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Graves' disease (GD) and gestational transient thyrotoxicosis (GTT) are the most common causes of thyrotoxicosis during pregnancy, with prevalence ranging from 0.1% to 1% and from 1% to 3%, respectively. Hyperthyroidism during pregnancy can have severe consequences if not promptly recognized and treated.

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Antithyroid drugs can cause neutropenia or agranulocytosis, rarely pancytopenia in hyperthyroidism therapy. The treatment is difficult and lethality is high when granulocytopenia or pancytopenia combined with hyperthyroidism crisis. First Affiliated Hospital of Army Medical University treated a patient who had pancytopenia caused by methimazole with systemic lupus erythematosus, secondary hyperthyroidism crisis and agranulocytosis.

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Immune-related adverse events (irAEs), including endocrine irAEs, can occur in response to cancer immunotherapy using immune checkpoint inhibitors (ICIs). Of the endocrine irAEs, pituitary and thyroid irAEs are most frequently observed, followed by primary adrenal insufficiency, type 1 diabetes mellitus and hypoparathyroidism. Notably, pituitary irAEs and type 1 diabetes mellitus can be lethal if overlooked, potentially leading to adrenal crisis and diabetic ketoacidosis, respectively.

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Thyroid Storm Management: Beta-1 Selective or Propranolol?

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January 2025

All authors: Department of Bioinformatics, School of Basic Medical Sciences, Chongqing Medical University, Chongqing, China.

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