Acute pericarditis: a rare complication of Graves' thyrotoxicosis?

Tsai, Min‐Shan; Yang, Chih‐Wei; Chi, Chun-Lin; Hsieh, Cheng-Chun; Chen, Wen‐Jone

doi:10.1016/j.ajem.2005.10.020

Cited by 17 publications

(13 citation statements)

References 6 publications

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“…Clarke et al 3 postulated for the first time a similar pathophysiological background of both diseases related to inflammation. At last, Tsai et al 4 and Koo et al 5 also described cases of (recurrent) pericarditis considered to be associated with Graves’ disease. The pathophysiology of acute pericarditis remains controversial: infections, autoimmune and autoinflammatory pathways are often mentioned.…”

Section: Discussionmentioning

confidence: 99%

Graves’ disease as an uncommon cause of acute pericarditis

et al. 2014

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Acute pericarditis is either dry, fibrinous or effusive, independent of its aetiology. A case is presented involving a 44-year-old man with acute pericarditis. The cause was established to be an aggravation of Graves' disease due to non-compliance with treatment. Pericarditis is an uncommon cardiac complication of Graves' disease and is associated with more recurrent episodes when not detected. Pharmacological treatment should include anti-inflammatory drugs in combination with treatment for hyperthyroidism. The specific pathophysiological link between the two conditions is still to be elucidated.

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Section: Discussionmentioning

confidence: 99%

Graves’ disease as an uncommon cause of acute pericarditis

et al. 2014

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“…Although 1 case was attributed to antithyroid medications, especially propylthiouracil, 1 most reported cases have occurred in individuals who were poorly adherent to treatment of known thyroid disease or who were previously unknown to be hyperthyroid. Antineutrophil cytoplasmic antibodies 1 and rheumatoid factor antibodies 8 have also been implicated in the development of pericarditis in previously published reports. Pericardial disease occurs similarly to other complications of Graves disease, such as pretibial myxedema or ophthalmic myopathy 2 ; however, most cases indicate resolution of pericarditis after initiation of appropriate treatment, in contrast to pretibial myxedema and ophthalmopathy, which generally persist despite treatment.…”

Section: Pathophysiologymentioning

confidence: 94%

“…Several authors have reported pericarditis in younger or middle-aged adults. 2,3,7,8 Three patients aged between 25 and 37 years were considered to have simultaneous Graves disease and pericarditis. 2,7,8 To date, no report has documented the association between pericarditis and Graves disease in an adolescent patient.…”

Section: Cardiac Manifestations Of Thyrotoxicosismentioning

confidence: 99%

Pericarditis as the Presenting Feature of Graves Disease in a Pediatric Patient

et al. 2017

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Pericarditis is a rare presentation of thyrotoxicosis associated with Graves disease. This association has not been previously described in the pediatric literature. We report a 17-year-old male patient who presented with chest pain, dyspnea, and tachycardia. He was found to have diffuse ST-segment elevation consistent with pericarditis. At presentation, he was noted to have bilateral proptosis. Abnormal thyroid function studies and an elevated thyroid-stimulating hormone receptor antibody level confirmed the diagnosis of Graves thyrotoxicosis. The patient was treated with anti-inflammatory and antithyroid agents and improved in time. We discuss previously reported cases of Graves disease-associated pericarditis in adults, potential etiologies, and management strategies.

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“…This differs from our patient in that he had negative antithyroid peroxidase antibodies and an exogenous source of thyrotoxicosis. Another case report described thyroid storm and acute pericarditis in a patient with antibodypositive Graves disease (14).…”

Section: Discussionmentioning

confidence: 99%

A Unique Presentation Of Thyroid Storm And Myopericarditis In A Young Muscular Man

Mathew

Rodriguez

Lawrence

et al. 2017

AACE Clinical Case Reports

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Objective: Thyroid storm represents the extreme manifestation of thyrotoxicosis and is a medical emergency with a high mortality rate. The clinical manifestations of a severely thyrotoxic state can be devastating, and its most significant effects occur in the cardiovascular system. Cardiac involvement is the leading cause of death in patients with thyroid storm. We report a unique case of thyroid storm precipitated by viral myopericarditis in the setting of exogenous thyroid hormone supplementation.Methods: Case report and review of the literature. Results:We report a case of a previously healthy 26-year-old male with a history of bodybuilding who developed thyroid storm with multi-organ failure, including acute-onset congestive heart failure, leading to cardiogenic shock. Investigations revealed ingestion of exogenous thyroid hormone as the source of his thyrotoxicosis. Initial labs revealed serum thyroid-stimulating hormone 0.015 mU/L, free thyroxine 2.3 ng/dL, free triiodothyronine 8.8 pg/mL, total triiodothyronine of 2.22 ng/ mL, and thyroglobulin 4.4 ng/mL. There was also evidence of viral myopericarditis, as demonstrated on cardiac imaging and multiple elevated Coxsackie virus B titer levels. Conclusion:Given the patient's underlying thyrotoxic state from exogenous thyroid hormone ingestion, we believe that his acute myopericarditis was the catalyst that precipitated his thyroid storm. The combination of acute myopericarditis and thyroid storm ultimately led to cardiogenic shock. He showed rapid improvement with cardiopulmonary supportive efforts and treatment for thyroid storm. In considering the etiology of thyroid storm, it is important to exclude the possibility of exogenous thyroid hormone ingestion, especially in the setting of nonregulated, over-the-counter, bodybuilding, or weight-loss supplement use. (AACE Clinical Case Rep. 2017;3:e74-e78) Abbreviations: MRI = magnetic resonance imaging; SSKI = supersaturated potassium iodide; T3 = triiodothyronine; T4 = thyroxine INTRODUCTION

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Acute pericarditis: a rare complication of Graves' thyrotoxicosis?

Cited by 17 publications

References 6 publications

Graves’ disease as an uncommon cause of acute pericarditis

Graves’ disease as an uncommon cause of acute pericarditis

Pericarditis as the Presenting Feature of Graves Disease in a Pediatric Patient

A Unique Presentation Of Thyroid Storm And Myopericarditis In A Young Muscular Man

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