文拉法辛致甲状腺炎1例报告

Ideh Ghafour, F. Elyasi
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摘要

甲状腺炎是影响甲状腺最常见的炎症性疾病。诊断主要基于临床表现,特别是甲状腺疼痛和压痛的程度。确证性实验室检查包括甲状腺特异性自身抗体的存在。治疗是基于症状的严重程度(疼痛和发红),目的是恢复甲状腺的正常功能。药物性甲状腺炎在以前的文献中已有描述。文拉法辛是一种抗抑郁剂,其疗效与选择性血清素再摄取抑制剂相似。这种药物的剂量可以调整到150毫克/天开始一年后。然而,由于剂量依赖性副作用,文拉法辛的使用可能受到限制。在这里,我们描述了一位被诊断为广泛性焦虑症和偏头痛的患者,在将文拉法辛的剂量调整到150mg /天的最大值后,出现了文拉法辛引起的甲状腺炎。根据Naranjo药物不良反应概率量表,根据临床症状和实验室确认检查做出诊断。减少文拉法辛剂量并开始强的松龙治疗后,甲状腺炎症状消退。值得注意的是,甲状腺功能只有在停止文拉法辛给药后才完全恢复正常。
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Venlafaxine-induced Thyroiditis: A Case Report
Thyroiditis is the most common inflammatory disorder that affects thyroid gland.The diagnosis is mainly based on clinical findings, in particular the degree of pain and tenderness of thyroid. Confirmatory laboratory test includes presence of thyroid specific autoantibodies. Treatment is based on the severity of symptoms (pain and redness) and aims to restore the normal function of thyroid. Drug-induced thyroiditis has been described previously in the literature. Venlafaxine is an antidepressant agent with an efficacy similar to that of selective serotonin reuptake inhibitors. The dose of this medicine can be adjusted up to 150 mg/day one year after initiation. However, usage of venlafaxine may be limited due to the dose-dependent side effects. Here we describe a patient diagnosed with generalized anxiety disorder and migraine headache who developed venlafaxine-induced thyroiditis following dose adjustment to the maximum of 150 mg/day. The diagnosis was made based on the clinical symptoms and confirmatory laboratory tests according to the Naranjo Adverse Drug Reaction Probability Scale. Thyroiditis symptoms subsided after reducing venlafaxine dose and initiating prednisolone therapy. It should be noted that thyroid function was fully restored to normal only after cessation of venlafaxine administration.
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