1,129 results match your criteria Hyperthyroidism Thyroid Storm & Graves Disease


Thyroid storm: a case of haemodynamic failure promptly reversed by aggressive medical therapy with antithyroid agents and steroid pulse.

BMJ Case Rep 2018 Dec 14;11(1). Epub 2018 Dec 14.

Intensive Care Unit, Centro Hospitalar do Médio Tejo EPE, Unidade de Abrantes, Abrantes, Santarém, Portugal.

Hyperthyroidism is a common metabolic disorder, although its presentation as an endocrine emergency called thyroid storm is rare. Here we review a case of a thyroid storm as the initial presentation of thyrotoxicosis, with multiple organ failure and haemodynamic collapse due to low-output cardiac dysfunction. Quick intervention with aggressive antithyroid therapy, including steroid pulse, and supportive intensive care measures led to an outstanding improvement and full recovery. Read More

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http://dx.doi.org/10.1136/bcr-2018-226669DOI Listing
December 2018

Acute Thyroid Storm Following Thymectomy: A Surprising Result of Undiagnosed Graves' Disease.

Cureus 2018 Aug 31;10(8):e3239. Epub 2018 Aug 31.

Surgery, University of Texas Medical Branch, Galveston, USA.

Postoperative thyroid storm represents a diagnostic dilemma in patients with overlooked hyperthyroid state undergoing a nonthyroid surgery. We report a 30-year-old female with a history of mixed connective tissue disease who presented with an anterior mediastinal mass and underwent a thoracoscopic resection of the mass. On postoperative day 1, she had an acute change in mental status with fever, tachycardia and hypercapnic respiratory failure requiring intubation and mechanical ventilation. Read More

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http://dx.doi.org/10.7759/cureus.3239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6209514PMC
August 2018
6 Reads

A pediatric case with prostaglandin I-associated thyrotoxicosis: Case report and the literature review.

J Clin Res Pediatr Endocrinol 2018 10 16. Epub 2018 Oct 16.

Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Prostaglandin I (PGI2) causes hyperthyroidism, a critical complication in patients with pulmonary arterial hypertension (PAH). However, it remains unknown whether PGI2 may have unfavorable effects on thyroid functions in children with congenital portosystemic venous shunt syndrome (CPSVS). We present a boy with CPSVS who developed PAH at 7 years of age. Read More

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http://cms.galenos.com.tr/Uploads/Article_19867/JCRPE-0-0-En
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http://dx.doi.org/10.4274/jcrpe.0169DOI Listing
October 2018
2 Reads

Weathering the storm: A case of thyroid storm refractory to conventional treatment benefiting from therapeutic plasma exchange.

J Clin Apher 2018 Dec 15;33(6):678-681. Epub 2018 Oct 15.

Department of Pathology, Division of Transfusion Medicine, University of Texas Medical Branch, Galveston, Texas.

Thyroid storm is a severe manifestation of thyrotoxicosis characterized by systemic organ dysfunction secondary to a hypermetabolic state. Although antithyroid drugs, steroids, beta-blockers, antipyretics, and cholestyramine are the standard of care, some patients inadequately respond to these conventional therapies. Therapeutic plasma exchange has been previously utilized as a treatment modality in patients with a poor response to routine therapies or with contraindications to them. Read More

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http://dx.doi.org/10.1002/jca.21658DOI Listing
December 2018
1 Read

Amiodarone and the thyroid physiology, pathophysiology, diagnosis and management.

Trends Cardiovasc Med 2018 Sep 20. Epub 2018 Sep 20.

Divisions of Cardiology and Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States.

Although amiodarone is considered the most effective antiarrhythmic agent, its use is limited by a wide variety of potential toxicities. The purpose of this review is to provide a comprehensive "bench to bedside" overview of the ways amiodarone influences thyroid function. We performed a systematic search of MEDLINE to identify peer-reviewed clinical trials, randomized controlled trials, meta-analyses, and other clinically relevant studies. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10501738183019
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http://dx.doi.org/10.1016/j.tcm.2018.09.005DOI Listing
September 2018
5 Reads
2.910 Impact Factor

Thyroid disorders induced by checkpoint inhibitors.

Rev Endocr Metab Disord 2018 Sep 21. Epub 2018 Sep 21.

Department of Clinical and Experimental Medicine, University of Pisa, School of Medicine, Via Savi, 10, I-56126, Pisa, Italy.

