Undiagnosed Thyrotoxicosis in a Pregnant Woman with Spontaneous Renal Artery Aneurysm Rupture
Undiagnosed Thyrotoxicosis in a Pregnant Woman with Spontaneous Renal Artery Aneurysm Rupture
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DOI：
10.1213/ane.0b013e3181a27cdf
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发表时间：
2009-06-01
影响因子：
5.7
通讯作者：
Mashimo, Takashi
中科院分区：
文献类型：
--
作者：
Shibata, Sho C.;Mizobuchi, Atsuko;Mashimo, Takashi
妊娠期肾动脉瘤破裂是一种罕见的事件，与母亲和胎儿的高死亡率相关。甲状腺功能亢进症可能存在于怀孕期间。这两种并发症很容易与更常见的情况混淆。我们报告一个不寻常的情况下，孕妇与未确诊的甲状腺功能亢进症和自发RAA破裂。甲状腺风暴可能是由RAA破裂引发的;然而，由于体征和症状被误认为是血容量不足，诊断被推迟。当低血容量性休克治疗后精神状态改变和心动过速持续存在时，应考虑甲状腺毒症的可能。（Anesth Analg 2009;108：1886-8）
Renal artery aneurysm (RAA) rupture during pregnancy is a rare event which is associated with high mortality rates for both mother and fetus. Hyperthyroidism may be present during pregnancy. Both complications are easily confused with more common conditions. We report an unusual case of a pregnant woman with undiagnosed hyperthyroidism and spontaneous RAA rupture. Thyroid storm may have been precipitated by the RAA rupture; however, the diagnosis was delayed because signs and symptoms were mistaken for those of hypovolemia. The possibility of thyrotoxicosis should be considered when mental status changes and tachycardia persist after the treatment of hypovolemic shock. (Anesth Analg 2009;108:1886-8)