目錄/各期文章

內科學誌 -第30卷第5期

病例 
Uncommon Presentation of Combined Graves’ Disease and Pulmonary Embolism in a 32-year-old Woman  全文閱讀
351~357 
英文 
Graves’ disease、Hyperthyroidism、Pulmonary embolism、Hypercoagulability 
湯舒宇1 、彭上軒2 、林家宏3 、李任光1 、周聖傑4 、呂金盈5  
臺大醫院內科部心臟科1 、臺大醫院腫瘤醫學部2 、臺大醫院新竹分院內科部內分泌科3 、臺大醫院內科部血液科4 、臺大醫院內科部內分泌科5  
Pulmonary embolism (PE) is related to hypercoagulable status, such as malignancy, nature anticoagulant deficiency, pregnancy and use of estrogen replacement. It has rarely been reported to be associated with endocrine diseases. We presented a 32-year-old woman with combined Graves’ disease and PE. The initial presentation was progressive exertional dyspnea and cough for one month. First impression was Graves’ disease complicated with thyrotoxic crisis at the emergency department, but PE was suspected clinically. A dilemma of diagnostic process was the use of iodine-containing contrast media. Increasing iodine uptake of thyroid glands would lead to potential exacerbation of thyrotoxicosis, but PE is usually diagnosed with a contrast-enhancing computed tomography (CT) of chest. We demonstrated a good result of combined treatment for Graves’ disease with anti-thyroid drugs and submassive PE with catheter-directed thrombolysis and anticoagulants. After extensive literature review, we hypothesized that hyperthyroidism per se may contribute to the development of PE.