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病例24-2019 ——一名患心悸、腹痛和呕吐的39岁女性
Case 24-2019 — A 39-Year-Old Woman with Palpitations, Abdominal Pain, and Vomiting


Victor Chiappa ... 其他 • 2019.08.08
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病例陈述


Kelsey Hills-Evans医师(内科):一名患周期性呕吐综合征和多种物质使用障碍的39岁女性因腹痛和呕吐到本院急诊科就诊。

在此次就诊前11周,患者曾因顽固性恶心和呕吐被本院附属医院收入院。患者月经时有稀便,右下腹疼痛。患者症状与之前被认为由周期性呕吐综合征引起的发作类似。艰难梭菌毒素、粪便白细胞以及粪便虫卵和寄生虫检查结果均为阴性;粪便培养显示为正常肠道菌群。尿液毒理学筛查显示可卡因和阿片类药物阳性。进行了影像学检查。





作者信息

Victor Chiappa, M.D., Mark A. Anderson, M.D., Conor D. Barrett, M.D., Nikolaos Stathatos, M.D., and Melis N. Anahtar, M.D., Ph.D.
From the Departments of Medicine (V.C., C.D.B., N.S.), Radiology (M.A.A.), and Pathology (M.N.A.), Massachusetts General Hospital, and the Departments of Medicine (V.C., C.D.B., N.S.), Radiology (M.A.A.), and Pathology (M.N.A.), Harvard Medical School — both in Boston.

 

参考文献

1. Iqbal MM, Basil MJ, Kaplan J, Iqbal MT. Overview of serotonin syndrome. Ann Clin Psychiatry 2012;24:310-318.

2. Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM 2003;96:635-642.

3. Klein I, Danzi S. Thyroid disease and the heart. Circulation 2007;116:1725-1735.

4. Wustmann K, Kucera JP, Zanchi A, et al. Activation of electrical triggers of atrial fibrillation in hyperthyroidism. J Clin Endocrinol Metab 2008;93:2104-2108.

5. Nordyke RA, Gilbert FI Jr, Harada AS. Graves’ disease: influence of age on clinical findings. Arch Intern Med 1988;148:626-631.

6. Rosenthal FD, Jones C, Lewis SI. Thyrotoxic vomiting. Br Med J 1976;2:209-211.

7. Stern RA, Robinson B, Thorner AR, Arruda JE, Prohaska ML, Prange AJ Jr. A survey study of neuropsychiatric complaints in patients with Graves’ disease. J Neuropsychiatry Clin Neurosci 1996;8:181-185.

8. Schott M, Hermsen D, Broecker-Preuss M, et al. Clinical value of the first automated TSH receptor autoantibody assay for the diagnosis of Graves’ disease (GD): an international multicentre trial. Clin Endocrinol (Oxf) 2009;71:566-573.

9. Thyretain TSI Reporter BioAssay. Athens, OH: Diagnostic HYBRIDS, 2009 (package insert).

10. Barbesino G, Tomer Y. Clinical utility of TSH receptor antibodies. J Clin Endocrinol Metab 2013;98:2247-2255.

11. Ralls PW, Mayekawa DS, Lee KP, et al. Color-flow Doppler sonography in Graves disease: “thyroid inferno.” AJR Am J Roentgenol 1988;150:781-784.

12. Aldasouqi S, Sheikh A, Klosterman P. Doppler ultrasonography in the diagnosis of Graves disease: a non-invasive, widely under-utilized diagnostic tool. Ann Saudi Med 2009;29:323-324.

13. Arslan H, Unal O, Algün E, Harman M, Sakarya ME. Power Doppler sonography in the diagnosis of Graves’ disease. Eur J Ultrasound 2000;11:117-122.

14. Cappelli C, Pirola I, De Martino E, et al. The role of imaging in Graves’ disease: a cost-effectiveness analysis. Eur J Radiol 2008;65:99-103.

15. Chaudhary V, Bano S. Thyroid ultrasound. Indian J Endocrinol Metab 2013;17:219-227.

16. Saleh A, Cohnen M, Fürst G, Godehardt E, Mödder U, Feldkamp J. Differential diagnosis of hyperthyroidism: Doppler sonographic quantification of thyroid blood flow distinguishes between Graves’ disease and diffuse toxic goiter. Exp Clin Endocrinol Diabetes 2002;110:32-36.

17. Burch HB, Wartofsky L. Life-threatening thyrotoxicosis: thyroid storm. Endocrinol Metab Clin North Am 1993;22:263-277.

18. Markou K, Georgopoulos N, Kyriazopoulou V, Vagenakis AG. Iodine-induced hypothyroidism. Thyroid 2001;11:501-510.

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