A patient with Graves' disease who survived despite developing thyroid storm and lactic acidosis.
Summary of "A patient with Graves' disease who survived despite developing thyroid storm and lactic acidosis."
Abstract A 56-year-old woman with Graves' disease presented with the complaints of diarrhea and palpitations. Physical examination and laboratory data revealed hypothermia and signs of mild hyperthyroidism, heart failure, hepatic dysfunction with jaundice, hypoglycemia, and lactic acidosis. The patient was diagnosed as having developed the complication of thyroid storm in the absence of marked elevation of the thyroid hormone levels, because of the potential hepatic and cardiac dysfunctions caused by heavy alcohol drinking. A year later, after successful treatment, the patient remains well without any clinical evidence of heart failure or hepatic dysfunction. Thyroid storm associated with lactic acidosis and hypothermia is a serious condition and has rarely been reported. Prompt treatment is essential even if the serum thyroid hormone levels are not markedly elevated. We present a report about this patient, as her life could eventually be saved.
Affiliation
Department of Internal Medicine, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima-ku, Tokyo, 176-8530, Japan.
Journal Details
This article was published in the following journal.
Name: Upsala journal of medical sciences
ISSN: 2000-1967
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20731531
- DOI: http://dx.doi.org/10.3109/03009734.2010.486908
Medical and Biotech [MESH] Definitions
Graves Disease
A common form of hyperthyroidism with a diffuse hyperplastic GOITER. It is an autoimmune disorder that produces antibodies against the THYROID STIMULATING HORMONE RECEPTOR. These autoantibodies activate the TSH receptor, thereby stimulating the THYROID GLAND and hypersecretion of THYROID HORMONES. These autoantibodies can also affect the eyes (GRAVES OPHTHALMOPATHY) and the skin (Graves dermopathy).
Immunoglobulins, Thyroid-stimulating
Autoantibodies that bind to the thyroid-stimulating hormone (TSH) receptor (RECEPTORS, THYROTROPIN) on thyroid epithelial cells. The autoantibodies mimic TSH causing an unregulated production of thyroid hormones characteristic of GRAVES DISEASE.
Receptors, Thyrotropin
Cell surface proteins that bind pituitary THYROTROPIN (also named thyroid stimulating hormone or TSH) and trigger intracellular changes of the target cells. TSH receptors are present in the nervous system and on target cells in the thyroid gland. Autoantibodies to TSH receptors are implicated in thyroid diseases such as GRAVES DISEASE and Hashimoto disease (THYROIDITIS, AUTOIMMUNE).
Graves Ophthalmopathy
An autoimmune disorder of the EYE, occurring in patients with Graves disease. Subtypes include congestive (inflammation of the orbital connective tissue), myopathic (swelling and dysfunction of the extraocular muscles), and mixed congestive-myopathic ophthalmopathy.
Thyroiditis, Autoimmune
Inflammatory disease of the THYROID GLAND due to autoimmune responses leading to lymphocytic infiltration of the gland. It is characterized by the presence of circulating thyroid antigen-specific T-CELLS and thyroid AUTOANTIBODIES. The clinical signs can range from HYPOTHYROIDISM to THYROTOXICOSIS depending on the type of autoimmune thyroiditis.
PubMed Articles
Graves' Disease and Thymic Hyperplasia: The Relationship of Thymic Volume to Thyroid Function.
Background: Thymic hyperplasia is associated with Graves' disease, particularly in young patients. The degree of thymic transformation is minimal in most but not all patients. In the latter group radi...
Graves' disease presenting with severe cholestasis.
Background: Hyperthyroidism has been associated with liver function abnormalities; however, cholestasis as the presenting feature of adolescent Graves' disease has not been previously reported. Patien...
The Marine-Lenhart syndrome revisited.
The coexistence of thyroid autonomy (Plummer's disease) and Graves' disease has been termed "Marine-Lenhart syndrome". During the last years, several papers have been published on the development of G...
Background:No consensus exists on optimal treatment for Graves' disease once anti-thyroid medication fails to induce remission. Total thyroidectomy is a more cost-effective treatment than radioactive...
Thyrotoxicosis is mainly caused by autonomous adenomas of the thyroid gland and by Graves' disease. A less frequent cause for thyrotoxicosis is Hashimoto's thyroiditis. Thyrotoxicosis in autonomous ad...
Clinical Trials
Effect of Lugol's Solution in the Patients With Graves' Disease
Context: Although some of endocrine surgeons administer Lugol's solution to decrease thyroid gland vascularity, there is still no agreement on its effectiveness. Objective: The aims of th...
Genetic Polymorphisms Associated With Cigarette Smoking and Risk of Graves’ Disease
Cigarette smoking is a well-recognized risk factor of Graves’ disease and, particularly, Graves’ ophthalmopathy. Hence, germline polymorphisms of detoxification genes and genes belongi...
Thyroid-Associated Ophthalmopathy Subtypes and Orbital Antibodies
The purpose of this study is to determine whether radioactive iodine, as compared to anti-thyroid medications, is a risk factor for the development or progression of thyroid-associated oph...
A Study of Otelixizumab, a New Treatment for Thyroid Eye Disease
The purpose of this study is to investigate the safety and tolerability of otelixizumab in patients with Graves' ophthalmopathy (thyroid eye disease). There is currently no alternative th...
The Effect of Early Total Thyroidectomy in the Course of Graves' Orbitopathy
The relationship between the method of the treatment of hyperthyroidism due to Graves' disease and the course of Graves' ophthalmopathy is debated. The investigators aimed to compare the r...