Immune checkpoint inhibitors are drugs that inhibit the "checkpoint molecules". Different types of cancer immune checkpoint inhibitors have been approved recently: CTLA-4 monoclonal antibodies (as ipilimumab); anti-PD-1 monoclonal antibodies (as pembrolizumab and nivolumab); and anti-PD-L1 monoclonal antibodies (as atezolizumab, avelumab, and durmalumab). The increased immune response induced by these agents leads to immune-related adverse events (irAEs), that can vary from mild to fatal, according to the organ system and severity. Read More

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http://link.springer.com/10.1007/s11154-018-9463-2
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http://dx.doi.org/10.1007/s11154-018-9463-2DOI Listing
September 2018
9 Reads

Thyroid storm following rapid sequence intubation.

Am J Emerg Med 2018 Dec 3;36(12):2338.e5-2338.e6. Epub 2018 Sep 3.

Department of Emergency Medicine, University of Texas Health Science Center at San Antonio, United States of America. Electronic address:

Thyroid storm is a rare complication with an estimated incidence ranging from 0.61 to 0.76 cases per 100,000 people. Read More

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http://dx.doi.org/10.1016/j.ajem.2018.09.006DOI Listing
December 2018
2 Reads

Thyrotoxic Periodic Paralysis and Cardiomyopathy in a Patient with Graves' Disease.

Cureus 2018 Jun 19;10(6):e2837. Epub 2018 Jun 19.

Critical Care, Maimonides Medical Center, Brooklyn, USA.

Thyrotoxic periodic paralysis (TPP) and cardiomyopathy are two established complications of thyrotoxicosis. Emergent management is essential as TPP and cardiac events secondary to thyrotoxic cardiomyopathy can be fatal. We report a unique case of a patient with Graves' disease presenting with symptoms secondary to both these complications. Read More

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http://dx.doi.org/10.7759/cureus.2837DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101465PMC
June 2018
3 Reads

A Rare Case of Thyrotropin-Secreting Pituitary Adenoma Coexisting with Papillary Thyroid Carcinoma Presenting with Visual Disturbance without Hyperthyroidism.

World Neurosurg 2018 Nov 7;119:394-399. Epub 2018 Aug 7.

Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan.

Background: Thyroid-stimulating hormone-secreting pituitary adenomas (TSHomas) are uncommon, and majority of the patients present with symptoms of hyperthyroidism. Herein, we report the first case of TSHoma with differentiated thyroid carcinoma (DTC) that presented with visual disturbance without any clinical feature of hyperthyroidism.

Case Description: A 57-year-old man presented with left temporal hemianopsia of his left eye without any sign of hyperthyroidism. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.07.274DOI Listing
November 2018
4 Reads

Thyroid Storm and Complete Heart Block after Treatment with Radioactive Iodine.

Case Rep Endocrinol 2018 11;2018:8214169. Epub 2018 Jun 11.

Division of Endocrinology and Diabetes, The Robert Larner, M.D. College of Medicine, The University of Vermont, Burlington, VT, USA.

Thyroid storm is a rare endocrine emergency characterized by dysfunction of multiple organ systems. Thyroid storm is more common in Graves' disease and can be precipitated by surgery, trauma, infection, metabolic abnormalities, iodine load, and parturition. We present a diagnostically challenging case of thyroid storm precipitated by radioiodine therapy and accompanied by bradycardia, a rare but life-threatening complication related to treatment for hyperthyroidism. Read More

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https://www.hindawi.com/journals/crie/2018/8214169/
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http://dx.doi.org/10.1155/2018/8214169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016161PMC
June 2018
8 Reads

Thyroid storm after choking.

J Pediatr Endocrinol Metab 2018 Aug;31(8):933-936

Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA.

Background: A thyroid storm (TS) is a rare, but life-threatening condition in hyperthyroid patients. Mortality in adult TS patients may be as high as 10%. Typically, a trigger precipitates the storm in hyperthyroid patients. Read More

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http://dx.doi.org/10.1515/jpem-2018-0072DOI Listing
August 2018
6 Reads

Nonthionamide Drugs for the Treatment of Hyperthyroidism: From Present to Future.

Int J Endocrinol 2018 22;2018:5794054. Epub 2018 Apr 22.

Division of Endocrine and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Hyperthyroidism is a common endocrine disease. Although thionamide antithyroid drugs are the cornerstone of hyperthyroidism treatment, some patients cannot tolerate this drug class because of its serious side effects including agranulocytosis, hepatotoxicity, and vasculitis. Therefore, nonthionamide antithyroid drugs (NTADs) still have an important role in controlling hyperthyroidism in clinical practice. Read More

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http://dx.doi.org/10.1155/2018/5794054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937426PMC
April 2018
5 Reads

Thyroid Storm Presenting as Psychosis.

