Objective To analyze the cause of misdiagnosis of hyperthyroidism, and to propose preventive measures.Methods The clinical data of 31 misdiagnosed cases of hyperthyroidism admitted in our hospital during January 2000 and October 2008 were retrospectively analyzed.Results The initial symptoms included chronic diarrhea complaints, fatigue and weight loss (9 cases), periodic limb flaccid paralysis(7 cases), palpitations and chest tightness (5 cases), tension and irritability (3 cases), mental disorder(2 cases), anorexia and abdominal distension(2 cases), fever and fatigue (1 case), jaundice and tired of greasy food (1 case) and insomnia( 1 case).In the group, 9 cases were earlier misdiagnosed as chronic colitis, 7 cases as hypokalemic periodic paralysis, 3 cases as neurosis, myocarditis and menopause syndrome respectively, 2 cases as coronary heart disease and mental illness respectively, and 1 case as jaundice hepatitis and agranulocytosis respectively.The misdiagnosis average time was (6.7 ± 1.2) months.All patients were diagnosed by thyroid function, thyroid ultrasound and other tests.After anti-thyroid drugs and symptomatic treatment, all the patients were cured.Conclusion Hyperthyroidism has complex and diverse clinical manifestations, and it is easily misdiagnosed when the primary symptoms and main performance appears as a systematic symptom, so more attention should be paid to thyroid function tests to avoid misdiagnosis.%目的 分析甲状腺功能亢进症(甲亢)的误诊原因并提出防范措施.方法 对我院2000年1月～2008年10月收治并误诊的31例甲亢的临床资料进行回顾性分析.结果 本组初诊时诉首发症状为慢性腹泻、乏力、消瘦9例,周期性四肢软瘫7例,心悸、胸闷5例,紧张、烦躁3例,精神异常2例,食欲缺乏、腹胀2例,发热、乏力1例,黄疸、厌油1例,失眠1例.本组早期误诊为慢性结肠炎9例,低血钾性周期性麻痹7例,神经症、心肌炎、更年期综合征各3例,冠心病、精神病各2例,黄疸性肝炎、粒细胞缺乏症各1例.误诊时间平均(6.7±1.2)个月.均经甲状腺功能、甲状腺彩超等检查确诊.确诊后经抗甲状腺药物及对症治疗后临床治愈.结论 甲亢的临床表现复杂多样,以某一系统症状为主要表现或首发症状时,易误诊或漏诊.在临床工作中应注意对此类患者进行甲状腺功能检查,以避免误诊.
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