Search Our Scientific Publications & Authors

Biopsychosoc Med 2021 May 27;15(1):11. Epub 2021 May 27.

Department of Psychiatry, Jichi Medical University, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.

Background: Graves' disease is characterized by hyperthyroidism and its symptoms often overlap with those of panic disorder, which may make it difficult to distinguish between the two conditions. In this report, we describe how proper diagnosis of thyroid disease in patients with mental illness can lead to appropriate treatment.

Case Presentation: We encountered a 34-year-old woman in whom thyroid crisis from Graves' disease was misdiagnosed as panic attack. Read More

Int J Gen Med 2021 3;14:1641-1646. Epub 2021 May 3.

Department of Endocrinology and Metabolism, Zhejiang University Affiliated Sir Run Run Shaw Hospital, School of Medicine, Hangzhou, People's Republic of China.

Introduction: In recent years, radioactive iodine (RAI) therapy has become a main choice for Graves' disease. The rapid release of thyroid hormones following RAI may on occasion trigger severe events, such as thyroid storm or heart block. This study presents two cases of possible acute adrenocortical insufficiency precipitated by radioiodine therapy. Read More

Cureus 2021 Apr 3;13(4):e14271. Epub 2021 Apr 3.

Internal Medicine, Salmaniya Medical Complex, Manama, BHR.

Hyperthyroidism is a common disease. Thyroglossal duct cysts are also a very common type of congenital anomalies. Their co-existence is, however, rare with only a few cases described in the literature of the same. Read More

Cureus 2021 Feb 6;13(2):e13167. Epub 2021 Feb 6.

Cardiology, University of Maryland Prince George's Hospital Center, Cheverly, USA.

The following case involves a 62-year-old female patient suffering from heart failure with reduced ejection fraction (HFrEF) secondary to non-ischemic cardiomyopathy and Graves disease, who developed ventricular fibrillation (VF) after discontinuation of methimazole in preparation for radioiodine ablation. Electrocardiogram (ECG) showed a severely prolonged QTc in the setting of thyrotoxicosis, which significantly improved with high dose methimazole. VF secondary to thyrotoxicosis has rarely been reported and the literature review shows scarce data on its mechanism. Read More

BMC Cardiovasc Disord 2021 Mar 4;21(1):124. Epub 2021 Mar 4.

Department of Cardiovascular Medicine, Narita-Tomisato Tokushukai Hospital, 1-1-1 Hiyoshidai, Tomisato, Chiba, 286-0201, Japan.

Background: Thyroid storm (TS) is a rare but potentially life-threatening sequelae of untreated or undertreated hyperthyroidism. While TS frequently causes high-output heart failure, low-output heart failure related to dilated cardiomyopathy (DCM) is extremely rare. Tachycardia is a common clinical presentation of TS, and β1-selective blockers are the first-line agents for treating TS-associated tachycardia. Read More

Ther Apher Dial 2021 Mar 4. Epub 2021 Mar 4.

Marmara University School of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey.

Antithyroid drugs (ATDs) are the mainstay of treatment for Graves' disease with possible detrimental adverse effects. Surgery or radioactive iodine (RAI) ablation is the second choice among the treatment options in cases of non-remission. Normalization of serum thyroid hormone levels as much as possible is required before surgery or RAI to prevent thyrotoxic crisis in patients with uncontrolled Graves' disease. Read More

Nihon Ronen Igakkai Zasshi 2021 ;58(1):158-163

Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences.

A 70-year-old woman was hospitalized for diarrhea, vomiting, loss of appetite, fatigue, and dyspnea on exertion for the past 3 weeks and treated with intravenous fluid for dehydration. She was receiving prednisolone for polymyositis. She did not have a history of thyroid disease. Read More

Endocrinol Diabetes Metab Case Rep 2020 Sep 4;2020. Epub 2020 Sep 4.

First Department of Internal Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan.

Summary: Thyroid storm (TS) is a life-threatening condition that may suffer thyrotoxic patients. Therapeutic plasma exchange (TPE) is a rescue approach for TS with acute hepatic failure, but it should be initiated with careful considerations. We present a 55-year-old male patient with untreated Graves' disease who developed TS. Read More

Endocrinol Diabetes Metab Case Rep 2021 Jan 11;2021. Epub 2021 Jan 11.

Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.

Summary: Thyroid storm is a rare but potentially life-threatening complication of excessive thyroid hormone action. It is associated with a hypercoagulable state and reported to increase the risk of thromboembolism. However, the role of anticoagulation in thyroid storm still remains controversial and inconclusive. Read More

BMJ Case Rep 2021 Jan 11;14(1). Epub 2021 Jan 11.

Department of Neonatology, Rotunda Hospital Neonatal Unit, Dublin, Ireland

A near-term infant became unwell immediately after birth with cardiorespiratory compromise-persistent tachycardia, pulmonary hypertension and reduced cardiac function. There had been no concerns during the pregnancy and the obstetrical and maternal medical history was unremarkable apart from hypothyroidism. A thyroid function test on admission revealed a significantly elevated free T4 and a diagnosis of a thyroid storm was made. Read More

Cureus 2020 Sep 9;12(9):e10333. Epub 2020 Sep 9.

