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Thyroid storm-induced multiple organ failure relieved quickly by plasma exchange therapy
Toshiharu Kokuho1, Tadashi Kuji, Gen Yasuda
1Second Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama, Japan. tkokuho@r3.dion.ne.jp
Summary
Plasma exchange rapidly improved a patient with thyroid storm and cerebral infarction. This treatment offers a faster solution than conventional drugs for severe thyroid storm cases.
Area of Science:
- Endocrinology
- Neurology
- Critical Care Medicine
Background:
- Thyroid storm is a life-threatening endocrine emergency.
- Cerebral infarction can precipitate or exacerbate thyroid storm.
- Conventional treatments may have limitations in rapidly controlling severe cases.
Observation:
- A 54-year-old female presented with tachycardia, fever, pulmonary congestion, hemiparalysis, and dysarthria.
- Elevated serum thyroid hormone levels and CT confirmed cerebral infarction, suggesting it precipitated the thyroid storm.
- Initial conventional therapy over 24 hours showed limited improvement.
Findings:
- Plasma exchange using fresh frozen plasma was initiated.
- The patient experienced rapid improvement in her critical condition following plasma exchange.
- This suggests plasma exchange effectively removed excess thyroid hormones.
Implications:
- Plasma exchange, combined with conventional therapy, can be a life-saving intervention for thyroid storm.
- It offers a rapid method to reduce high thyroid hormone levels, especially when precipitated by events like cerebral infarction.
- This case highlights the potential of plasma exchange in managing severe, complex endocrine emergencies.