Vidanapathirana Manudi, Wijayaratne Dilushi
National Hospital of Sri Lanka, Colombo, Sri Lanka.
Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Clin Diabetes Endocrinol. 2024 Aug 24;10(1):24. doi: 10.1186/s40842-024-00182-9.
Thyroid storm is a medical emergency with a high mortality rate. Acute liver failure (ALF) and disseminated intravascular coagulation (DIC) are rarely reported with thyroid storm, and their occurrence is unrelated to the degree of free circulating thyroxine.We present the case of a 41-year-old Sri Lankan female, with a fatal case of thyroid storm. She initially presented with palpitations and heat intolerance, and subsequently developed acute liver failure with hepatic encephalopathy and coagulopathy. There was hypoglycemia and resistant lactic acidosis consequent to the liver failure. The clinical course progressed to DIC and she eventually succumbed to the illness. Treatment comprised the standard management of thyroid storm.This case report highlights the importance of bearing ALF and DIC in mind as complications of thyroid storm, outlines their pathophysiology, and uses pathophysiological mechanisms to justify, evolving extracorporeal therapeutic strategies for resistant cases.
甲状腺危象是一种死亡率很高的医疗急症。急性肝衰竭（ALF）和弥散性血管内凝血（DIC）在甲状腺危象中很少有报道，它们的发生与游离循环甲状腺素的水平无关。我们报告了一例41岁的斯里兰卡女性致命性甲状腺危象病例。她最初表现为心悸和不耐热，随后发展为伴有肝性脑病和凝血病的急性肝衰竭。肝衰竭导致低血糖和难治性乳酸酸中毒。临床病程进展为弥散性血管内凝血，最终她因病死亡。治疗包括甲状腺危象的标准管理。本病例报告强调了将急性肝衰竭和弥散性血管内凝血视为甲状腺危象并发症的重要性，概述了它们的病理生理学，并运用病理生理机制为难治性病例不断发展的体外治疗策略提供依据。
