■甲状腺风暴是一种罕见但危及生命的甲状腺毒症表现,死亡率为10%。我们的目标是研究人口统计学,临床和生化特征,以及在印度背景下诊断为甲状腺风暴的住院患者的结果。
这项回顾性研究是通过分析2004年至2020年所有甲状腺风暴患者的机构电子病历(EMR)进行的,Burch-Wartofsky评分(BWS)≥45。
■纳入35例BWS≥45的患者,其中71.4%是女性,平均年龄为44.9±10.2岁。43%没有甲状腺毒症病史。格雷夫斯病是最常见的潜在病因(71.4%),其次是有毒多结节性甲状腺肿(14.3%)。心血管(94.3%)和胃肠道肝功能障碍(88.6%)是最常见的临床表现。中枢神经系统(CNS)功能障碍的特征仅在被诊断为甲状腺风暴的42.3%的患者中可见。日本甲状腺协会(JTA)标准仅诊断出26例(74.3%)患有“明确”甲状腺风暴。死亡率为8.6%,所有三名患者在入院后48小时内死亡。
■几乎每两个甲状腺风暴患者中就有一个以前未被诊断为甲状腺毒症。在印度人中,有毒的多结节性甲状腺肿是一种值得注意的病因。中枢神经系统功能障碍的特征,被认为是甲状腺风暴的相对特异性,在我们的系列中不那么突出。JTA标准可能会改变一些被诊断患有甲状腺风暴的患者的分类,由于印度患者的CNS特征较少,因此与BWS评分相比。
UNASSIGNED: Thyroid storm is an uncommon but life-threatening presentation of thyrotoxicosis with a mortality rate of 10%. Our objective was to study the demographics, clinical and biochemical characteristics, and outcomes of inpatients diagnosed with thyroid storm in the Indian context.
UNASSIGNED: This retrospective study was conducted by analysing the institutional electronic medical records (EMR) of all patients admitted with thyroid storm from 2004 to 2020 with a Burch-Wartofsky score (BWS) of ≥45.
UNASSIGNED: Thirty-five patients with a BWS ≥45 were included, of whom 71.4% were women, with a mean age of 44.9 ± 10.2 years. 43% did not have any prior history of thyrotoxicosis. Graves\' disease was the most common underlying aetiology (71.4%), followed by toxic multinodular goitre (14.3%). Cardiovascular (94.3%) and gastrointestinal-hepatic dysfunction (88.6%) were the most common clinical manifestations. Features of Central nervous system (CNS) dysfunction were seen in only 42.3% of patients diagnosed with a thyroid storm. The Japanese Thyroid Association (JTA) criteria diagnosed only 26 patients (74.3%) with \"definite\" thyroid storm. The mortality rate was 8.6%, and all three patients expired within 48 hours of admission.
UNASSIGNED: Nearly one in every two patients with thyroid storm had previously undiagnosed thyrotoxicosis. Toxic multinodular goitre is a notable aetiology in Indians. Features of CNS dysfunction, considered relatively specific for thyroid storm, were less prominent in our series. The JTA criteria might alter the classification of some patients diagnosed with a thyroid storm, when compared to the BWS score due to fewer CNS features among Indian patients.