J Investig Med High Impact Case Rep 2018 Jan-Dec;6:2324709618777014. Epub 2018 May 18.

Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Thyroid storm is a life-threatening endocrine emergency with an incidence rate of 1% to 2%. It is a systemic condition of excessive thyroid hormone production and release leading to thermoregulatory, adrenergic, neuropsychiatric, cardiovascular, and abdominal manifestations. Although it is a rare condition, it carries a significant mortality rate. Read More

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http://journals.sagepub.com/doi/10.1177/2324709618777014
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http://dx.doi.org/10.1177/2324709618777014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960855PMC
May 2018
11 Reads

A retrospective cohort study: do patients with graves' disease need to be euthyroid prior to surgery?

J Otolaryngol Head Neck Surg 2018 May 21;47(1):37. Epub 2018 May 21.

Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2, Canada.

Background: The 2016 American Thyroid Association guidelines indicate that patients with Graves' disease who undergo a thyroidectomy should be rendered euthyroid through the use of antithyroid drugs (ATD) prior to surgery to avoid complications such as a thyroid storm. At times, the use of ATDs can have limited efficacy and therefore some patients will inevitably remain biochemically hyperthyroid at the time of surgery. The aim of this study is to assess if hyperthyroid patients undergoing a thyroidectomy are at an increased risk of developing a thyroid storm in comparison to euthyroid patients. Read More

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http://dx.doi.org/10.1186/s40463-018-0281-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963139PMC
May 2018
1 Read

Flushing Disorders Associated with Gastrointestinal Symptoms: Part 2, Systemic Miscellaneous Conditions.

Clin Med Res 2018 Jun 12;16(1-2):29-36. Epub 2018 Apr 12.

University of Central Florida College of Medicine/HCA, Consortium Graduate Medical Education, North Florida, Regional Medical Center, 6500 W Newberry Rd, Gainesville, FL 32605.

Flushing disorders with involvement of the gastrointestinal tract represent a heterogeneous group of conditions. In part 1 of this review series, neuroendocrine tumors (NET), mast cell activation disorders (MCAD), and hyperbasophilia were discussed. In this section we discuss the remaining flushing disorders which primarily or secondarily involve the gastrointestinal tract. Read More

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http://dx.doi.org/10.3121/cmr.2017.1379bDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6108508PMC
June 2018
3 Reads

Flushing Disorders Associated with Gastrointestinal Symptoms: Part 1, Neuroendocrine Tumors, Mast Cell Disorders and Hyperbasophila.

Clin Med Res 2018 Jun 12;16(1-2):16-28. Epub 2018 Apr 12.

University of Central Florida College of Medicine/HCA Consortium Graduate Medical Education, North Florida Regional Medical Center, 6500 W Newberry Rd, Gainesville, FL 32605.

Flushing is the subjective sensation of warmth accompanied by visible cutaneous erythema occurring throughout the body with a predilection for the face, neck, pinnae, and upper trunk where the skin is thinnest and cutaneous vessels are superficially located and in greatest numbers. Flushing can be present in either a wet or dry form depending upon whether neural-mediated mechanisms are involved. Activation of the sympathetic nervous system results in wet flushing, accompanied by diaphoresis, due to concomitant stimulation of eccrine sweat glands. Read More

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http://dx.doi.org/10.3121/cmr.2017.1379aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6108509PMC
June 2018
3 Reads

Type 2 Diabetes Decompensation as the Clinical Presentation of Thyroid Storm - Cause or Consequence?

Eur Endocrinol 2017 Aug 22;13(2):99-101. Epub 2017 Aug 22.

Endocrinology Department, Hospital de Braga, Braga, Portugal.

This case study aims to discuss the unusual forms of hyperthyroidism presentation, the nonspecific symptoms and precipitating events. A 70-year-old male was taken to the emergency department for hyperglycaemia, nausea, vomiting and altered mental status with a week of evolution. He had a past medical history of type 2 diabetes, hypertension and dyslipidemia. Read More

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http://www.touchendocrinology.com/articles/type-2-diabetes-d
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http://dx.doi.org/10.17925/EE.2017.13.02.99DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813473PMC
August 2017
8 Reads

Use of low-dose neostigmine intravenously in the treatment of thyroid storm-induced severe tachycardia in patient during huge pelvic mass resection: A case report and review of literature.

