ECE2017 Eposter Presentations: Thyroid Thyroid (non-cancer) (260 abstracts)
1Sanatorio Méndez, Buenos Aires, Argentina; 2Hospital Británico, Buenos Aires, Argentina; 3CEBBAD, Universidad Maimonides, Buenos Aires, Argentina.
Thyroid storm (TS) is a rare and life threatening condition that requires a prompt recognition and treatment. The clinical features may overlap with other acute medical conditions. Currently both Akamizu Criteria (JTA) and Burch and Wartofsky Scale (BW) are helpful diagnostics tools.
Objective: To evaluate TS patients according to currently available criteria and to identify the clinical features and outcomes.
Methods: A single center retrospective study covering a 6 year period was performed.
Results: Fifteen cases were identified, resulting in four cases of TS per 10 000 admitted. Mean age 49.8±17.3 years (range: 3186). Male/Female: 3/12. Etiology: autoimmune (n=8), factitious (n=3), amiodarone-induced (n=3), undetermined (n=1). Manifestations at admission: cardiovascular (n=8), fever (n=3), delirium (n=2), diabetic ketoacidosis (n=1) and hypokalemic paralysis (n=1). Eleven had previous history of thyroid disease. Precipitating factors were found in 12 cases. Thyroid hormone levels did not correlate with the severity of thyrotoxicosis. Mortality rate was 6.6%: 1 patient died from sepsis. Late hospital discharge was found in 4 patients (P=0.01): 3 required antithyroid drugs withdrawal and the other received a heart transplant. The table resumes patients according to BW and JTA. JTA fails to detect 4 patients with impending TS (st0), one of which later on developed st1 (p8).
Conclusions: Ours results shows discrepancies between the two diagnostic systems. BW appears to select a higher percentage of patients for aggressive therapy than JTA. This presentation provides useful information for the management of TS, a rare and acute disease that requires high clinical suspicion in order to improve patient survival.
p1 | p2 | p3 | p4 | p5 | p6 | p7 | p8 | p9 | p10 | p11 | p12 | p13 | p14 | p15 | |
BW | 35 | 40 | 40 | 75 | 60 | 55 | 35 | 35 | 55 | 35 | 35 | 80 | 65 | 65 | 35 |
JTA | st0 | st0 | st2 | st1 | st1 | st2 | st1 | st0 | st1 | st2 | st2 | st1 | st1 | st1 | st0 |