Hyperthyroidism during pregnancy is a relatively rare event, but poor control of hyperthyroidism during pregnancy is associated with a host of issues. These include intrauterine fetal demise, hypertensive disorders of pregnancy, preterm delivery, low birth weight, intrauterine growth restriction, and maternal congestive heart failure. One of the most feared sequelae of hyperthyroidism is thyroid storm, which has a mortality rate >10%. Patients who develop thyroid storm present several challenges to anesthesiologists including hemodynamic instability and medication management. Here, we present the anesthetic management for a parturient whose delivery was complicated by signs and symptoms consistent with thyroid storm.
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http://dx.doi.org/10.1213/XAA.0000000000001059 | DOI Listing |
Neurologist
January 2025
Public Health, Khamis Mushayt General Hospital, Khamis Mushait, Saudi Arabia.
Introduction: Thyrotoxicosis is associated with a hypercoagulable state, increasing the risk of thrombotic events like CVST. Literature review reveals thyroid hormone's role in promoting prothrombotic abnormalities, impacting coagulation factors and platelet function.
Case Report: This study explores the rare occurrence of thyroid storm complicated by deep cerebral venous sinus thrombosis (CVST) in a young male with no prior history of thyroid disease.
Cureus
December 2024
Public Health Sciences, Scientific Knowledge for Ageing and Neurological Ailments (SKAN) Research Trust, Bengaluru, IND.
Cureus
November 2024
Endocrinology and Diabetes, Hospital Selayang, Selayang, MYS.
Hyperthyroidism is a common endocrine disease caused by the production of thyroid hormones in excessive amounts. Propylthiouracil (PTU) is one of the anti-thyroid drugs (ATD) used in the treatment of hyperthyroidism. Rectal PTU should be considered by physicians as a valuable option for managing hyperthyroidism as an alternative route of administration for patients who cannot tolerate oral medications.
View Article and Find Full Text PDFFront Endocrinol (Lausanne)
December 2024
Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Background: Current guidelines recommend that hyperthyroid patients should be rendered euthyroid prior to surgical procedures. These guidelines rely heavily on the use of ATDs as the primary medication, and do not give recommendations for patients who have contraindications to ATDs, or for whom standalone ATD treatment is inadequate.
Objectives: To evaluate the efficacy and safety of adjunctive pharmacological therapy and/or therapeutic plasma exchange (TPE) in the perioperative management of patients with thyrotoxicosis who were intolerant to ATD or for whom standalone ATD therapy was inadequate to achieve euthyroidism prior to surgery.
Intern Med
December 2024
Department of Diabetes and Endocrinology, Osaka General Medical Center, Japan.
Objective The Glasgow Coma Scale (GCS) is widely used to assess the levels of consciousness. This study examined whether or not the initial GCS score could be a marker of the length of hospital stay (LOS) in patients with thyroid storm. Methods We retrospectively analyzed 29 patients with thyroid storm in our hospital between January 2010 and December 2023.
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