Medicine (Baltimore) 2018 Apr;97(14):e0300

Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Rationale: Thyroid storm is a rare and life-threatening metabolic crisis because of an emergent release of excess thyroid hormone. Sinus tachycardia induced by excess thyroid hormone may result in congestive heart failure due to decreased diastolic filling time.

Patient Concerns: A controlled hyperthyroidism patient with severe sinus tachycardia. Read More

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http://dx.doi.org/10.1097/MD.0000000000010300DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902261PMC
April 2018
7 Reads

Steroids and Thyrotoxicosis Precipitate Periodic Paralysis.

Cureus 2018 Jan 23;10(1):e2106. Epub 2018 Jan 23.

Internal Medicine, St. Joseph Mercy Oakland Hospital.

Thyrotoxic Periodic Paralysis (TPP) belongs to a group of muscle diseases called channelopathies, which present with painless generalized muscle weakness without exertion. TPP can be precipitated by a large carbohydrate meal, stress, strenuous exercise, alcohol, a high-salt diet, menstruation, and cold temperatures. Rarely, steroids such as dexamethasone can also precipitate a TPP attack. Read More

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http://dx.doi.org/10.7759/cureus.2106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866117PMC
January 2018
1 Read

Thyrotoxic crisis as an acute clinical presentation in a child.

BMJ Case Rep 2018 Mar 23;2018. Epub 2018 Mar 23.

Paediatrics, University Hospitals of Leicester Foundation Trust, Leicester, UK.

A previously well, 4-year-old girl presented with a 4-6 weeks' history of increased appetite, weight loss, tiredness, sleep difficulty, excessive sweating, swelling in the neck and new-onset 'prominent, protruding eyes.' Family history revealed paternal grandmother receiving treatment for hyperthyroidism. Clinical assessment demonstrated features of thyrotoxicosis (tachycardia, warm peripheries, small smooth goitre with no nodules, exophthalmos). Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2017-22285
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http://dx.doi.org/10.1136/bcr-2017-222850DOI Listing
March 2018
19 Reads

[Thyroid Storm and Myxedema Coma].

Dtsch Med Wochenschr 2018 Mar 15;143(6):397-405. Epub 2018 Mar 15.

Thyroid storm and myxedema coma are the most severe clinical forms of thyroid dysfunction. While both hyper- and hypothyroidsm are common diseases, thyroid storm and myxedema coma are rare. Due to their unspecific signs and symptoms they are often difficult to diagnose. Read More

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http://dx.doi.org/10.1055/s-0043-111728DOI Listing
March 2018
6 Reads

Diltiazem-Associated Cardiogenic Shock in Thyrotoxic Crisis.

Am J Ther 2018 Nov/Dec;25(6):e666-e669

Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL.

Clinical Features: The patient we present is a 39-year-old woman with a history of hyperthyroidism who developed fast atrial fibrillation secondary to thyrotoxic storm. After the initiation of intravenous diltiazem drip, she developed hypotension, bradycardia, then asystole cardiac arrest.

Therapeutic Challenge: It is well known that calcium channel blockers and beta blockers should be used with extreme caution if the patient with thyroid storm has decompensated heart failure with reduced ejection fraction. Read More

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http://dx.doi.org/10.1097/MJT.0000000000000739DOI Listing
March 2018
3 Reads
1.130 Impact Factor

Graves' hyperthyroidism in pregnancy: a clinical review.

Clin Diabetes Endocrinol 2018 1;4. Epub 2018 Mar 1.

4Division of Endocrinology, Diabetes & Metabolism, Department of Medicine and Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, 1540 Alcazar Street CHP 204, Los Angeles, California 90033 USA.

Background: Graves' hyperthyroidism affects 0.2% of pregnant women. Establishing the correct diagnosis and effectively managing Graves' hyperthyroidism in pregnancy remains a challenge for physicians. Read More

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http://dx.doi.org/10.1186/s40842-018-0054-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831855PMC
March 2018
5 Reads

More, less or both?

BMJ Case Rep 2018 Mar 5;2018. Epub 2018 Mar 5.

Department of Internal medicine, VU Medical Center, Amsterdam, The Netherlands.

