Subacute thyroiditis causing thyrotoxic crisis; a case report with literature review

Salih, Abdulwahid M.; Kakamad, Fahmi H.; Rawezh, Q.S.; Masrur, S.A.; Shvan, H. Mohammed; Hawbash, M.R.; Lhun, T.H.

doi:10.1016/j.ijscr.2017.02.041

Cited by 11 publications

(9 citation statements)

References 11 publications

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“…Otra de las causas más importantes es la tiroiditis, la cual puede ser aguda, subaguda, postparto o por fármacos. Descrita por primera vez por el Dr. Fritz de Quervain en 1902 (5), la tiroiditis subaguda es una enfermedad inflamatoria autolimitada, con incidencia de 4,9 casos por cada 100 000 personas al año (6). Se presenta clásicamente con dolor en la parte anterior del cuello, siendo este su hallazgo clínico más característico, que puede ser unilateral o bilateral y frecuentemente irradia a oídos o mandíbula, tal como sucedió en el paciente del presente caso, lo cual colocó la tiroiditis subaguda de Quervain como principal diagnóstico diferencial.…”

Section: Discussionunclassified

Tirotoxicosis transitoria por tiroiditis subaguda (de Quervain): reporte de caso

2022

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La tiroiditis subaguda o de Quervain, es una entidad inflamatoria de la tiroides que se caracteriza por su curso trifásico que incluye una fase de liberación excesiva de hormona tiroidea. Esta entidad suele tener un curso autolimitado y su manejo es principalmente sintomático. En este artículo se presenta el caso de un paciente masculino de 32 años de edad sin antecedentes personales patológicos, con un cuadro de 10 días de evolución de dolor en cuello anterior y síntomas compatibles con tirotoxicosis. Posteriormente, se confirmó la elevación de niveles de hormona tiroidea en sangre y se decidió manejo conservador con tratamiento sintomático. A los 12 meses de seguimiento el paciente se presenta con función tiroidea normal y completa resolución de los síntomas.

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Section: Discussionunclassified

Tirotoxicosis transitoria por tiroiditis subaguda (de Quervain): reporte de caso

2022

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“…38,53 These factors aggravate the underlying abnormal glucose metabolism and intensify insulin deficiency, which in this case served as a trigger for the onset of DKA. It has been reported that the identification of TS tends to be delayed in patients with DKA because of suppression by fever 13,44,45 and relatively low thyroid hormone levels. 40,56 Our patient presented a high fever even after DKA was corrected, and this clinical presentation might delay the diagnosis of TS.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…11 The literature related to TS was searched from 2016 to 2019, and the clinical characteristics of gastrointestinal symptoms in patients with TS were found to mainly be nausea, and the main cause of TS to be Graves' disease with unknown or poor compliance with anti-thyroid drugs (Table 3). [33][34][35][36][37][38][39][40][41][42][43][44][45][46] Considering that hiccups are not common in either DKA or TS, we speculate that the incidence of intractable hiccups is rare when DKA overlaps with TS. By carefully searching the literature, we found the following related cases.…”

Section: Case Presentationmentioning

confidence: 99%

Intractable hiccups as a rare gastrointestinal manifestation in severe endocrine and metabolic crisis: case report and review of the literature

Jiang

Zhong

et al. 2020

Therapeutic Advances in Endocrinology

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Diabetic ketoacidosis (DKA) and thyroid storm (TS) are severe metabolic and endocrine disorders. Both usually manifest with multiple systemic clinical signs and symptoms, and digestive symptoms, such as nausea and vomiting, are most common in these patients. Moreover, the presence of a concurrent severe or rare complication may worsen the condition or even cause death due to misdiagnosis, delayed diagnosis, or inappropriate treatment. The identification of these symptoms is usually closely related to the severity and prognosis of the disease. Although clinical prognosis might be improved by prompt diagnosis and aggressive treatment, some rare and insidious metabolic complications are difficult to identify early. Moreover, life-threatening gastrointestinal symptoms are very rare in patients with DKA and TS. Here, we report an inpatient diagnosed with DKA and Graves’ disease who developed life-threatening intractable hiccups resulting in TS and respiratory failure during the treatment of DKA. In addition, we review the literature to discuss the possible underlying mechanism of intractable hiccups in the development of TS.

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“…2,3,4 Burch et al introduced the Burch and Wartofsky point scale which assigns a numerical value based on the presence of signs and symptoms. 5 An aggregate score of more than 45 implies thyroid storm and between 25-45 an impending storm. This patient's score was 30 and he was diagnosed with an impending storm on a background of hyperthyroidism as evident by his perioperative biochemical results.…”

Section: Discussionmentioning

confidence: 99%

Delayed recovery from general anaesthesia following thyroidectomy: a "near miss"

DASSANAYAKE

Welikala

Ramasinghe

2020

Sri Lankan J Anaesthesiol

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Thyroid storm is an endocrine emergency which carries a high mortality. The spectrum of emergencies can vary from an impending storm to a thyroid crisis depending upon the degree of systemic decompensation. It is a clinical diagnosis which can be supported by biochemical investigations. In the perioperative setting a multitude of factors can act as potential triggers for a patient to develop a thyroid storm. However subtle signs of an "impending storm" can be masked by other co-morbid factors which befits the phrase "calm before a storm". There are a number of case reports in the literature on delayed recovery in hypothyroid patients undergoing general anaesthesia for various procedures. However, there were no reported cases of delayed recovery among patients with hyperthyroidism following surgery secondary to an impending storm. We report a case of a 48-year old man who underwent a total thyroidectomy combined with a herniorrhaphy and a hydrocelectomy and had a delayed recovery from general anaesthesia due to an impending thyroid storm, which could have resulted in a catastrophic postoperative period.

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Subacute thyroiditis causing thyrotoxic crisis; a case report with literature review

Cited by 11 publications

References 11 publications

Tirotoxicosis transitoria por tiroiditis subaguda (de Quervain): reporte de caso

Tirotoxicosis transitoria por tiroiditis subaguda (de Quervain): reporte de caso

Intractable hiccups as a rare gastrointestinal manifestation in severe endocrine and metabolic crisis: case report and review of the literature

Delayed recovery from general anaesthesia following thyroidectomy: a "near miss"

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