抗甲状腺药物诱发嗜中性肠炎成人肠穿孔的罕见病例

Alexander Yuen
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摘要

中性粒细胞减少性小肠结肠炎(NE)是一种危及生命的中性粒细胞减少并发症,在成人中很少见。在血液恶性肿瘤或肿瘤治疗之外出现的中性粒细胞减少性肠炎病例仍极为罕见。我们在此介绍一例继发于 NE 的肠穿孔病例,患者为一名成年女性,因甲状腺功能亢进开始使用硫代酰胺类抗甲状腺药物治疗后出现粒细胞减少。近期开始服用硫胺类药物的患者应了解粒细胞减少的症状并前往医院就诊。急诊内科医生和外科医生都应高度怀疑这类患者患有NE,可能需要及时进行手术干预,以降低可观的死亡率。
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A rare case of bowel perforation in an adult with antithyroid medication induced neutropaenic enterocolitis
Neutropaenic enterocolitis (NE) is a life-threatening complication of neutropenia rarely seen in adults. Cases of NE arising outside the context of haematological malignancies or oncological treatments remain extremely infrequent. We present a case of bowel perforation secondary to NE in a female adult patient who developed agranulocytosis after commencement of thionamide antithyroid medications for hyperthyroidism. Patients recently commenced on thionamides should be educated on the symptoms of agranulocytosis and present to the hospital. Emergency physicians and surgeons alike should have a high index of suspicion for NE in this group of patients and prompt surgical intervention may be required to reduce the significant mortality rate.
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