A 67-year-old Caucasian woman with no prior medical history was admitted to our hospital with complaints of generalised weakness, nausea, diarrhoea and weight loss. The patient suffered from tachycardia and hypotension. Blood tests revealed Graves' thyrotoxicosis and the patient was treated accordingly. Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2017-22235
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http://dx.doi.org/10.1136/bcr-2017-222355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5847917PMC
March 2018
3 Reads

Impending thyroid storm in a pregnant woman with undiagnosed hyperthyroidism: A case report and literature review.

Medicine (Baltimore) 2018 Jan;97(3):e9606

Department of Anesthesiology, West China Second University Hospital.

Rationale: Thyroid storm is a rare complication during caesarean section of patients with hyperthyroidism. It occurs abruptly, with a high mortality rate if not recognized immediately and aggressively treated. Herein, we reported a case of impending thyroid storm during a caesarean section. Read More

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http://dx.doi.org/10.1097/MD.0000000000009606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779755PMC
January 2018
5 Reads

Manifestation of Central Diabetes Insipidus in a Patient with Thyroid Storm.

Intern Med 2018 Jul 28;57(13):1939-1942. Epub 2018 Feb 28.

Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan.

We herein report a case of central diabetes insipidus complicated with thyroid storm. A middle-aged woman who was receiving treatment for Graves' disease suddenly complained of polydipsia, polyuria and general fatigue. Laboratory tests showed hyperthyroidism, hypernatremia, hypoosmolar urine and a decreased plasma vasopressin level. Read More

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http://dx.doi.org/10.2169/internalmedicine.0063-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064704PMC
July 2018
9 Reads

A case of sudden onset of thyroid storm just before cesarean section manifesting congestive heart failure and pulmonary edema.

JA Clin Rep 2017 26;3(1):20. Epub 2017 Apr 26.

Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, Nagano 390-8621 Japan.

Background: Since acute respiratory failure (ARF) is a life-threatening complication, particularly in the gestational period, differential diagnosis and rapid treatment are required. Among the various causes of sudden onset of ARF, thyroid storm is a rare cause in a parturient complicated with well-controlled hyperthyroidism. In this case report, we describe a parturient with hyperthyroidism in whom a thyroid storm manifesting congestive heart failure and pulmonary edema developed just before an emergency ceasarean section, even though hyperthyroidism was well-controlled with antithyroid drugs. Read More

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http://dx.doi.org/10.1186/s40981-017-0088-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804602PMC
April 2017
7 Reads

A thyroid storm patient with protracted disturbance of consciousness and reversible lesion in the splenium of corpus callosum: A case report.

Medicine (Baltimore) 2018 Feb;97(7):e9949

Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Johnan-cho, Hitachi, Ibaraki, Japan.

Rationale: Various neurological manifestations are observed in thyroid storm patients but protracted disturbance of consciousness is rare.

Patient Concerns: A 58-year-old male was admitted to our hospital after a traffic accident.

Diagnoses: Although awake on arrival, he fell into coma after admission. Read More

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http://dx.doi.org/10.1097/MD.0000000000009949DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839822PMC
February 2018
7 Reads

Notes on Trauma-Related Thyroid Storm in the Emergency Department.

Authors:
Adam Morton

J Emerg Med 2018 02;54(2):e35

Mater Health, South Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.

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http://dx.doi.org/10.1016/j.jemermed.2017.06.045DOI Listing
February 2018
3 Reads

Thyrotoxic Neuropathy: A rare cause of acute flaccid paraplegia.

Sultan Qaboos Univ Med J 2017 Nov 10;17(4):e460-e463. Epub 2018 Jan 10.

Department of Neurology, Royal Hospital, Muscat, Oman.

Acute polyneuropathy is a rare manifestation of severe hyperthyroidism. We report a 22-year-old Omani male who presented to the Sohar Hospital, Sohar, Oman, in 2016 with acute-onset rapidly progressive flaccid areflexic paraplegia as the presenting manifestation of thyrotoxicosis. Nerve conduction studies revealed mixed axonal and demyelinating polyneuropathy in both the motor and sensory nerves. Read More

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http://dx.doi.org/10.18295/squmj.2017.17.04.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5766304PMC
November 2017
4 Reads

Propranolol-Induced Circulatory Collapse in a Patient With Thyroid Crisis and Underlying Thyrocardiac Disease: A Word of Caution.

J Investig Med High Impact Case Rep 2017 Oct-Dec;5(4):2324709617747903. Epub 2017 Dec 20.

Detroit Medical Center, Wayne State University, Detroit, MI, USA.

