心機能障害を合併した巨大バセドウ病甲状腺腫の１例

概要

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Recently,cases of Graves’disease with a large goiter are scarce.We performed subtotal thyroidectomy in a patient with Graves’disease with a large goiter and heart dysfunction. The postoperative course was uneventful because of continual intubation. A 61-year old man was diagnosed with Graves’disease about 20years earlier.He had been medicated with antithyroid drugs,but the disease had been poorly controlled.Since 1988his goiter had become larger, and from 1994he had noticed palpation and dyspnea.On 1997,he was diagnosed with chronic heart failure due to Graves’disease, based on morphological examination of biopsied myocardial tissue, and he was admitted for surgery. On admission, blood examination revealed positive TRAb and autoantibody, and hyperthyroidism.Thyroid function was improved to euthyroid by iodine and the antithyroid drug,and then subtotal thyroidectomy was performed. Total removed thyroid weight was 391.8g, and residual thyroid weight was1.8g.For5days after operation the patient was administrated glucocorticoid and kept continuously intubated to prevent trachea collapse,resulting in an uneventful postoperative course. In addition, we report 16 cases of Graves’disease with a large goiter who underwent subtotal thyroidectomy from 1979through 1997by our group at Shinshu University Hospital.
信州医学会の論文
2000-12-10