Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2016) 44 EP92 | DOI: 10.1530/endoabs.44.EP92

SFEBES2016 ePoster Presentations (1) (116 abstracts)

A case of uncontrolled thyrotoxicosis and congestive heart failure due to Graves’ disease

Clement Aransiola & Michael Olamoyegun


LAUTECH Teaching Hospital, Ogbomoso, Oyo, Nigeria.


Introduction: Graves’ disease is the commonest cause of thyrotoxicosis. If left untreated myriad of complications, chief among which are cardiac related morbidity and mortality might supervene.

Case presentation: A 31-year-old man presented to the endocrine clinic of LAUTECH Teaching Hospital, Ogbomoso, Nigeria 19 months ago with features suggestive of hyperthyroidism and a diagnosis of thyrotoxicosis secondary to Graves’ disease was made. He was commenced on carbimazole and propranolol tablets. He has defaulted follow-up care until 14 months later when he presented at the emergency unit with a 10 month history of progressive bilateral swelling of the legs and 2 week history of worsening dyspnoea accompanied by other features of congestive heart failure; and tell tail signs of unabated thyrotoxicosis. He has not been compliant with carbimazole. On examination he was conscious but in respiratory distress and afebrile with temperature of 36.4°C. Other findings include: chemosis, exolphthalmos, lid lag, goitre and bilateral pitting pedal oedema. Cardiovascular system examination revealed a pulse of 108/min regular and of normal volume. His blood pressure was 160/100 mmHg, has distended neck veins, apex beat was not displaced and heart sounds were S1S2S3 and no murmurs. Significant findings in other systems included a right pleural effusion and ascites. He was stabilized on supplemental oxygen, intravenous lasix; carbimazole and propranolol were recommenced. Antimicrosomal antibody titre was 615.65 IU\ml (reference range is 0–35). His latest TFTs results of 13/05/2016: free T3-18.83 pmol/l (reference range is 3.1–6.8) free T4-22.03 pmol/l (reference range is 12–22), and TSH-0.005 uUI/ml (reference range is 0.270–4.20). He is presently out of failure and has been continued on carbimazole to await definitive treatment once euthyroid.

Conclusion: Graves’disease can be complicated by congestive heart failure which is reversible with the use of antithyroid drugs, and diuretics at the acute phase.

Volume 44

Society for Endocrinology BES 2016

Brighton, UK
07 Nov 2016 - 09 Nov 2016

Society for Endocrinology 

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