Thyrotoxic myopathyの4例

FOUR CASES OF THYROTOXIC MYOPATHY

I．はじめに

　最近各種内分泌障害に伴う筋疾患が注目されてきたがその詳細な機構はなお不明の分野が多い。内分泌障害としては甲状腺中毒症，Cushing症候群，副腎皮質機能障害，副甲状腺障害，その他筋強直ジストロフィー，重症筋無力症，閉経期ジストロフィーなどがあげられている。

　甲状腺機能亢進に伴う筋疾患は1853年Gravis Base—dowにより初めて報告され，その後Millikan^1），　Mc—Eachen^2），　Quinn^3），　Thorn^4）などが報告し，わが国では里吉^5），小林ら^6）の二，三の報告がみられる。なかでもMillikanは甲状腺中毒症に伴う筋疾患を重症筋無力症，慢性中毒性ミオパチー，周期性四肢麻痺，眼球突出性眼筋麻痺に分類し，その臨床症状を詳細に報告している。

Four cases of thyrotoxic myopathy were reported. The main findings were as follows:

1) Three patients were male and the other was female, and the age of these cases were between 39 and 50 years old.

2) It was very interesting that the similar thyrotoxic myopathic symptoms were found in the same siblings (case 1 and 2).

3) The characteristic symptoms and signs were muscular atrophy, weakness of the pro-ximal muscular groups and moderate thyro-toxic symptoms. In case 4, moreover, periodic palsy combined with thyrotoxic myopathy.

4) The results of the muscular biopsy at the atrophied muscle revealed the myopathic fea-tures and the reduced activity of the phosph-olylase scattered in the muscular fiber.