Thyrotoxicosis factitia in a post-aortocoronary bypass patient

Redahan, C

doi:10.1007/bf03010940

Cited by 13 publications

(10 citation statements)

References 7 publications

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“…However, most of these studies proposed the usefulness of betaAAs in general, rather than propranolol specifically [133]. The number of studies that suggest the risks associated with propranolol and the usefulness of esmolol increased after the 1990s [134][135][136][137][138][139]. Esmolol has several potential advantages over propranolol in thyroid storm.…”

mentioning

confidence: 99%

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

et al. 2016

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confidence: 99%

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

et al. 2016

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“…Furthermore, in our case thyroid storm was suspected because of the hypermetabolic state characterized hemodynamically by tachycardia, a high cardiac output, and systemic vasodilation, requiring norepinephrine therapy. [1][2][3] These features probably contributed to our patient's postoperative hemodynamic instability, because thyroid suppression therapy restored hemodynamic stability within 48 hours.…”

Section: Discussionmentioning

confidence: 89%

“…Thyroid storm is a rare but life-threatening complication of thyrotoxicosis that in this case was precipitated by cardiac surgery. [1][2][3] Thyroid storm is characterized by fever, altered mental status, gastrointestinal dysfunction, tachycardia, and high-output cardiac failure. [1][2][3] In this report, we have described a case of thyroid storm after CABG in a 45-year-old female patient with no known history of either thyroid or coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

“…At this point, b-blockade was not commenced because the patient was still vasopressor dependent. 2 A significant hemodynamic response to thyroid suppression therapy was evident within 48 hours, as outlined in Table 1. The patient had strongly positive test results for antibodies to thyroid peroxidase and the thyroid-stimulating hormone receptor.…”

Section: Clinical Summarymentioning

confidence: 97%

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Thyroid storm after coronary artery bypass grafting

Bish

Bavaria

Augoustides

2010

The Journal of Thoracic and Cardiovascular Surgery

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We describe a 45-year-old woman with thyroid storm developing after urgent coronary artery bypass grafting (CABG). The hallmark clinical features included fever, tachycardia, depressed mental status, and jaundice. Thyroid testing confirmed severe hyperthyroidism caused by Graves disease. The patient was rendered euthyroid after initiation of therapy with methimazole (INN, thiamazole), potassium iodide, and hydrocortisone.

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“…There are several reports of cases of life-threatening thyrotoxicosis during anesthesia that have mimicked malignant hyperthermia [9][10][11][12][13][14][15][16]. After the introduction of antithyroid drugs, however, the incidence of perioperative thyroid crises was reduced.…”

Section: Discussionmentioning

confidence: 99%

Malignant Hyperthermia in a Patient with Graves' Disease during Subtotal Thyroidectomy.

et al. 2001

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Abstract.We report the case of a 31-year-old man with Graves' disease who manifested malignant hyperthermia during subtotal thyroidectomy. His past medical history and family history were unremarkable. Before surgery, his condition was well controlled with propylthiouracil, ,l-adrenergic blocker and iodine. During the operation, anesthesia was induced by intravenous injection of vecuronium and thiopental, followed by suxamethonium for endotracheal intubation.Anesthesia was maintained with nitrous oxide and sevoflurane. One hour after induction of anesthesia, his end tidal carbon dioxide concentration (ETC02) increased from 40 to 50 mmHg, heart rate increased from 90 to 100 beats per min and body temperature began to rise at a rate of 0.3°C per 15 min. Suspecting thyroid storm, propranolol 0.4 mg and methylprednisolone 1,500 mg were administered, which, however, had little effect. Despite the lack of muscular rigidity, the diagnosis of malignant hyperthermia was made based on respiratory acidosis. Sevoflurane was discontinued and dantrolene was given by intravenous bolus. Soon after the treatment, ETC02, heart rate and body temperature started to fall to normal levels. His laboratory findings showed abnormally elevated serum creatine phosphokinase and myoglobin but normal thyroid hormone levels. Since dantrolene is efficacious in thyrotoxic crisis and malignant hyperthermia, an immediate intravenous administration of dantrolene should be considered when a hypermetabolic state occurs during anesthesia in surgical treatment for a patient with Graves' disease.

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Thyrotoxicosis factitia in a post-aortocoronary bypass patient

Cited by 13 publications

References 7 publications

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

Thyroid storm after coronary artery bypass grafting

Malignant Hyperthermia in a Patient with Graves' Disease during Subtotal Thyroidectomy.

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