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Related Experiment Video

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Thyroid storm: Is there a role for thyroid function test?

T Z Tengku Ibrahim¹, S C Thambiah, I N Samsudin

¹Universiti Putra Malaysia, Faculty of Medicine & Health Sciences, Department of Pathology, Serdang, Malaysia. subashini@upm.edu.my.

The Malaysian Journal of Pathology

|January 6, 2020

Summary

Thyroid storm (TS) is a critical endocrine emergency. Plasmapheresis may improve thyroid function tests in TS, but prompt initiation is crucial for patient survival.

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Area of Science:

Endocrinology
Critical Care Medicine

Background:

Thyroid storm (TS) is a life-threatening endocrine emergency requiring prompt diagnosis and treatment.
High mortality rates associated with TS underscore the need for effective therapeutic interventions.

Observation:

A patient with hyperthyroidism, dilated cardiomyopathy, and mitral regurgitation presented with respiratory distress and declining consciousness.
Initial management did not yield improvement, necessitating the initiation of plasmapheresis on day 4.

Findings:

Biochemical thyroid function tests (TFTs) demonstrated improvement following plasmapheresis.
Despite biochemical improvements, the patient ultimately succumbed to multi-organ failure.

Implications:

Plasmapheresis is a potential treatment for TS when initial therapies fail, particularly if initiated within 24-48 hours.
Hemodynamic instability can delay plasmapheresis, highlighting the importance of careful patient selection and management.
This case emphasizes the critical nature of TS and the challenges in managing severe cases, even with advanced interventions.