol Metab. 2001;86(7):3016-3021. doi: 10.1210/jcem.86.7.7639.

Thyrotoxic crisis. Rare manifestations and the difficulties of timely diagnostics

Thyroid storm is a rare, life-threatening complication of thyrotoxicosis. It may be precipitated by an acute event such as discontinuation of antithyroid drug therapy, thyroid or nonthyroidal surgery, infection, parturition, or an acute iodine load. The variety of clinical presentations of this disorder can lead to delayed diagnostics and high mortality. The typical and atypical clinical manifestations, diagnosis, and management of thyroid storm will be reviewed here. It also describes a case study of a young man with thyroid storm.

Keywords:
thyroid storm, Burch-Wartovsky scale, treatment, тиреотоксический криз, шкала Бурха, Вартовского, лечение