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[Post-traumatic hyperthyroxinemia or hyperthyroidism].

J F Doussin, J Dubost, V Banssillon

    Annales Francaises D'Anesthesie Et De Reanimation
    |January 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

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    Severe trauma can trigger post-traumatic hyperthyroidism, a rare condition. This case highlights a late T4 increase after initial stabilization, emphasizing the need for vigilance in trauma patients.

    Area of Science:

    • Endocrinology
    • Trauma Surgery
    • Critical Care Medicine

    Background:

    • Road traffic accidents can cause severe trauma, leading to complex medical complications.
    • Fat embolism, adult respiratory distress syndrome (ARDS), and disseminated intravascular coagulation (DIC) are known severe complications of major trauma.
    • Post-traumatic endocrine dysfunction, particularly thyroid hormone alterations, can occur but is not well-documented.

    Observation:

    • A 15-year-old female sustained multiple fractures from a road traffic accident.
    • She developed fat embolism, ARDS, and DIC, requiring intensive therapy.
    • Following initial recovery, she presented with persistent tachycardia, fever, exophthalmos, and a thyroid murmur, suggestive of hyperthyroidism.

    Findings:

    • Elevated serum T4 (204 nmol/L) with normal T3 levels was observed.

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  • Clinical symptoms and T4 levels normalized after treatment with carbimazole and acebutolol.
  • Literature review indicated that while post-traumatic hyperthyroidism is known, a late increase in T4 is a rare occurrence, contrasting with the usual early fall in thyroid hormones after trauma.

    • Implications:

    • This case underscores the importance of considering post-traumatic hyperthyroidism in trauma patients with persistent unexplained symptoms.
    • Early recognition and appropriate management of this rare syndrome are crucial for patient recovery.
    • Further research into the mechanisms and incidence of late-onset post-traumatic thyroid dysfunction is warranted.