{"title":"甲状腺风暴中救命的血浆交换治疗","authors":"Yema Jalal , Justin Sandhu , Yi McWhorter","doi":"10.1016/j.jecr.2022.100116","DOIUrl":null,"url":null,"abstract":"<div><h3>Background/objective</h3><p>Thyroid storm is a devastating possibility in patients with hyperthyroidism. Patients can manifest, though not limited to, neurologic and cardiac symptoms that require a variety of different treatments. Previous case reports have demonstrated the efficacy of therapeutic plasma exchange (TPE) therapy in treating thyroid storm refractory to traditional therapy, but due to the rarity of this condition, the evidence supporting the use of TPE in thyroid storm remains scant.</p></div><div><h3>Case report</h3><p>We present a successful case of TPE and medical management for a patient with repeated admissions for thyroid storm. Her cardiac function and encephalopathy both improved substantially after four sessions of TPE.</p></div><div><h3>Discussion</h3><p>Thyroid storm is a rare and serious complication of hyperthyroidism from inappropriately high circulating free T3 and T4 hormones. Clinical symptoms include tachycardia, fever, dehydration, and deterioration leading to life-threatening heart failure and coma. In addition to promptly initiating medical treatment to remove eliciting causes, correct elevated hormonal levels, aggressively control sympathetic tone, TPE may be used as a life-saving adjunct to halt the decline in multi-organ system failure and facilitate rapid recovery.</p></div><div><h3>Conclusion</h3><p>Therefore, we recommend this therapy as a rescue adjunct for the treatment of thyroid storm, allowing time for evaluation of definitive thyroidectomy.</p></div>","PeriodicalId":56186,"journal":{"name":"Journal of Clinical and Translational Endocrinology: Case Reports","volume":"24 ","pages":"Article 100116"},"PeriodicalIF":0.0000,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214624522000107/pdfft?md5=20d8a35a5108d2a3e4e0b1aad26bd84a&pid=1-s2.0-S2214624522000107-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Life-saving therapeutic plasma exchange in thyroid storm\",\"authors\":\"Yema Jalal , Justin Sandhu , Yi McWhorter\",\"doi\":\"10.1016/j.jecr.2022.100116\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background/objective</h3><p>Thyroid storm is a devastating possibility in patients with hyperthyroidism. Patients can manifest, though not limited to, neurologic and cardiac symptoms that require a variety of different treatments. Previous case reports have demonstrated the efficacy of therapeutic plasma exchange (TPE) therapy in treating thyroid storm refractory to traditional therapy, but due to the rarity of this condition, the evidence supporting the use of TPE in thyroid storm remains scant.</p></div><div><h3>Case report</h3><p>We present a successful case of TPE and medical management for a patient with repeated admissions for thyroid storm. Her cardiac function and encephalopathy both improved substantially after four sessions of TPE.</p></div><div><h3>Discussion</h3><p>Thyroid storm is a rare and serious complication of hyperthyroidism from inappropriately high circulating free T3 and T4 hormones. Clinical symptoms include tachycardia, fever, dehydration, and deterioration leading to life-threatening heart failure and coma. In addition to promptly initiating medical treatment to remove eliciting causes, correct elevated hormonal levels, aggressively control sympathetic tone, TPE may be used as a life-saving adjunct to halt the decline in multi-organ system failure and facilitate rapid recovery.</p></div><div><h3>Conclusion</h3><p>Therefore, we recommend this therapy as a rescue adjunct for the treatment of thyroid storm, allowing time for evaluation of definitive thyroidectomy.</p></div>\",\"PeriodicalId\":56186,\"journal\":{\"name\":\"Journal of Clinical and Translational Endocrinology: Case Reports\",\"volume\":\"24 \",\"pages\":\"Article 100116\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2214624522000107/pdfft?md5=20d8a35a5108d2a3e4e0b1aad26bd84a&pid=1-s2.0-S2214624522000107-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical and Translational Endocrinology: Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2214624522000107\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical and Translational Endocrinology: Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214624522000107","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Life-saving therapeutic plasma exchange in thyroid storm
Background/objective
Thyroid storm is a devastating possibility in patients with hyperthyroidism. Patients can manifest, though not limited to, neurologic and cardiac symptoms that require a variety of different treatments. Previous case reports have demonstrated the efficacy of therapeutic plasma exchange (TPE) therapy in treating thyroid storm refractory to traditional therapy, but due to the rarity of this condition, the evidence supporting the use of TPE in thyroid storm remains scant.
Case report
We present a successful case of TPE and medical management for a patient with repeated admissions for thyroid storm. Her cardiac function and encephalopathy both improved substantially after four sessions of TPE.
Discussion
Thyroid storm is a rare and serious complication of hyperthyroidism from inappropriately high circulating free T3 and T4 hormones. Clinical symptoms include tachycardia, fever, dehydration, and deterioration leading to life-threatening heart failure and coma. In addition to promptly initiating medical treatment to remove eliciting causes, correct elevated hormonal levels, aggressively control sympathetic tone, TPE may be used as a life-saving adjunct to halt the decline in multi-organ system failure and facilitate rapid recovery.
Conclusion
Therefore, we recommend this therapy as a rescue adjunct for the treatment of thyroid storm, allowing time for evaluation of definitive thyroidectomy.
期刊介绍：
The journal publishes case reports in a variety of disciplines in endocrinology, including diabetes, metabolic bone disease and osteoporosis, thyroid disease, pituitary and lipid disorders. Journal of Clinical & Translational Endocrinology Case Reports is an open access publication.
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