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本文报告1例甲状腺功能亢进(甲亢)病人在抗甲状腺药治疗中伴发胰岛素自身免疫综合征(IAS)和药物性肝损害。患者女性,77岁。患甲亢,服他巴唑(MMI)1个月后血中出现胰岛素抗体,1.5个月后频发低血糖约7天。测定血浆总免疫反应胰岛素(TIRI)为680μU/L,~(125)Ⅰ-胰岛素结合率(%B)为81%。停服 MMI 后两者均迅速降低,但改服丙基硫氧嘧啶(PTU)后1个月复又上升,2.8个月出现低血糖症状,停服 PTU 后再次下降。改用~(131)Ⅰ治疗
This article reports 1 case of hyperthyroidism (hyperthyroidism) patients with anti-thyroid drug treatment associated with insulin autoimmune syndrome (IAS) and drug-induced liver damage. Patient female, 77 years old. Hyperthyroidism, taking methimazole (MMI) 1 month after the emergence of insulin antibodies in the blood, 1.5 months after the frequent occurrence of hypoglycemia about 7 days. Total plasma TIRI was 680μU / L, and the ratio of 125I-insulin binding (% B) was 81%. Both of them dropped rapidly after stopping taking MMI, but rose again after one month of taking propylthiouracil (PTU), and showed symptoms of hypoglycemia 2.8 months later, and then dropped again after stopping taking PTU. Switch to ~ (131) Ⅰ treatment