一名 7 岁儿童的甲亢瓣膜病:病例报告和文献综述

Ujunwa FA, Ohuche Ijeoma, Eke Cb, Chikani U, Chinawa Jm
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摘要

简介甲亢患儿很少会出现瓣膜病。这种疾病是由于循环甲状腺激素水平升高而引起的全身性高动力状态综合征。 病例报告:O.C是一名7岁女童,7天前开始腹痛,5天前开始排稀便,5天前开始体重下降。就诊时的突出表现是心动过速、颈部前部肿胀,吞咽时肿胀会移动,伴有 3/6 级泛收缩期杂音,以心尖处最大。根据实验室证据,诊断为甲状腺功能亢进,有甲状腺中毒的风险。超声心动图显示二尖瓣严重反流。她正在服用卡比马唑片和普萘洛尔。她的病情明显好转,并一直在接受随访。结论类脂质过剩症会影响人体多个器官系统,心脏也不能幸免。大多数心脏表现是功能性的,是腺体功能亢进的结果。由于许多患者仅表现为甲状腺功能亢进的后遗症,因此需要高度怀疑。
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Thyrotoxic Valvulopathy in a 7-year-Old Child: Case Report and Literature Review
Introduction: Children with thyrotoxicosis may present rarely with valvulopathies. This disease is a syndrome complex of hyperdynamic status due to systemic manifestation of elevated circulating thyroid hormone levels.  Case Reports: O.C, a 7-year-old female child presented with abdominal pain that started seven days ago, passage of loose stool that started five days ago and weight loss that started five days ago. Salient findings at presentation were tachycardia, anterior neck swelling that moves with swallowing with a grade 3/6 pan-systolic murmur maximal at the apex. A diagnosis of hyperthyroidism at risk of thyrotoxicosis was made based on supported laboratory evidence. Echocardiography done showed severe mitral regurgitation. She is on Tabs Carbimazole and Propranolol. She has improved remarkably and has been on follow up. Conclusion: Hyperthyoidism affects multiple organ systems in the body and the heart is not spared. Most of the cardiac manifestations are functional and occur as a result of the hyperfunctioning gland. A high index of suspicion is required, as many of the patients present with only the consequences of hyperthyroidism.
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