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

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

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


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 languageEnglish
JournalBMJ Case Reports
Issue number7
StatePublished - Jul 6 2020

Bibliographical note

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


  • drugs: endocrine system
  • paediatrics (drugs and medicines)
  • thyrotoxicosis

ASJC Scopus subject areas

  • Medicine (all)


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