Department of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma, USA.

Although mild elevations in liver enzymes are relatively common in thyrotoxicosis, acute liver failure (ALF) is an infrequent occurrence. Despite the emergence of liver transplantation as a viable treatment for ALF, survival rates continue to remain unsatisfactory, coupled with higher rates of postoperative complications and re-transplantation in this group. We present the disease course, management, and outcome of a patient with Graves' disease who presented with ALF secondary to thyroid storm. Read More

Cureus 2020 Sep 4;12(9):e10248. Epub 2020 Sep 4.

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Myasthenia gravis (MG) is a rare autoimmune neuromuscular junction disorder, and thyroid disorder is a disorder involving the thyroid receptor, of which Graves' disease (GD) is the most common autoimmune thyroid disorder, in which antibodies develop against thyroid receptors. Both may have similar clinical features. In myasthenia gravis, autoimmune antibodies develop against postsynaptic neuromuscular junction disrupting the neuromuscular transmission, resulting in fluctuating muscle weakness and fatigue. Read More

AACE Clin Case Rep 2020 Jan-Feb;6(1):e14-e18. Epub 2020 Sep 26.

Objective: Graves disease is the most common cause of thyrotoxicosis. Medical management is the first-line treatment but may be contraindicated or ineffective. In patients with severe, refractory thyrotoxicosis therapeutic plasma exchange (TPE) may be indicated as a bridge to thyroidectomy. Read More

Ann Endocrinol (Paris) 2020 Oct 18;81(5):507-510. Epub 2020 Sep 18.

Service d'endocrinologie et maladies métaboliques, pôle cardiovasculaire et métabolique, CHU Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France. Electronic address:

The World Health Organization (WHO) declared the COVID-19 epidemic to be a global pandemic in March 2020. COVID-19 is an infection caused by SARS-CoV-2, a coronavirus that utilizes the angiotensin-2 converting enzyme to penetrate thyroid and pituitary cells, and may result in a "cytokine storm". Based on the pathophysiological involvement of the pituitary-thyroid axis, the current review discusses the diagnosis of abnormal thyroid function test, and the management of patients presenting with thyrotoxicosis, thyroid-associated orbitopathy and hypothyroidism in the context of SARS-CoV-2 infection. Read More

Cureus 2020 Jul 29;12(7):e9461. Epub 2020 Jul 29.

Psychiatry, Lewisgale Medical Center, Salem, USA.

Thyroid storm is a rare, life-threatening condition characterized by severe or exaggerated clinical manifestations of thyrotoxicosis, commonly occurring in patients with longstanding, untreated hyperthyroidism such as Graves' disease and toxic nodular goiter. Subacute painful thyroiditis, also known as de Quervain thyroiditis, is a self-limited inflammatory disease of the thyroid gland that is characterized by neck pain, a tender diffuse thyroid goiter, elevated inflammatory markers, and a predictable course of thyroid function evolution. Rarely, it can cause thyroid storm. Read More

BMJ Case Rep 2020 Jul 6;13(7). Epub 2020 Jul 6.

Department of Pediatrics, University of Kentucky, Lexington, Kentucky, USA.

Paediatric hyperthyroidism cases are mostly caused by Grave's disease. Thyroid storm is a life-threatening condition seen rarely, in severe thyrotoxicosis, occurring in about 1%-2% of patients with hyperthyroidism. Antithyroid medications and beta-blockers are typically the first-line management of thyroid storm. Read More

Eur J Endocrinol 2020 Jul;183(1):G33-G39

Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

This manuscript provides guidance on the management of thyroid dysfunction during the COVID-19 pandemic. Autoimmune thyroid diseases are not linked to increased risks of COVID-19. Uncontrolled thyrotoxicosis may result in more severe complications from SARS-CoV-2 infection, including thyroid storm. Read More

Case Rep Endocrinol 2020 19;2020:7986581. Epub 2020 Mar 19.

Reading Hospital, Wyomissing, USA.

Thyrotoxicosis is a constellation of symptoms including palpitations, tremors, agitation, and heat intolerance, caused by excess thyroid hormone. It can be life-threatening in its most serious form. We present a rare case of thyrotoxicosis provoked by mechanical trauma to the neck via strangulation in a young female with a history of self-resolving postpartum symptoms of hyperthyroidism one year prior, but no formal diagnosis of thyroid dysfunction. Read More

Gland Surg 2020 Feb;9(1):124-135

Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

Hyperthyroidism is a condition where the thyroid gland produces and secretes inappropriately high amounts of thyroid hormone which can lead to thyrotoxicosis. The prevalence of hyperthyroidism in the United States is approximately 1.2%. Read More

J Coll Physicians Surg Pak 2020 Mar;30(3):330-331

National Institute of Diabetes & Endocrinology (NIDE), Dow University of Health Sciences (Ojha Campus) Karachi, Pakistan.

