摘要
甲狀腺毒症(thyrotoxicosis)是一種常見之內分泌疾患，臨床上可由甲狀腺功能過砲確立診斷；其員每個病人的臨床懷徵(症狀symptom及徵象sign)都不儘相同，症狀和徵象的嚴重度及發生頻率也不一樣，使得要從臨床表徵來診斷甲狀腺毒症，不一定很容易。有極少數的甲狀腺慣症病人(特別是老年人)的臨床徵甚至只有心房顫動及心臟衰竭，是屬於冷漠、隱藏性的(apathetic、masked)。本病例是一位二十一歲年輕女性，臨床上只有主訴自覺全身多汗(generalized hyperhidrosis)，並無其他常見的甲狀腺症的臨床表徵，經抽血檢查卻證實為格雷氏症(Graves’ disease)，是屬於一種幾漠性的甲狀腺機能亢進(apathetic hyperthyroidism)。本文之目的乃是希望基層醫師能多了解甲狀腺慣症的臨床懷徵，在診療過程中，對這種以非典型的甲狀腺毒症臨床懷徵的病人能提高警覺，細心評估，使甲狀腺機能亢進得以斗期診斷，早期治療。
關鍵字
無資料並列摘要
Thyrotoxicosis is a common endocrinological disease that can be clinically diagnosed by elevated levels of thyroid function test. In general practices, each patient’s clinical manifestations are quite different from others and his/her manifestations’ severity and frequency differ significantly as well. That makes diagnosing thyrotoxicosis from clinical manifestations very difficult. Some patients diagnosed with thyrotoxicosis only have signs of atrial fibrillation and heart failure, which we described as apathetic or masked cases, although such cases are rare and most of the patients are senior ones. The case we discussed here was a 21-year-old young female patient, who complained only having symptoms of generalized hyperhidrosis and showed no established common thyrotoxicosis signs. Proven by abnormal thyroid function test, she was diagnosed as a case of Graves’ disease and apathetic hyperthyroidism. The main purpose of this rare case report is to remind our primary care hyperthyroidism. The main purpose of this rare case report is to remind our primary care physicians of the clinical manifestations of thyrotoxicosis, and keeping the atypical thyrotoxicosis in mind to make early diagnosis and early treatment.