Radiocontrast-Induced Thyroid Storm

Thumma, Soumya; Manchala, Venkata; Mattana, Joseph

doi:10.1097/mjt.0000000000000844

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Eventually, the patient was diagnosed with thyroid storm [ 7 ]. Furthermore, it is possible that the patient was already in a state of thyroid storm since admission, and this state may have been exacerbated by the use of iodine contrast medium and surgical invasion [ 14 ]. However, since the results of the patient’s thyroid hormone tests were unavailable when a contrast-enhanced CT was performed on the first visit, we believe that contrast-enhanced evaluation was unavoidable.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment approaches for simultaneous onset of subarachnoid hemorrhage and thyroid storm: a case report

et al. 2023

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Background Subarachnoid hemorrhage and thyroid storm are similar in their clinical symptomatology, and diagnosis of these conditions, when they occur simultaneously, is difficult. Here, we report a rare case of concurrent subarachnoid hemorrhage and thyroid storm we encountered at our hospital. Case presentation The patient was a 52-year-old woman. While bathing at home, the patient experienced a sudden disturbance of consciousness and was brought to our hospital. The main physical findings upon admittance were Glasgow Coma Scale score of E1V2M4, elevated blood pressure (208/145 mmHg), and tachycardia with atrial fibrillation (180 bpm) along with body temperature of 36.1 °C. Brain computed tomography revealed subarachnoid hemorrhage associated with a ruptured aneurysm of the posterior communicating artery branching from the left internal carotid artery, and aneurysm clipping was performed. Blood tests upon admission revealed high levels of free T3 and free T4 and low levels of thyroid-stimulating hormone. Upon determining that the patient had hyperthyroidism, thiamazole was administered. However, due to continuous impaired consciousness, fever, and persistence of tachycardia, the patient was diagnosed with thyroid storm. Oral potassium iodide and hydrocortisone were added to the treatment. The treatment was successful as the patient’s symptoms improved, and she became lucid. In this case, we believe that in the presence of untreated hyperthyroidism, the onset of subarachnoid hemorrhage induced thyroid storm. Tachycardia of 130 bpm or higher, which is the diagnostic criterion for thyroid storm, rarely occurs with subarachnoid hemorrhage. Therefore, we believe it is an important factor for recognizing the presence of the thyroid storm. In this case, clipping surgery was prioritized which resulted in a favorable outcome. However, it is possible that invasive surgery may have exacerbated thyroid storm, suggesting that treatment should be tailored as per patient’s condition. Conclusion If a pulse rate of 130 bpm or higher is observed alongside subarachnoid hemorrhage, we recommend considering the possibility of concomitant thyroid storm and testing for thyroid hormone. If concomitant thyroid storm is present, we believe that a treatment plan tailored to the patient’s condition is critical, and early diagnosis will lead to a favorable outcome for the patient.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment approaches for simultaneous onset of subarachnoid hemorrhage and thyroid storm: a case report

et al. 2023

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“…Untreated and uncontrolled hyperthyroidism is a major risk factor for the development of thyroid storm during pregnancy [ 4 ]. Similarly to the general population, thyroid storm in pregnancy can be precipitated by acute stressors such as infection, surgery, trauma, burns, hypoglycemia/diabetic ketoacidosis, and drugs/toxins (amiodarone, chemotherapy, aspirin toxicity, organophosphates or iodinated contrast) [ 22 – 26 ], but it can also be precipitated by pregnancy-associated conditions (anemia, pre-eclampsia, placenta previa, induction of labor/C-section, chorioamnionitis etc.) [ 4 , 27 – 30 ].…”

Section: Causes and Risk Factorsmentioning

confidence: 99%

“…Propranolol is a non-selective beta blocker which can be given enterally (60–80 mg every 4-6 h) or intravenously (1 mg over 10 min IV) if cardiac dysfunction is considered highly unlikely. It is recommended by the American Thyroid Association because at high doses it also inhibits peripheral conversion of T4 to T3 through inhibition of type 1 deiodinase [ 22 , 37 ]. However, it has a duration of action of 6-12 h and has been associated with circulatory collapse [ 53 , 54 ].…”

Section: Managementmentioning

confidence: 99%

Thyroid storm in pregnancy: a review

Vadini,

Vasistha,

Shalit

et al. 2024

Thyroid Res

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Background Thyroid storm is a state of circulating thyroid hormone excess leading to multiorgan dysfunction and systemic decompensation. It typically occurs in the setting of poorly controlled hyperthyroidism and a precipitating illness or event. Management of thyroid storm in pregnancy poses unique diagnostic and therapeutic challenges. Main body Thyroid storm is a clinical diagnosis characterized by hyperpyrexia, tachyarrhythmias, congestive heart failure, gastrointestinal and neuropsychiatric disturbances. However, diagnostic scoring systems have not been validated in pregnancy. Treatment involves specialist consultation, supportive care, and pharmacological options such as anti-thyroid medications, beta blockers, iodine solutions, glucocorticoids, and cholestyramine. These must be adapted and modified in pregnancy to prevent fetal and maternal complications. Conclusion There is a critical need to recognize thyroid storm during pregnancy and initiate proper medical interventions promptly.

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Multiple drugs

2020

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Radiocontrast-Induced Thyroid Storm

Cited by 4 publications

References 5 publications

Diagnosis and treatment approaches for simultaneous onset of subarachnoid hemorrhage and thyroid storm: a case report

Diagnosis and treatment approaches for simultaneous onset of subarachnoid hemorrhage and thyroid storm: a case report

Thyroid storm in pregnancy: a review

Multiple drugs

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