汞中毒致甲状腺暂时性功能障碍及儿茶酚胺过量6例报告。

IF 1.3 Q3 PEDIATRICS Turkish archives of pediatrics Pub Date : 2023-10-11 DOI:10.5152/TurkArchPediatr.2023.23150
Yavuz Özer, Mehmet Yıldız, Hande Turan, Aydilek Dağdeviren Çakır, Gürkan Tarçın, Dilek Bingöl Aydın, Elvan Bayramoğlu, Fatih Haşlak, Sezgin Şahin, Amra Adrovic, Kenan Barut, Olcay Evliyaoğlu, Özgür Kasapçopur, Oya Ercan
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引用次数: 0

摘要

目的:汞中毒是一种多器官功能障碍的疾病,对中枢神经系统、胃肠系统、心血管系统、皮肤、肺部和肾脏都有影响。如果治疗延迟或不及时治疗,它可能是致命的,也可能导致神经系统紊乱等后遗症。汞暴露对内分泌的影响尚不清楚。我们旨在评估汞中毒患者。材料和方法:本研究共纳入3个家庭的6例汞中毒病例。记录临床、实验室和随访数据。结果:5例(83.3%)甲状腺功能异常表现为甲状腺激素升高和促甲状腺激素水平正常(未抑制),5例(8.33%)高血压患者出现嗜铬细胞瘤样综合征。尽管儿茶酚胺过量和甲状腺功能障碍导致降压治疗,但这4例患者是第一例因心动过速和高血压而使用甲氧咪唑治疗汞中毒的患者。低钠血症3例(50%)。结论:汞中毒是一种罕见的、非特异性的物理和实验室表现,诊断起来很困难。早期诊断和提供适当的治疗对于预防后遗症至关重要。不明原因的高血压和心动过速患者应考虑汞中毒,这表明甲状腺激素和儿茶酚胺参与其中。
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Temporary Thyroid Dysfunction and Catecholamine Excess Due to Mercury Poisoning in 6 Cases.

Objective: Mercury poisoning is a condition with multiple-organ dysfunction that has effects on the central nervous system, gastrointestinal system, cardiovascular system, skin, lungs, and kidneys. It can be fatal or may result in sequelae such as neurological disturbances, if treated late or left untreated. The endocrinological effects of mercury exposure are not well-known. We aimed to evaluate patients with mercury poisoning.

Materials and methods: A total of 6 cases of mercury poisoning from 3 families were included in the study. Clinical, laboratory, and follow-up data were recorded.

Results: Thyroid dysfunction was presented as high thyroid hormones and normal thyrotropin level (unsuppressed) in 5 cases (83.3%). On the other hand, pheochromocytoma-like syndrome was detected in 5 cases (83.3%) with hypertension. The 4 cases were the first to use methimazole for mercury poisoning due to tachycardia and hypertension despite antihypertensive treatment due to catecholamine excess and thyroid dysfunction. Hyponatremia was detected in 3 cases (50%).

Conclusion: Mercury poisoning is difficult to diagnose because it is rare and presents with nonspecific physical and laboratory findings. Early diagnosis and providing appropriate treatment are essential in order to prevent sequelae. Mercury poisoning should be considered in patients with unexplained hypertension and tachycardia suggesting the involvement of thyroid hormones and catecholamines.

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