甲状腺素(T_4)型甲亢,临床罕见,我们见到1例甲状腺不肿大并发甲亢危象,报道如下。 患者,男,33岁,主因多食,消瘦,低热2个月于1988年7月14日住院。始于住院前2个月多食,善饥,大便频呈糊状,多汗,心悸,体重明显下降,曾于门诊诊为发热原因不明,冠心病等。既往体健,家族史(-)。查体:体温38.5℃,脉搏110次/分,血压110/70。双目炯炯,眼球无突出,甲状腺无肿大,无血管杂音,肺无异常。心尖部第一心音亢进,肝脾未扪及。双手细震颤(+)。入院后因右肺下感染,体温骤升39.3℃,心率154次/公,大汗淋漓,躁动,憋气,拟诊甲亢危象,经治疗好转后出院。实验室及特殊检查:血红蛋白105g/L,白细胞5.5×10~9/L,血清钠137mmol/L,钾4.0mmol/L,氯104mmol/L,钙2.6mmol/L,胆固醇2.1mmol/L,甘油三酯0.15mmol/L,糖4.1mmol/L,CPK 69u,LDH 115u,GOT 23u。EKG:窦性心动过速,UCG Thyroxine (T_4) type hyperthyroidism, clinical rare, we see a case of hyperthyroidism thyroid enlargement crisis, reported as follows. Patients, male, 33 years old, mainly due to eating more, weight loss, fever 2 months in July 14, 1988 hospitalization. Two months before hospitalization began to eat more food, good hunger, stool frequency paste, sweating, palpitations, weight decreased significantly, had outpatient clinics for unknown causes of fever, coronary heart disease. Past physical health, family history (-). Physical examination: body temperature 38.5 ℃, pulse 110 beats / min, blood pressure 110/70. Eyes eyelid, no prominent eye, no swelling of the thyroid, no vascular noise, no abnormal lung. First heart accent hyperthyroidism, liver and spleen not palpable. Fine hands tremor (+). After admission due to infection of the right lung, the temperature jumped 39.3 ℃, heart rate 154 times / male, sweating, restlessness, suffocation, hypothyroidism to be diagnosed crisis, after treatment improved after discharge. Laboratory and special examination: hemoglobin 105g / L, white blood cells 5.5 × 10 ~ 9 / L, serum sodium 137mmol / L, potassium 4.0mmol / L, chlorine 104mmol / L, calcium 2.6mmol / L, cholesterol 2.1mmol / L, Triester 0.15 mmol / L, sugar 4.1 mmol / L, CPK 69u, LDH 115u, GOT 23u. EKG: Sinus Tachycardia, UCG