Soria Brian X, Miceli Ana L, Iroulart Juan M, Blanco Rocio, Bocci Bruno D, Pellegrini Maria N, Arias Anibal M, Giunta Javier N, Russo-Picasso María F, Pizarro Rodolfo
Cardiology Department, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina; Endocrinology Department, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina.
Cardiology Department, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina; Endocrinology Department, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina.
JACC Case Rep. 2025 May 21;30(11):103313. doi: 10.1016/j.jaccas.2025.103313. Epub 2025 Apr 9.
Thyroid storm is a condition characterized by excess circulating thyroid hormones with the development of severe clinical manifestations that may progress to cardiogenic shock, multiorgan failure, and death.
A 41-year-old woman with Graves' disease and poor medical compliance presented to the emergency department with thyroid storm. After initiation of antithyroid and beta-blocker treatment, the patient developed cardiogenic shock and multiorgan failure, requiring placement of a temporary mechanical circulatory support device, immunosuppressive treatment with corticosteroids, and plasmapheresis. She had a good clinical response and underwent total thyroidectomy.
Thyroid storm is a rare cause of cardiogenic shock and multiorgan failure with a high mortality rate despite medical treatment. The case emphasizes the usefulness of multidisciplinary management to avoid adverse outcomes.
TAKE-HOME MESSAGE: The case demonstrates the usefulness of alternative therapies (eg, plasmapheresis) and caution in the use of beta-blockers in patients with thyroid storm.
甲状腺危象是一种以循环甲状腺激素过多为特征的病症，会出现严重的临床表现，可能进展为心源性休克、多器官功能衰竭和死亡。
一名41岁患有格雷夫斯病且医疗依从性差的女性因甲状腺危象就诊于急诊科。在开始抗甲状腺和β受体阻滞剂治疗后，患者出现心源性休克和多器官功能衰竭，需要放置临时机械循环支持装置、使用皮质类固醇进行免疫抑制治疗以及进行血浆置换。她有良好的临床反应并接受了全甲状腺切除术。
甲状腺危象是心源性休克和多器官功能衰竭的罕见原因，尽管进行了药物治疗，但死亡率很高。该病例强调了多学科管理以避免不良后果的有用性。
该病例展示了替代疗法（如血浆置换）的有用性以及在甲状腺危象患者中使用β受体阻滞剂时需谨慎。
