Postoperative thyreotoxische Krisen nach schilddr�senfernen Eingriffen

Keminger, K; Piribauer, J.

doi:10.1007/bf01440573

Cited by 5 publications

(2 citation statements)

References 5 publications

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“…Surgical stress precipitated TS in two patients only; one of them undergoing thyroidectomy for Graves’ disease and the other a non-thyroid surgery. Another study in 1958 reported five instances of postoperative thyroid storm among 16,450 surgeries performed over a period of 12 years [ 17 ]. In a more recent Japanese nationwide survey, non-thyroid surgeries were reported as the trigger in eight (2.2%) of 356 patients with TS studied between 2004 and 2008 [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Thyroid Storm Following Thymectomy: A Surprising Result of Undiagnosed Graves’ Disease

Shoja

Lopez

Okereke

2018

Cureus

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Postoperative thyroid storm represents a diagnostic dilemma in patients with overlooked hyperthyroid state undergoing a nonthyroid surgery. We report a 30-year-old female with a history of mixed connective tissue disease who presented with an anterior mediastinal mass and underwent a thoracoscopic resection of the mass. On postoperative day 1, she had an acute change in mental status with fever, tachycardia and hypercapnic respiratory failure requiring intubation and mechanical ventilation. An elevated free thyroxine concentration and almost undetectable serum thyroid stimulating hormone suggested thyroid storm as the culprit. The patient was rendered euthyroid after initiation of therapy with propylthiouracil/methimazole, potassium iodide oral solution and systemic steroid. Histopathology of the resected anterior mediastinal mass showed thymic hyperplasia. In retrospect, the patient had hyperthyroid symptoms before surgery, but this diagnosis was overlooked.Non-thyroid surgeries can trigger thyroid storm in the setting of poorly controlled or overlooked hyperthyroidism. Although uncommon, thyroid storm should be considered in differential diagnosis of perioperative tachycardia and respiratory failure. We emphasize on the importance of preoperative thyroid workup in patients with tachycardia, palpitation, labile blood pressure, unexplained weight changes or poorly controlled anxiety. The significance of a proper preoperative assessment cannot be overestimated.

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Section: Discussionmentioning

confidence: 99%

Acute Thyroid Storm Following Thymectomy: A Surprising Result of Undiagnosed Graves’ Disease

Shoja

Lopez

Okereke

2018

Cureus

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“…This confirms Dent's (1966) statement: 'The parathyroid gland appears to offer a unique opportunity for the study of tumour formation mechanisms, all stages from normal, through hyperplasia, to adenoma and finally cancer being readily available.' In some cases the recurrence stems from parts of the original benign tumour, intentionally or inadvertently left behind (Burk, 1947;Black and Ackerman, 1950;Keminger, 1964). It is regrettable that only a few authors describe the condition of the parathyroid glands not removed at operation (Greenfield et al, 1959;Haff et al, 1971 ;Clark and Taylor, 1972;Doury et al, 1973).…”

Section: Observationsmentioning

confidence: 99%

True recurrence of hyperparathyroidism: Proposed criteria of recurrence

Müller

1975

Journal of British Surgery

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Although recurrent hyperparathyroidism should not be rare on theoretical grounds, only a few cases of proved recurrence have been reported in the literature. In the present author's series only 4 patients (1 per cent) had true recurrence. Criteria for recurrence were: 1. Histological identification by biopsy and frozen section of all the parathyroid glands at the first operation. 2. Complete removal of the enlarged gland(s). 3. A normocalcaemic period of at least 1 year. 4. The finding of a tumour at the site of a previously normal-sized gland. The low incidence of recurrent hyperparathyroidism might be explained by the long period of time needed for the recurrence to develop. However, since diagnosis of hyperparathyroidism is now more easily made and patients are treated surgically earlier in the course of the disease, the incidence of true recurrence might be expected to rise. A meticulous exploration during operation and careful follow-up of the patients are therefore required.

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Operation schwerster Hyperthyreosen unter Verwendung von „Beta-Receptoren-blockierenden Pharmaka“

Keminger¹

1972

Anaesthesiology and Resuscitation / Anaesthesiologie Und Wiederbelebung / Anesthésiologie Et Réanimation

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Postoperative thyreotoxische Krisen nach schilddr�senfernen Eingriffen

Cited by 5 publications

References 5 publications

Acute Thyroid Storm Following Thymectomy: A Surprising Result of Undiagnosed Graves’ Disease

Acute Thyroid Storm Following Thymectomy: A Surprising Result of Undiagnosed Graves’ Disease

True recurrence of hyperparathyroidism: Proposed criteria of recurrence

Operation schwerster Hyperthyreosen unter Verwendung von „Beta-Receptoren-blockierenden Pharmaka“

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