Sepsis and thyroid storm in a patient with methimazole-induced agranulocytosis

Vaishnavi Divya Nagarajan; Alba Morales; Lawtanya Pleasant; Asha Shenoi

doi:10.1136/bcr-2020-235536

Sepsis and thyroid storm in a patient with methimazole-induced agranulocytosis

Vaishnavi Divya Nagarajan, Alba Morales, Lawtanya Pleasant, Asha Shenoi

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Paediatric hyperthyroidism cases are mostly caused by Grave's disease. Thyroid storm is a life-threatening condition seen rarely, in severe thyrotoxicosis, occurring in about 1%-2% of patients with hyperthyroidism. Antithyroid medications and beta-blockers are typically the first-line management of thyroid storm. We report a challenging case of a 15-year-old girl who presented with thyroid storm in the setting of septic shock and methimazole-induced agranulocytosis. Since the first-line agents were contraindicated, plasmapheresis was used to control the thyroid storm and as a bridging therapy to the definitive therapy of early thyroidectomy. This is the first paediatric case report that outlines the use of plasmapheresis in the management of complicated thyrotoxicosis in a setting of septic shock.

Original language	English
Journal	BMJ Case Reports
Volume	13
Issue number	7
DOIs	https://doi.org/10.1136/bcr-2020-235536
State	Published - Jul 6 2020

Bibliographical note

Publisher Copyright:
© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords

drugs: endocrine system
paediatrics (drugs and medicines)
thyrotoxicosis

ASJC Scopus subject areas

General Medicine

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10.1136/bcr-2020-235536

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abstract = "Paediatric hyperthyroidism cases are mostly caused by Grave's disease. Thyroid storm is a life-threatening condition seen rarely, in severe thyrotoxicosis, occurring in about 1%-2% of patients with hyperthyroidism. Antithyroid medications and beta-blockers are typically the first-line management of thyroid storm. We report a challenging case of a 15-year-old girl who presented with thyroid storm in the setting of septic shock and methimazole-induced agranulocytosis. Since the first-line agents were contraindicated, plasmapheresis was used to control the thyroid storm and as a bridging therapy to the definitive therapy of early thyroidectomy. This is the first paediatric case report that outlines the use of plasmapheresis in the management of complicated thyrotoxicosis in a setting of septic shock.",

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AU - Morales, Alba

AU - Pleasant, Lawtanya

AU - Shenoi, Asha

N1 - Publisher Copyright: © BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/7/6

Y1 - 2020/7/6

N2 - Paediatric hyperthyroidism cases are mostly caused by Grave's disease. Thyroid storm is a life-threatening condition seen rarely, in severe thyrotoxicosis, occurring in about 1%-2% of patients with hyperthyroidism. Antithyroid medications and beta-blockers are typically the first-line management of thyroid storm. We report a challenging case of a 15-year-old girl who presented with thyroid storm in the setting of septic shock and methimazole-induced agranulocytosis. Since the first-line agents were contraindicated, plasmapheresis was used to control the thyroid storm and as a bridging therapy to the definitive therapy of early thyroidectomy. This is the first paediatric case report that outlines the use of plasmapheresis in the management of complicated thyrotoxicosis in a setting of septic shock.

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Sepsis and thyroid storm in a patient with methimazole-induced agranulocytosis

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

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