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Percutaneous Hepatic Perfusion PHP with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

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Doble sistema de adsorción molecular de plasma combinado con plasmaféresis tratado con éxito una tormenta tiroidea y

Jiali Liu¹, Weiwei Zhang²

¹Internal Medicine Nursing Teaching and Research Department, Chongqing Medical and Pharmaceutical College, Chongqing, China.

|December 23, 2025

Abstracto

Rationale:

Graves' disease is the most common cause of hyperthyroidism, and antithyroid drugs are the main treatment, but they have the side effect of liver injury. Uncontrolled hyperthyroidism can trigger a life-threatening thyroid storm.

Patients Concerns:

A 15-year-old girl developed severe liver injury and mononucleosis caused by Epstein-Barr virus infection after methimazole treatment, which eventually induced thyroid storm.

Diagnoses:

Graves' disease, liver injury, mononucleosis, Epstein-Barr virus infection, thyroid storm.

Interventions:

Conventional medical treatment was ineffective, and the patient finally received the double plasma molecular adsorption system (DPMAS) combined with plasma exchange therapy and radioactive iodine treatment.

Outcomes:

The patient's critical condition was relieved after 2 courses of DPMAS combined with plasma exchange therapy, and hyperthyroidism was controlled after radioactive iodine treatment.

Lessons:

DPMAS combined with plasma exchange therapy is effective in controlling thyroid storm with severe liver injury. It is also important for such patients to choose the appropriate time for radioactive iodine therapy.

Palabras clave:

DPMAS Enfermedad de Graves lesión hepática plasmaféresis tratamiento con yodo radiactivo

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