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https://doi.org/10.3389/fendo.2021.725559
Title: | Crash Landing of Thyroid Storm: A Case Report and Review of the Role of Extra-Corporeal Systems | Authors: | Lim, Shir Lynn Wang, Kangjie Lui, Pak Ling Ramanathan, Kollengode Yang, Samantha Peiling |
Keywords: | thyroid storm multi-organ failure extra-corporeal membrane oxygenation therapeutic plasma exchange continuous renal replacement therapy out-of-hospital cardiac arrest |
Issue Date: | 20-Aug-2021 | Publisher: | FRONTIERS MEDIA SA | Citation: | Lim, Shir Lynn, Wang, Kangjie, Lui, Pak Ling, Ramanathan, Kollengode, Yang, Samantha Peiling (2021-08-20). Crash Landing of Thyroid Storm: A Case Report and Review of the Role of Extra-Corporeal Systems. FRONTIERS IN ENDOCRINOLOGY 12. ScholarBank@NUS Repository. https://doi.org/10.3389/fendo.2021.725559 | Abstract: | Thyroid storm is a rare but life-threatening endocrinological emergency with significant mortality ranging from 10-30% with multi-organ involvement and failure. In view of the rarity of this condition and efficacy of established first line medical treatment, use of extra-corporeal treatments are uncommon, not well-studied, and its available evidence exists only from case reports and case series. We describe a 28-year-old man who presented with an out-of-hospital cardiac arrest secondary to thyroid storm. Despite conventional first-line pharmacotherapy, he developed cardiogenic shock and circulatory collapse with intravenous esmolol infusion, as well as multi-organ failure. He required therapeutic plasma exchange, concurrent renal replacement therapy, and veno-arterial extra-corporeal membrane oxygenation, one of the few reported cases in the literature. While there was clinical stabilization and improvement in tri-iodothyronine levels on three extra-corporeal systems, he suffered irreversible hypoxic-ischemic brain injury. We reviewed the use of early therapeutic plasma exchange and extra-corporeal membrane oxygenation, as well as the development of other novel extra-corporeal modalities when conventional pharmacotherapy is unsuccessful or contraindicated. This case also highlights the complexities in the management of thyroid storm, calling for caution with beta-blockade use in thyrocardiac disease, with close monitoring and prompt organ support. | Source Title: | FRONTIERS IN ENDOCRINOLOGY | URI: | https://scholarbank.nus.edu.sg/handle/10635/206082 | ISSN: | 16642392 | DOI: | 10.3389/fendo.2021.725559 |
Appears in Collections: | Staff Publications Elements |
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Crash Landing of Thyroid Storm A Case Report and Review of the Role of Extra-Corporeal Systems.pdf | 3.73 MB | Adobe PDF | OPEN | Published | View/Download |
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