ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket12709ketendo-12709Research ArticleКлинический случайCase ReportЛечение тиреотоксикоза карбонатом лития. Случаи из практикиThyrotoxicosis treatment with lithium corbanate. Cases reportedhttps://orcid.org/0000-0003-2996-0067МацуеваИ. А.MatsuevaI. A.

Мацуева Ирина Александровна, студентка

ул. Льва Толстого, 6-8, Санкт-Петербург, 197022

eLibrary SPIN: 9628-0458

Irina A. Matsueva, student

6-8 L’va Tolstogo street, 197022 Saint Petersburg

eLibrary SPIN: 9628-0458

irina.macueva.98@mail.ruhttps://orcid.org/0000-0001-8393-6805ДалматоваА. Б.DalmatovaA. B.

Далматова Анна Борисовна, ассистент, кандидат медицинских наук

Санкт-Петербург

eLibrary SPIN: 5995-0259

 

Anna B. Dalmatova, MD, PhD

Saint Petersburg

eLibrary SPIN: 5995-0259

dalmatova.anna@mail.ruhttps://orcid.org/0000-0002-7952-7010АндрейченкоТ. В.AndreychenkoT. V.

Андрейченко Татьяна Викторовна, врач-эндокринолог

Санкт-Петербург

Tatiana V. Andreychenko, MD

Saint Petersburg

andreychenko.t.v@mail.ruhttps://orcid.org/0000-0003-0042-7680ГриневаЕ. Н.GrinevaE. N.

Гринёва Елена Николаевна, доктор медицинских наук, профессор

Санкт-Петербург

eLibrary SPIN: 2703-0841

Elena N. Grineva, MD, PhD, Professor

Saint Petersburg

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grineva_e@mail.ruНациональный медицинский исследовательский центр им. В.А. Алмазова; Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаРоссияAlmazov National Medical Research Centre; Academician I.P. Pavlov First Saint Petersburg State Medical UniversityRussian FederationНациональный медицинский исследовательский центр им. В.А. АлмазоваRussian FederationAlmazov National Medical Research CentreRussian Federation2021251120211732226Copyright © Мацуева И.А., Далматова А.Б., Андрейченко Т.В., Гринева Е.Н., 20212021Мацуева И.А., Далматова А.Б., Андрейченко Т.В., Гринева Е.Н.Matsueva I.A., Dalmatova A.B., Andreychenko T.V., Grineva E.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/12709

Лечение тиреотоксикоза, вызванного болезнью Грейвса или многоузловым токсическим зобом, в большинстве случает не представляет трудностей, так как назначение тионамидов позволяет быстро и безопасно нормализовать уровень тиреоидных гормонов. Однако в ряде случаев такая терапия может сопровождаться развитием серьезных побочных эффектов (агранулоцитоз, токсический гепатит, холестаз), тяжелых аллергических реакций, а также у пациента может быть индивидуальная непереносимость тионамидов. Именно в таких случаях используют карбонат лития (КЛ), особенно при тяжелом течении тиреотоксического синдрома. Известно, что КЛ способен накапливаться в  щитовидной железе (ЩЖ), возможно, через использование натрий-йодного симпортера. В результате активного транспорта концентрация КЛ в ЩЖ оказывается в 3–4 раза выше, чем в плазме крови, и это может сопровождаться уменьшением как синтеза, так и секреции ее гормонов. В работе представлены случаи применения КЛ с целью нормализации уровня гормонов ЩЖ перед тиреоидэктомией. Назначение небольших доз КЛ (900 мг/сут) в течение 7–14 дней привело к существенному снижению или нормализации сывороточной концентрации тиреоидных гормонов, что позволило выполнить пациентам тиреоидэктомию. Короткий курс лечения КЛ не сопровождался развитием каких-либо побочных эффектов.

Treatment of thyrotoxicosis caused by Graves’ disease or multinodular toxic goiter, is not difficult, in most cases, since the prescription of thionamides allows to normalize the level of thyroid hormones quickly and safety. But in a number of cases this therapy might be associated with serious side effects (agranulocytosis, toxic hepatitis, cholestasis), severe allergic reactions and also individual intolerance on thionamides. In such cases lithium carbonate is used, especially in severe thyrotoxic syndrome. It is known, that lithium can accumulate in the thyroid gland at a concentration 3–4 times higher than in the plasma. Perhaps, lithium uses Na+/I- ions. It can inhibit the synthesis and secretion thyroid hormones of thyroid gland. The article presents the cases reported the use of lithium carbonate in thyrotoxicosis treatment before thyroidectomy. Administering low doses of carbonate lithium (900 mg/ per day) renders significant decrease or normalization of thyroid hormones concentration within 7–14 days, thus it let perform thyroidectomy on the patients. No side effects have been identified with such a short course of lithium carbonate treatment.

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The authors declare that there are no conflicts of interest present.