Thyrotoxic crisis or thyroid storm is a severe form of hyperthyroidism and a rare endocrinological emergency. The cornerstones of medical therapy in thyroid storm include decreasing the levels of circulating T3 in the blood as well as inhibiting the hormone's peripheral effects through β-adrenergic blockade. Propranolol is the preferred agent for β-blockade in hyperthyroidism and thyroid storm due to its additional effect of blocking the peripheral conversion of inactive T4 to active form T3. Read More

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http://journals.sagepub.com/doi/10.1177/2324709617747903
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http://dx.doi.org/10.1177/2324709617747903DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753961PMC
December 2017
18 Reads

Anaesthetic Implications of Severe Hyperthyroidism Secondary to Molar Pregnancy: A Case Report and Review of Literature.

Anesth Essays Res 2017 Oct-Dec;11(4):1115-1117

Department of Anaesthesiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Pregnant women with gestational trophoblastic disease have an increased likelihood to develop hyperthyroidism secondary to increased secretion of human chorionic gonadotropin. Most of these cases of hyperthyroidism remain undiagnosed and may present as a thyrotoxic crisis during the perioperative period. Pregnant patients with gestational trophoblastic disease should be always evaluated for hyperthyroidism, and in cases of severe hyperthyroidism, antithyroid treatment should be initiated before evacuation of the mole. Read More

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http://dx.doi.org/10.4103/aer.AER_38_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735464PMC
December 2017
7 Reads

Cytomegalovirus-mononucleosis-induced thyroiditis in an immunocompetent patient.

Endocrinol Diabetes Metab Case Rep 2017 24;2017. Epub 2017 Nov 24.

Division of Endocrinology, Jewish General Hospital, Montréal, Québec, Canada.

Enteroviruses, including coxsackieviruses and Echovirus, are well known pathogens responsible for the development of thyroiditis. We describe the case of a 49-year-old woman with no personal or family history of thyroid disease who presented to the emergency room with a two-week history of daily fevers up to 39°C, a sore throat, occasional palpitations and diaphoresis, decreased appetite and an unintentional 10 kg weight loss over the same time course Physical examination revealed mild tachycardia, an intention tremor and a normal-sized, nontender thyroid gland without palpable nodules. The remainder of the physical examination was unremarkable and without stigmata of Graves' disease. Read More

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http://dx.doi.org/10.1530/EDM-17-0142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704440PMC
November 2017
6 Reads

Methamphetamine Use With Subsequent Thyrotoxicosis/Thyroid Storm, Agranulocytosis, and Modified Total Thyroidectomy: A Case Report.

Clin Med Insights Ear Nose Throat 2017 17;10:1179550617741293. Epub 2017 Nov 17.

Division of Otolaryngology, Department of Surgery, St. Joseph's Medical Hospital and Medical Center, Phoenix, AZ, USA.

Thyroid storm is a rare, potentially lethal condition involving collapse of the hypothalamic-pituitary-thyroid feedback loop. Thyroid storm carries a significant mortality rate, thus requiring prompt identification and treatment. A 47-year-old woman presented to the emergency department complaining of palpitations, shortness of breath, and emesis for 24 hours after using methamphetamine. Read More

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http://dx.doi.org/10.1177/1179550617741293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697581PMC
November 2017
29 Reads

Preoperative management in patients with Graves' disease.

Gland Surg 2017 Oct;6(5):476-481

Department of Medicine and Surgery, University of Insubria, Varese, Italy.

Graves' disease is the most frequent cause of hyperthyroidism in iodine-sufficient geographical areas and is characterized by the presence in patients' serum of autoantibodies directed against the thyrotropin receptor (TRAb) that cause overproduction and release of thyroid hormones. Clinical presentation results from both hyperthyroidism and underlying autoimmunity. The diagnosis is based on characteristic clinical features and biochemical abnormalities. Read More

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http://dx.doi.org/10.21037/gs.2017.05.09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676164PMC
October 2017
7 Reads

Iodinated Contrast Administration Resulting in Cardiogenic Shock in Patient with Uncontrolled Graves Disease.

J Emerg Med 2017 Dec 6;53(6):e125-e128. Epub 2017 Nov 6.

Virginia Tech Carilion Emergency Medicine Residency, Department of Emergency Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia.

Background: Thyroid storm (also known as thyroid or thyrotoxic crisis) is part of the spectrum of thyrotoxicosis and represents the extreme end of that spectrum. The condition is quite rare, yet mortality rates are high and may approach 10-30%.

