Andrade Luz Ivan, Pereira Tiago, Catorze Nuno
Nephrology, Centro Hospitalar do Médio Tejo EPE, Unidade de Torres Novas, Torres Novas, Santarém, Portugal.
Intensive Care Unit, Centro Hospitalar do Médio Tejo EPE, Unidade de Abrantes, Abrantes, Santarém, Portugal.
BMJ Case Rep. 2018 Dec 14;11(1):e226669. doi: 10.1136/bcr-2018-226669.
Hyperthyroidism is a common metabolic disorder, although its presentation as an endocrine emergency called thyroid storm is rare. Here we review a case of a thyroid storm as the initial presentation of thyrotoxicosis, with multiple organ failure and haemodynamic collapse due to low-output cardiac dysfunction. Quick intervention with aggressive antithyroid therapy, including steroid pulse, and supportive intensive care measures led to an outstanding improvement and full recovery. The present case clearly shows the beneficial impact of initial clinical suspicion resulting in an early diagnosis and intensive therapy. Moreover, it supports the additional role of steroids to aggressive antithyroid strategy in order to control associated deleterious systemic inflammatory reactions.
甲状腺功能亢进症是一种常见的代谢紊乱疾病,尽管其作为一种称为甲状腺危象的内分泌急症表现较为罕见。在此,我们回顾一例以甲状腺危象为甲状腺毒症初始表现的病例,该患者因低输出量心功能不全出现多器官功能衰竭和血流动力学崩溃。迅速采取积极的抗甲状腺治疗,包括类固醇冲击治疗,并辅以支持性重症监护措施,使病情显著改善并完全康复。本病例清楚地显示了初始临床怀疑对早期诊断和强化治疗的有益影响。此外,它支持了类固醇在积极抗甲状腺策略中的额外作用,以控制相关的有害全身炎症反应。