A case of thyroid storm with multiple organ failure effectively treated with plasma exchange

Intern Med. 2011;50(22):2801-5. doi: 10.2169/internalmedicine.50.6078. Epub 2011 Nov 15.

Abstract

We describe a 48-year-old man with thyroid storm presenting with heart failure. He presented severely impaired left ventricular wall motion and a marked increase in the liver enzymes. He developed disseminated intravascular coagulation on day 2. Due to elevated serum thyroid hormone level, anti-thyroid hormone receptor antibody positivity, and his clinical symptoms, he was diagnosed as thyroid storm due to untreated Graves' disease. His condition did not improve even after 6 days of conventional therapy including steroids. After therapeutic plasma exchange was carried out, his thyroid hormone level decreased markedly. Consequently, his condition recovered gradually, and he was discharged at day 43.

Publication types

  • Case Reports

MeSH terms

  • Disseminated Intravascular Coagulation / complications
  • Disseminated Intravascular Coagulation / therapy
  • Graves Disease / complications
  • Graves Disease / diagnosis
  • Graves Disease / therapy
  • Heart Failure / complications
  • Humans
  • Liver Diseases / complications
  • Male
  • Middle Aged
  • Multiple Organ Failure / complications*
  • Multiple Organ Failure / diagnosis
  • Multiple Organ Failure / therapy*
  • Plasma Exchange*
  • Thyroid Crisis / complications*
  • Thyroid Crisis / diagnosis
  • Thyroid Crisis / therapy*
  • Thyroid Hormones / blood

Substances

  • Thyroid Hormones