Int J Thyroidol.  2023 Nov;16(2):200-204. 10.11106/ijt.2023.16.2.200.

A Case of a Patient with Medical-Refractory Thyroid Storm Treated Successfully by Surgical Resection

• Lee SY
• Kim J
• Won S
• Park JJ

• KMID: 2548749
• DOI: http://doi.org/10.11106/ijt.2023.16.2.200

Abstract

Thyroid storm is a life-threatening condition caused by elevated thyroid hormone levels. While multidrug treatments, encompassing antithyroid agents, inorganic iodine, and corticosteroids, are typically employed, they may be ineffective in certain cases. We present the case of a 41-year-old woman whose thyroid storm did not respond to standard medical treatments or therapeutic plasma pheresis, which led to a deterioration in her condition. Ultimately, an emergency total thyroidectomy was performed with no postoperative complications, such as recurrent laryngeal nerve injury or bleeding. This case underscores the potential efficacy of emergency thyroidectomy for the management of refractory thyroid storm.

Keyword

Thyroid storm; Thyroidectomy; Thyrotoxicosis; Thyroid crisis

Figure

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  Fig. 1 Gross photograph of anterior huge neck mass.

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  Fig. 2 Bruch-Wartofsky point.

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  Fig. 3 (A) Intra-operative specimen, resected thyroid specimen. (B) Post-operative operation field, saved both recurrent laryngeal nerve. (C) The pathology of the resected specimen showed an increased follicular component, Hematoxylin and Eosin stain (H&E stain), ×40.

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  Fig. 4 Thyroid hormone level change trend.

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  Fig. 5 Emergency tracheostomy though previous operation site.

Reference

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