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首页> 外文期刊>Journal of Medical Case Reports >Hypothyroidism in a five-year-old boy with rhabdomyolysis and recent history of cardiac tamponade: a case report
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Hypothyroidism in a five-year-old boy with rhabdomyolysis and recent history of cardiac tamponade: a case report

机译：一名五岁男孩横纹肌溶解症和最近的心脏压塞史甲状腺功能减退：一例报告

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Introduction Cardiac tamponade is a rare manifestation of hypothyroidism, and a less rare cause of pericardial effusion. The accumulation of the pericardial fluid is gradual, and often does not compromise cardiac hemodynamic function. There is a relationship between the severity and chronicity of the disease with the presence of pericardial effusion. There are few cases describing associated pericardial tamponade published in the literature. When a tamponade occurs, a concomitant provocative factor such as a viral pericarditis may be related. Our patient's case appears to be the youngest patient described so far. Case presentation We report the case of a previously healthy five-year-old Hispanic (non-indigenous) boy who developed rhabdomyolysis with a history of a recent pericardial effusion and tamponade two months before that required the placement of a percutaneous pericardial drainage. Pericardial effusion was considered to be viral. Later on readmission, clinical primary hypothyroidism was diagnosed and thought to be associated with the previous cardiac tamponade. He developed rhabdomyolysis, which was considered to be autoimmune and was treated with steroids. The level of creatine phosphate kinase and creatine kinase MB fraction returned to within the reference rangeone week after our patient was started on steroids and three weeks after he was started on thyroid hormones. Conclusions Physicians should consider hypothyroidism as a differential diagnosis in patients with pericardial effusion. Pericardial effusion may progress and cause a cardiac tamponade with hemodynamic instability. The fact that our patient did not have any manifestations of hypothyroidism might have delayed diagnosis.
机译：引言心脏填塞是甲状腺功能低下的罕见表现，也是心包积液的罕见原因。心包积液是逐渐积累的，通常不会损害心脏的血液动力学功能。心包积液的存在与疾病的严重程度和慢性之间存在关系。文献中很少有描述相关心包填塞的案例。当发生填塞时，可能会引起诸如病毒性心包炎之类的刺激因素。该患者的病例似乎是迄今为止描述的最年轻的患者。病例介绍我们报告了一个以前健康的五岁西班牙裔（非土著）男孩的病例，该男孩发生横纹肌溶解症，有最近的心包积液和填塞的历史，两个月前需要进行经皮心包引流。心包积液被认为是病毒性的。再次入院后，诊断出临床原发性甲状腺功能减退症，并认为与先前的心脏压塞有关。他发生了横纹肌溶解症，被认为是自身免疫性的，并接受了类固醇治疗。病人开始接受类固醇激素治疗一周后，开始接受甲状腺激素治疗三周后，肌酸磷酸激酶和肌酸激酶MB的水平恢复到参考范围内。结论医师应将甲状腺功能低下作为心包积液患者的鉴别诊断。心包积液可能进展并导致心脏压塞，血流动力学不稳定。我们的患者没有任何甲状腺功能减退的表现，这可能会延迟诊断。

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