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Akutni miksedem nakon terapije hipertireoze radioaktivnim jodom i posledice
Klinički centar Srbije, Klinika za ORL i MFH, Beograd

e-adresastasaivkovic@eunet.rs
Ključne reči: radioaktivni jod; hipertireoza; polineuropatija; hipotireoza; T4/T3 terapija
Sažetak
Prikazujemo slučaj pacijentkinje kod koje je, nakon terapije Graves-ove hipertireoze radioaktivnim jodom, nastala teška, klinički manifestna hipotireoza u okviru koje je došlo do razvoja pretežno senzitivne neuropatije dominantno aksonalnog tipa. Pored simptoma i neurofizioloških znakova polineuropatije, kod pacijentkinje su se tokom 2 godine naizgled adekvatne monoterapije hipotireoze levotiroksinom održavali hipotireoidni simptomi od strane CNS-a, povišene serumske koncentracije ukupnog i LDL holesterola i klinički znakovi povećanog perifernog vaskularnog otpora. Održavao se nefiziološki odnos serumskih koncentracija FT3 i FT4, uz serumske koncentracije TSH i FT4 koje su ukazivale na smanjenu osetljivost tireoidno-hipofizne negativne povratne sprege. Nakon započinjanja kombinovane LT4/LT3 supstitucione terapije veoma brzo je došlo do nestanka hipotireoidnih simptoma vezanih za CNS, značajnog smanjenja serumskih koncentracija ukupnog i LDL holesterola, normalizacije FT3/FT4 odnosa makar u prvim časovima nakon uzimanja leka, nestanka kliničkih znakova povećanog perifernog vaskularnog otpora. Stepen polineuropatskih tegoba se smanjio do nivoa kad ne ometa spavanje. Vreme i kontrolna ENG će pokazati kakvi će biti definitivni efekti kombinovane T4/T3 terapije na oštećenja perifernih nerava. Tokom prvih 6 meseci nisu zabeleženi neželjeni efekti kombinovane T4/T3 terapije.
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O članku

jezik rada: srpski, engleski
vrsta rada: neklasifikovan
DOI: 10.5937/medgla1349042I
objavljen u SCIndeksu: 09.09.2013.

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