Case Report: A 34-year-old-man who had a history of Graves disease presented in atrial fibrillation with rapid ventricular response and mild congestive heart failure. Read More

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http://dx.doi.org/10.1016/j.jemermed.2017.08.096DOI Listing
December 2017
6 Reads

Total Thyroidectomy for Thyroid Cancer Followed by Thyroid Storm due to Thyrotropin Receptor Antibody Stimulation of Metastatic Thyroid Tissue.

Eur Thyroid J 2017 Sep 3;6(5):276-280. Epub 2017 Aug 3.

Department of Endocrinology, Odense University Hospital, Odense, Denmark.

Background: Graves disease (GD) is an autoimmune condition characterized by the presence of antibodies against the thyrotropin receptor (TRAB), which stimulate the thyroid gland to produce excess thyroid hormone. Theoretically, TRAB could stimulate highly differentiated thyroid cancer tissue and/or metastases to produce thyroid hormone.

Case: A 68-year-old male, with weight loss and palpitations, was diagnosed with thyrotoxicosis. Read More

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http://dx.doi.org/10.1159/000479061DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649237PMC
September 2017
21 Reads

Malignant Hyperthermia Versus Thyroid Storm in a Patient With Symptomatic Graves Disease: A Case Report.

A A Pract 2018 Mar;10(5):97-99

From the Department of Anesthesiology, Loyola University Medical Center, Maywood, Illinois.

Malignant hyperthermia and thyroid storm are intraoperative emergencies with overlapping symptoms but different treatment protocols. We faced this diagnostic dilemma in a 25-year-old patient with symptomatic hyperthyroidism, elevated free T3 and free T4, and low thyroid-stimulating hormone from Graves disease despite treatment with propranolol 80 mg daily and methimazole 40 mg every 8 hours. During thyroidectomy, he developed hyperthermia and hypercarbia without tachycardia. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000639DOI Listing
March 2018
9 Reads

[Thyroid emergencies : Thyroid storm and myxedema coma].

Internist (Berl) 2017 Oct;58(10):1011-1019

Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland.

Thyroid emergencies are rare life-threatening endocrine conditions resulting from either decompensated thyrotoxicosis (thyroid storm) or severe thyroid hormone deficiency (myxedema coma). Both conditions develop out of a long-standing undiagnosed or untreated hyper- or hypothyroidism, respectively, precipitated by an acute stress-associated event, such as infection, trauma, or surgery. Cardinal features of thyroid storm are myasthenia, cardiovascular symptoms, in particular tachycardia, as well as hyperthermia and central nervous system dysfunction. Read More

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http://dx.doi.org/10.1007/s00108-017-0306-0DOI Listing
October 2017
22 Reads

Thyroidectomy for the treatment of Graves' thyrotoxicosis in thioamide-induced agranulocytosis and sepsis.

Endocrinol Diabetes Metab Case Rep 2017 4;2017. Epub 2017 Sep 4.

Department of Endocrinology and Diabetes, University Hospital Geelong, Geelong, Victoria, Australia.

A 51 year old man presented with sepsis in the setting of thioamide-induced agranulocytosis. Empiric broad-spectrum antibiotics was followed by directed narrow-spectrum antibiotics, and his neutrophil count recovered with support from granulocyte-colony stimulating factor (G-CSF) analogue transfusions. After a brief period of multi-modal therapy for nine days including potassium iodide (Lugol's iodine), cholestyramine, propanolol and lithium to temper his persisting hyperthyroidism, a total thyroidectomy was performed while thyroid hormone levels remained at thyrotoxic levels. Read More

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http://dx.doi.org/10.1530/EDM-17-0071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592706PMC
September 2017
8 Reads

Thyrotoxicosis and Choledocholithiasis Masquerading as Thyroid Storm.

Case Rep Med 2017 23;2017:9454698. Epub 2017 Aug 23.

Madigan Army Medical Center, Tacoma, WA, USA.

A 26-year-old female, thirteen months postpartum, presented to the emergency department for four weeks of epigastric abdominal pain, pruritus, new onset jaundice, and 11.3 kgs (25 lbs) unintentional weight loss. On examination, she was afebrile, tachycardic, alert, and oriented and had jaundice with scleral icterus. Read More

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http://dx.doi.org/10.1155/2017/9454698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587932PMC
August 2017
5 Reads

Thyroid Storm: A Japanese Perspective.

Authors:
Takashi Akamizu

Thyroid 2018 01 5;28(1):32-40. Epub 2017 Oct 5.

The First Department of Medicine, Wakayama Medical University , Wakayama, Japan .

