职业性三氯乙烯药疹样皮炎合并甲状腺功能亢进症3例临床分析

发布时间：2018-04-28 00:29

本文选题：三氯乙烯 + 药疹样皮炎　；参考：《中国职业医学》2015年06期

【摘要】：目的分析职业性三氯乙烯药疹样皮炎(OMDT)合并甲状腺功能亢进症(以下简称"甲亢")的临床特点。方法收集3例OMDT合并甲亢患者的临床资料进行回顾性分析。结果本组3例OMDT患者均于停用糖皮质激素2~7 d后出现发热、失眠、烦躁、心悸和多汗等高代谢症候群。体格检查和彩色多普勒超声检查均检出双侧颈部甲状腺肿大者2例,甲状腺无肿大者1例。1例患者出现突眼征。3例患者血清三碘甲状腺原氨酸和甲状腺激素水平均升高,促甲状腺激素水平均降低;1例患者血清甲状腺球蛋白抗体、甲状腺微粒体抗体和抗甲状腺过氧化物酶抗体水平均升高,1例患者血清促甲状腺激素受体抗体水平升高。临床上诊断为OMDT合并甲亢。予抗甲状腺药物治疗后,临床症状好转。结论 OMDT合并甲亢起病隐匿,易漏诊;及时予抗甲状腺药物治疗,预后较好。
[Abstract]:Objective to analyze the clinical features of occupational trichloroethylene drug rash dermatitis (OMDT) with hyperthyroidism (hereinafter referred to as hyperthyroidism). Methods the clinical data of 3 OMDT patients with hyperthyroidism were retrospectively analyzed. Results all 3 patients with OMDT developed fever, insomnia, irritability, palpitation and hyperlipidemia syndrome 7 days after discontinuation of glucocorticoid. The results of physical examination and color Doppler ultrasonography showed that there were 2 cases of thyroid enlargement in bilateral neck and 1 case without goiter in 1 case. The serum levels of triiodothyronine and thyroid hormone were increased in 3 cases with exophthalmos. The serum thyroglobulin antibody, thyroid microsomal antibody and anti-thyroid peroxidase antibody were increased in 1 patient, while the serum thyrotropin receptor antibody was increased in one patient. OMDT with hyperthyroidism was clinically diagnosed. After antithyroid drug treatment, clinical symptoms improved. Conclusion OMDT complicated with hyperthyroidism is occult and easy to be missed, and the prognosis is good if antithyroid drugs are given in time.
【作者单位】：广东省职业病防治院广东省职业病防治重点实验室;
【基金】：国家科技支撑计划项目(2014BAI12B01) 国家临床重点专科建设项目(2011-09)
【分类号】：R135.7

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