Please use this identifier to cite or link to this item: https://doi.org/10.3389/fendo.2021.725559
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dc.titleCrash Landing of Thyroid Storm: A Case Report and Review of the Role of Extra-Corporeal Systems
dc.contributor.authorLim, Shir Lynn
dc.contributor.authorWang, Kangjie
dc.contributor.authorLui, Pak Ling
dc.contributor.authorRamanathan, Kollengode
dc.contributor.authorYang, Samantha Peiling
dc.date.accessioned2021-11-12T12:18:47Z
dc.date.available2021-11-12T12:18:47Z
dc.date.issued2021-08-20
dc.identifier.citationLim, 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
dc.identifier.issn16642392
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/206082
dc.description.abstractThyroid 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.
dc.language.isoen
dc.publisherFRONTIERS MEDIA SA
dc.sourceElements
dc.subjectthyroid storm
dc.subjectmulti-organ failure
dc.subjectextra-corporeal membrane oxygenation
dc.subjecttherapeutic plasma exchange
dc.subjectcontinuous renal replacement therapy
dc.subjectout-of-hospital cardiac arrest
dc.typeReview
dc.date.updated2021-11-10T02:43:20Z
dc.contributor.departmentDEPT OF MEDICINE
dc.contributor.departmentDEPT OF SURGERY
dc.description.doi10.3389/fendo.2021.725559
dc.description.sourcetitleFRONTIERS IN ENDOCRINOLOGY
dc.description.volume12
dc.published.statePublished
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