Background: Thyroid storm (TS) is life threatening. In the mid-2000s, its incidence was poorly defined, peer-reviewed diagnostic criteria were not available, and management and treatment did not seem to be verified based upon evidence and latest advances in medicine.

Methods: First, diagnostic criteria were developed based on 99 patients in the literature and seven patients in this study. Read More

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http://dx.doi.org/10.1089/thy.2017.0243DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770119PMC
January 2018
6 Reads

Switching Therapy from Intravenous Landiolol to Transdermal Bisoprolol in a Patient with Thyroid Storm Complicated by Decompensated Heart Failure and Gastrointestinal Dysfunction.

Intern Med 2017 Oct 6;56(19):2603-2609. Epub 2017 Sep 6.

Department of Emergency and Critical Care Medicine, Tohoku University Hospital, Japan.

Thyroid storm is a life-threatening disorder that remains a therapeutic challenge. Although β-blockers are the mainstay for treatment, their use can be challenging in cases complicated by rapid atrial fibrillation and decompensated heart failure. We present a case of thyroid storm-associated atrial fibrillation and decompensated heart failure complicated by gastrointestinal dysfunction secondary to diffuse peritonitis that was successfully managed by a switching therapy, in which the continuous intravenous administration of landiolol was changed to bisoprolol via transdermal patch, in the acute phase treatment. Read More

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http://dx.doi.org/10.2169/internalmedicine.8846-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658526PMC
October 2017
14 Reads

Psychiatric Emergencies for Physicians: Clinical Management and Approach to Distinguishing Pheochromocytoma From Psychiatric and Thyrotoxic Diseases in the Emergency Department.

J Emerg Med 2017 Nov 2;53(5):712-716. Epub 2017 Sep 2.

Department of Emergency Medicine, Director of Behavioral Emergencies Research, University of California-San Diego, San Diego, California.

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http://dx.doi.org/10.1016/j.jemermed.2017.05.032DOI Listing
November 2017
8 Reads

Thyroid storm and warm autoimmune hemolytic anemia.

Transfus Apher Sci 2017 Aug 18;56(4):606-608. Epub 2017 Aug 18.

Division of Hematology Oncology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, United States.

Graves' disease is often associated with other autoimmune disorders, including rare associations with autoimmune hemolytic anemia (AIHA). We describe a unique presentation of thyroid storm and warm AIHA diagnosed concurrently in a young female with hyperthyroidism. The patient presented with nausea, vomiting, diarrhea and altered mental status. Read More

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http://dx.doi.org/10.1016/j.transci.2017.08.003DOI Listing
August 2017
14 Reads

Trends in the Incidence and In-Hospital Outcomes of Cardiogenic Shock Complicating Thyroid Storm.

Am J Med Sci 2017 08 25;354(2):159-164. Epub 2017 Apr 25.

Department of Anesthesiology, Mayo Clinic, Phoenix, Arizona.

Background: Thyroid storm (TS) constitutes an endocrine emergency with an incidence of up to 10% of all admissions for thyrotoxicosis. Cardiogenic shock (CS) is a rare complication of TS and very limited data exists on its incidence and outcomes. We aimed to estimate the national trends in incidence and outcomes of CS among patients admitted to US hospitals with TS. Read More

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http://dx.doi.org/10.1016/j.amjms.2017.04.017DOI Listing
August 2017
40 Reads

[Thyroid storm associated with multiorganic dysfunction].

Medicina (B Aires) 2017 ;77(4):337-340

Servicio de Endocrinología, Fundación Valle del Lili, Cali, Colombia. E-mail:

Thyroid storm is a rare and potentially fatal condition. Unusual presentations in patients with thyroid storm have been described but multiorganic dysfunction is uncommonly seen. We describe the case of a 36-year-old woman with unknown underlying Graves's disease who developed thyroid storm. Read More

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July 2018
47 Reads

Thyroid Emergencies: New Insight into Old Problems.

J Assoc Physicians India 2017 Aug;65(8):68-76

Senior Resident, Dept. of Medicine, LHMC and Associated Hospitals, New Delhi.

Thyroid emergencies are major life-threatening endocrine conditions associated with life-threatening disorders resulting from either severe deficiency or excess of thyroid hormones. Deficiency of thyroid hormones may present as myxedema coma whereas excessive hormone production can present as life threatening thyrotoxic storm. The diagnosis of both requires a high index of clinical suspicion. Read More

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August 2017
11 Reads