{"created":"2023-06-20T15:50:35.214782+00:00","id":3420,"links":{},"metadata":{"_buckets":{"deposit":"a324f40a-8304-4392-9f92-5d92e8908f8f"},"_deposit":{"created_by":18,"id":"3420","owners":[18],"pid":{"revision_id":0,"type":"depid","value":"3420"},"status":"published"},"_oai":{"id":"oai:redcross.repo.nii.ac.jp:00003420","sets":["99:64:118"]},"author_link":["8208","49","8223","48","8085","8221","8222","8109"],"item_5_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2005-03-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"37","bibliographicPageStart":"32","bibliographicVolumeNumber":"10","bibliographic_titles":[{"bibliographic_title":"徳島赤十字病院医学雑誌"},{"bibliographic_title":"Tokushima Red Cross Hospital Medical Journal","bibliographic_titleLang":"en"}]}]},"item_5_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は74歳,女性.2003年9月上旬より動悸,不眠が続き,近医に入院した.心室性期外収縮の多発と甲状腺機能亢進症を指摘され,10月27日に当科に転入院した.びまん性甲状腺腫,,FT4>7.7μg/dl,TSH <1.0μU/ml, TRAb 18.5IU/LなどからGraves 病と診断した.嘔吐・衰弱などの全身症状が著明なため,thiamazole, metoprolol, mexiletine に加え,無機ヨードとprednisolone を併用して状態は改善したが,11月12日より高熱,次いで胆道系酵素優位の肝障害が出現した.薬剤性肝障害を疑いthiamazole などの薬剤を中止し,少量のprednisolone を開始したが,その後も発熱は続き,11月29日にはT-bil11.8mg/dl,GOT218U/l,GPT473U/l, ALP1,090U/l にまで重症化した.ステロイドパルス療法を施行して発熱・肝障害は緩徐に改善し,Graves 病の治療にはアイソトープ治療を行った.Graves 病には種々の機序の肝障害が合併することが報告されているが,多くは比較的軽症である.本例の肝障害の発現にはthiamazole が関与した可能性が高いが,本例のように重症の胆汁うっ滞型肝障害が遷延する例は極めて稀である.","subitem_description_type":"Abstract"}]},"item_5_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifierScheme":"WEKO"}],"names":[{"name":"MIYAGI, 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dysfunction","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"thiamazole","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"technical report"}]},"item_title":"薬物治療の開始後に発熱と高度の胆汁うっ滞型肝障害をきたしたGraves病の1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"薬物治療の開始後に発熱と高度の胆汁うっ滞型肝障害をきたしたGraves病の1例"},{"subitem_title":"A Case of Graves’Disease Resulting in Fever and Severe Cholestatic Liver Dysfunction Following the Initiation of Drug 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