Analysis Of90Cases Of Hyperthyroidism With Gastrointestinal Symptoms As The Main Manifestation

Objective: To analyze90cases of digestive symptoms as the main or first symptomin patients with hyperthyroidism, analysis of the clinical data of these patients, in orderto improve the understanding of atypical hyperthyroidism, reduce the rate ofmisdiagnosis.Methods: Retrospective analysis of the First Affiliated Hospital of Dalian MedicalUniversity from October2000to January2013,internal medicine were treated togastrointestinal symptoms as the main performance or symptoms of gastrointestinalsymptoms in90patients with hyperthyroidism, and the data was statistically analyzed.Results:1.General information:90cases of hyperthyroidism patients, male35cases (39%),female55cases (61%), the proportion of men to women is7:11. The age ranged from17to68years, mean age43.9±6.8years,16-20years5cases (6%),21-40years29cases (32%),41-60years17cases (19%),39patients over the age of60(43%). Thehighest proportion of them is more than60years old.2.The main clinical manifestations:60cases (66.67%) is abnormal liver function(symptomatic and subclinical).41cases(45.56%) is diarrhea.37cases (41.11%) is lossof appetite.36cases(40%) is nausea and vomiting. Weight loss in30cases (33.33%),abdominal pain in25cases (27.78%), abdominal distention in15cases (16.67%), othersymptoms (such as acid reflux, heartburn) in7cases (7.78%).3.Hyperthyroidism with liver damage data: in the90cases,liver function damage in60cases (66.67%), the symptoms of liver injury in12cases (20%), mainly manifestedas loss of appetite, fatigue, abdominal distention, yellow urine and48cases insubclinical hepatic injury (80%). Abnormal liver function is enzymatic increased, inwhich ALT was elevated in80patients (88.89%) and AST was elevated in68patients(75.56%) and γ-GT was elevated in58patients (64.44%) and TBIL was elevated in44 patients (48.89%). Enzymology increased to <2-3times ULN (upper limit of normalvalue).4.The main symptoms: in90patients, thyroid enlargement in21cases (23%), heartrate>90/min in19cases (21%),10cases of mild scleral jaundice (11%).5.Misdiagnosis and prognosis: the90patients was newly diagnosed with superficialgastritis,8cases of suspected of dyspepsia, reflux esophagitis in5cases,7cases weresuspected as colitis, irritable bowel syndrome in8cases,6cases of digestive tract tumor,8cases of virus hepatitis, visit to definite time of about13days to28months. Afterdiagnosis, all patients were treated with antithyroid drugs and symptomatic treatment,and gastrointestinal symptoms of them was improved.Conclusion:1.Female senior are the high risk groups for uncharacteristic hyperthyroidism withthe alimentary tract symptoms.2.Alimentary tract symptoms vary in hyperthyroidism patients.3.Liver damage with hyperthyroidism mainly manifested in subclinic liver damage,with lightly enzymology rising.