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Acute thyroid crisis on induction of anaesthesia
1London Hospital, Whitechapel.
Anaesthesia
|January 1, 1989
Summary
Dantrolene effectively treated thyroid crisis during anesthesia induction, mistakenly diagnosed as malignant hyperthermia. This suggests dantrolene may counteract thyroid storm's pathological mechanisms by affecting calcium flux.
Area of Science:
- Anesthesiology
- Endocrinology
- Pharmacology
Background:
- Thyroid crisis, a life-threatening condition, can manifest during anesthesia induction.
- Malignant hyperthermia is a rare pharmacogenetic disorder of skeletal muscle.
Observation:
- A patient experiencing thyroid crisis under anesthesia was mistakenly treated for malignant hyperthermia with dantrolene.
- Immediate improvement was observed, including reduced muscle rigidity, mental confusion, and fever.
Findings:
- Dantrolene administration led to rapid amelioration of thyroid crisis symptoms.
- High circulating thyroxine (T4) may impact calcium flux in the sarcoplasmic reticulum, a pathway potentially inhibited by dantrolene.
Implications:
- Dantrolene may represent a viable therapeutic option for managing thyroid crisis during anesthesia.
- The findings suggest a shared pathophysiological mechanism involving calcium flux between thyroid crisis and malignant hyperthermia.
- Further research is warranted to confirm dantrolene's efficacy and optimal dosage for thyroid crisis treatment.