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Related Concept Videos

Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

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Hyperglycemic Clamp and Hypoglycemic Clamp in Conscious Mice
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Severe hypoglycemia accompanied with thyroid crisis.

Yuki Nakatani1, Tsuyoshi Monden, Minoru Sato

  • 1Department of Endocrinology and Metabolism, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan ; Department of Diabetes & Endocrinology, Dokkyo Medical University Nikko Medical Center, 632 Takatoku, Nikko-shi, Tochigi 321-2593, Japan.

Case Reports in Endocrinology
|December 1, 2012
PubMed
Summary

A Japanese woman experienced severe hypoglycemia and thyroid crisis, leading to cardiopulmonary arrest. Prompt treatment with glucose, hydrocortisone, diuretics, and continuous hemodiafiltration (CHDF) proved life-saving, highlighting the link between thyroid crisis and critical metabolic derangements.

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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
04:39

Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model

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Area of Science:

  • Endocrinology
  • Cardiology
  • Nephrology

Background:

  • Thyroid crisis, a life-threatening condition, can manifest with diverse and severe systemic complications.
  • Co-existing heart failure and liver dysfunction can exacerbate metabolic derangements during thyroid crisis.

Purpose of the Study:

  • To report a rare case of severe hypoglycemia in the context of a thyroid crisis with concurrent heart failure and liver dysfunction.
  • To highlight the critical management of this complex clinical scenario.

Main Methods:

  • Case report detailing a 32-year-old Japanese woman with hyperthyroidism.
  • Inclusion of clinical presentation, diagnostic findings (including severe hypoglycemia), and interventions.
  • Description of intensive care unit management including continuous hemodiafiltration (CHDF).

Main Results:

  • The patient presented with symptoms of hyperthyroidism, dyspnea, fatigue, and leg edema, indicative of congestive heart failure and liver dysfunction.
  • A critical event of cardiopulmonary arrest occurred, with a recorded serum glucose level of 7 mg/dL.
  • Intravenous glucose, hydrocortisone, diuretics, and CHDF were crucial in stabilizing the patient.

Conclusions:

  • Severe hypoglycemia can be a critical complication of thyroid crisis, particularly when associated with heart failure and liver dysfunction.
  • Multimodal intensive care, including fluid management, metabolic support, and renal replacement therapy (CHDF), is essential for survival in such complex cases.
  • This case underscores the importance of recognizing and aggressively managing metabolic disturbances in thyroid crisis.