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Results for “THYROID CRISIS”

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At least 19 recordsLinked to original sources

Utility of esmolol in thyroid crisis.

Thyroid storm is an uncommon but potentially life-threatening manifestation of hyperthyroidism. Mortality can be 30-60% in hospitalized patients unless appropriately treated by combined therapy. We report a case of a 25-year-old African American woman with past medical history of Graves disease and moderately persistent asthma who presented to the emergency department with signs and symptoms of thyrotoxic crisis. Therapy instituted and included the use of an esmolol infusion for control of hypersympathetic activity. A review of the clinical presentation, diagnosis, and management of thyrotoxic crisis is presented along with a discussion on the choice of beta blockade therapy.

Adrenergic beta-Antagonists↗

Differential diagnosis of thyroid crisis and malignant hyperthermia in an anesthetized porcine model.

The intra-operative differential diagnosis between thyroid crisis and malignant hyperthermia can be difficult. Also stress alone can trigger MH. The purposes of this study were: 1) to investigate the metabolic and hemodynamic differences between thyroid crisis and MH, 2) determine how thyroid crisis affects the development of MH, and 3) determine if the stress of thyroid crisis can trigger MH in susceptible individuals. We studied MH susceptible and normal swine. Two groups of animals (MH susceptible and normal) were induced into thyroid crisis (critical core hyperthermia, sustained tachycardia and increase in oxygen consumption) by pretreatment with intraperitoneal triiodothyronine (T3) followed by large hourly intravenous injections of T3. Two similar groups were given intravenous T3 but no pretreatment. These animals did not develop thyroid crisis and served as controls. Thyroid crisis did not result in metabolic changes or rigidity characteristic of an acute episode of MH. When the animals were subsequently challenged with MH triggering agents (halothane plus succinylcholine) dramatic manifestations of fulminant MH episodes (acute serious elevation in exhaled carbon dioxide, arterial CO2, rigidity and acidemia) were noted only in the MH susceptible animals. Although thyroid crisis did not trigger MH in the susceptible animals it did decrease the time to trigger MH (14.1 +/- 7.2 minutes versus 47.2 +/- 17.7 minutes, p < 0.01) in susceptible animals. Hormone induced elevations in temperature and possibly other unidentified factors during thyroid crisis may facilitate the triggering of MH following halothane and succinylcholine challenge.

Animals↗

Acute thyroid crisis on induction of anaesthesia.

Thyroid crisis on induction of anaesthesia was treated with dantrolene, because of a mistaken diagnosis of malignant hyperthermia. There was immediate improvement after dantrolene with reduction in muscle rigidity, mental confusion and pyrexia. High circulating T4 has an effect on calcium flux across the sarcoplasmic reticulum and dantrolene may inhibit this pathological mechanism. We suggest the same dosage regimen as is used in the treatment of malignant hyperthermia.

Acute Disease↗

[A case report of postoperative thyroid crisis accompanied with struma ovarii].

A 39-year-old female without any specific past history was scheduled to receive an operation for myoma uteri and ovarian cyst. She was premedicated with atropine. Anesthesia was induced with thiopental and was maintained with nitrous oxide and enflurane. Tachycardia shortly after premedication with atropine and remarkable sweat during the operation were observed. On the 1st postoperative day an outbreak of thyroid crisis as well tachycardia of 180.min-1 and fever (39.3 degrees C) were observed. Such outbreak of thyroid crisis indicated that the patient had been suffering from Grave disease. Pathological diagnosis of extirpated ovarian cyst was struma ovarii. It is, however, still uncertain whether struma ovarii induced thyroid crisis in this case. It might be concluded that screening of hyperthyroidism at preoperative rounds is essential for prevention of thyroid crisis.

Adult↗

Rhabdomyolysis accompanying thyroid crisis: an autopsy case report.

Rhabdomyolysis is occasionally associated with metabolic disorders such as diabetic coma, severe electrolyte disturbances and myxedema coma. We describe rhabdomyolysis accompanying thyroid crisis. A 50-year-old man with Graves' disease developed rhabdomyolysis, congestive heart failure and hepatic failure during the course of thyroid crisis and then died of acute renal failure. Postmortem examination revealed rhabdomyolysis in the cardiac and psoas muscles, old myocardial infarction, hepatic centrilobular necrosis, renal cortical necrosis, and follicular hyperplasia in the thyroid. Circulatory collapse and dehydration under excessive hypermetabolic state presumably suppressed the source of energy and oxygen for muscle cells, leading to cellular damage.

Adrenal Cortex Hormones↗

Thyroid crisis presenting as coma.

Coma is a rare complication of thyrotoxicosis. A patient with coma due to a thyroid crisis is reported. The EEG showed extremely slow and low voltage activity, which gradually returned to normal. Coma as a presenting symptom of thyroid crisis has not been reported before.

Adult↗

Thyroid crisis associated with severe hypocalcemia.

A 30-year-old woman with thyroid crisis and impaired renal function presented with severe hypocalcemia. She had already had hypocalcemia one yr previously when her serum creatinine level was normal. A normal level of serum amino terminal fragment of parathyroid hormone in spite of severe hypocalcemia suggested impairment of parathyroid function. Since her serum magnesium was normal and she had no history of neck surgery or radioiodine therapy, her hypoparathyroidism was considered to be idiopathic. This is the seventh case with co-existing Graves' disease and idiopathic hypoparathyroidism reported in the literature.

Adult↗

[Thyroid crisis diagnosed on the basis of anatomic-pathologic examination].

Graves-Basedow disease is the most common cause of hyperthyroidism. Rhabdomyolysis is occasionally associated with metabolic coma or severe electrolyte disturbances. We describe rhabdomyolysis accompany ing thyroid crisis. A 48-years old man admitted with hypovolemic shock developed rhabdomyolysis, congestive heart failure, hepatic failure and renal failure and then died. It is interesting that correct diagnosis was done on the basis of microscopic examination of specimens of the thyroid gland.

Fatal Outcome↗

Thyroid crisis.

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Humans↗