急性甲亢肌病的临床特征、发病机制及诊断进展

Clinical features, pathogenesis, and diagnostic advances of acute thyrotoxic myopathy

摘要:

急性甲亢肌病（ATM）又称甲亢伴急性延髓麻痹，是甲状腺功能亢进的一种严重的并发症，患者出现吞咽困难、构音障碍、饮水呛咳等急性延髓麻痹症状，因其症状不典型极易导致漏诊、误诊。患者错过治疗黄金时期病死率高，ATM的临床特征及潜在发病机制对ATM的鉴别诊断具有重要的临床意义。该文就ATM的临床特征、流行病学现状、中枢神经系统影像学变化、甲状腺激素及其相关抗体对ATM的潜在发病机制作一综述。

Abstract:

Acute thyrotoxic myopathy (ATM), also known as acute thyrotoxic bulbar palsy, is a severe complication of hyperthyroidism characterized by acute bulbar symptoms such as dysphagia, dysarthria and choking on water. Due to its atypical clinical presentations, ATM is often underdiagnosed or misdiagnosed. Delayed diagnosis and treatment of ATM can result in high mortality, highlighting the critical clinical significance of understanding its characteristic features and underlying pathogenesis for accurate differential diagnosis. This review provides a comprehensive overview of the clinical features, epidemiology and central nervous system imaging findings of ATM, as well as the potential pathogenic roles of thyroid hormones and thyroid-related autoantibodies in its development.