The aim of this study is to describe the characteristics and outcome of thyroid storm patients presenting at two tertiary care centres of Karachi, i.e. at Dow University of Health Sciences; and Liaquat National Hospital, Karachi, from December 2018 to May 2019. Read More

Chest 2020 03;157(3):e75-e78

Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO.

Case Presentation: A 62-year-old woman with a history of partially treated Graves disease and hypertension presented with approximately 3 weeks of worsening fatigue, lower extremity myalgias, and shortness of breath. Her medical history included a thyroid radiofrequency ablation several years earlier. Following the ablation, she was found to have some residual thyroid activity, negating the need for therapy. Read More

Indian J Med Res 2020 01;151(1):42-46

Department of Endocrinology, Command Hospital, Lucknow, Uttar Pradesh, India.

Background & Objectives: Thyrotoxic periodic paralysis (TPP) is an endocrine emergency presenting with acute-onset flaccid paralysis in a patient having thyrotoxicosis accompanied by hypokalaemia. This study was conducted to evaluate the clinical profile of patients with TPP presenting to three centres in India.

Methods: This retrospective, observational study was conducted at three tertiary care Armed Forces medical centres, located at Lucknow, Kolkata and Delhi. Read More

J Pediatr Endocrinol Metab 2020 Apr;33(4):575-578

Catholic Childrens Hospital Wilhelmstift, Department of Paediatrics, Hamburg, Germany.

Background Autoimmune polyglandular syndrome type II (APS II) is defined as the combination of autoimmune adrenal insufficiency and autoimmune thyroid disease (AITD) and/or type I diabetes mellitus (T1DM) in the same patient. Case presentation A 15-year-old boy had a history of weight loss, nausea and vomiting, headache, restlessness, and tanned skin. He was diagnosed with Graves' disease. Read More

J Family Med Prim Care 2020 Jan 28;9(1):432-434. Epub 2020 Jan 28.

Department of Endocrinology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.

Fever as an indicator of disease has always been and remains a clinical symptom of great importance. It may be a manifestation of any inflammatory process of the thyroid and also may be presenting feature of thyroid storm. Melioidosis, is an infection caused by the gram negative bacterium Burkholderia pseudomallei and the commonest co-morbidity observed in India is diabetes mellitus. Read More

Pediatrics 2020 02;145(2)

Division of Pediatric Endocrinology, Department of Pediatrics and.

Although simple febrile seizures are relatively common and benign in toddlers, it is important to rule out any underlying critical disease that necessitates further intervention and treatment. Thyroid storm, the extreme manifestation of hyperthyroidism, is relatively rare and not often considered in the differential diagnosis of a febrile seizure despite its high mortality rate. Here, we report 1 of the youngest patients with thyroid storm, who initially presented with a febrile seizure. Read More

Crit Care Med 2020 01;48(1):83-90

Medical Intensive Care Unit, Hôpital Pontchaillou, CHU de Rennes, France.

Objectives: Thyroid storm represents a rare but life-threatening endocrine emergency. Only rare data are available on its management and the outcome of the most severe forms requiring ICU admission. We aimed to describe the clinical manifestations, management and in-ICU and 6-month survival rates of patients with those most severe thyroid storm forms requiring ICU admission. Read More

BMJ Case Rep 2019 Oct 10;12(10). Epub 2019 Oct 10.

Metabolism and Endocrinology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Setagaya-ku, Tokyo, Japan.

A 39-year-old man was admitted to our hospital with the diagnosis of thyroid storm due to Graves' disease. Near-total thyroidectomy was performed after 1 month's pharmacological treatment, and he presented with tetany next morning. Serum corrected calcium value was 5. Read More

Endocrinol Diabetes Metab Case Rep 2019 Sep 27;2019. Epub 2019 Sep 27.

Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

Summary: We report the case of a 48-year-old man with thyroid storm associated with fulminant hepatitis and elevated levels of soluble interleukin-2 receptor (sIL-2R). Fatigue, low-grade fever, shortness of breath, and weight loss developed over several months. The patient was admitted to the hospital because of tachycardia-induced heart failure and liver dysfunction. Read More

Cureus 2019 Jul 4;11(7):e5079. Epub 2019 Jul 4.

Cardiology, University of Central Florida College of Medicine/Hospital Corporation of America Graduate Medical Education Consortium, Orlando, USA.

Thyroid storm is an extreme form of hyperthyroidism associated with a high mortality rate. Heart failure is considered the leading cause of mortality in patients with thyroid storm, though the underlying cardiac pathology is unclear. Approximately 6% of patients with thyroid storm have heart failure symptoms as the initial presenting complaint. Read More

World J Surg 2019 12;43(12):3051-3058

Endocrine Surgery Unit, Sheffield Teaching Hospitals NHS Foundation Trust, F8, Ward F2, Royal Hallamshire Hospital, Beech Hill Road, Sheffield, S10 2JF, UK.

Background: Surgery for Graves' disease (GD) is usually performed after adequate control with medical treatment. Occasionally, rapid pre-operative optimization is required. The primary objective was to compare the outcomes of patients undergoing elective surgery for well-controlled GD with those undergoing rapid pre-operative treatment. Read More