ECE2024 Eposter Presentations Thyroid (198 abstracts)
Challenging thyroid storm in pregnancy case report
Hemmat El Haddad 1 , Heba Murad 1 , Nehal Hamdy 1 , Rokaya Abdel Aziz 1 , Heba Moustafa 1 , Randa Salam 1 , Mohamed Magdy 1 , Fady Nagy 1 & Ahmed Atef 1
1Cairo University, Internal Medicine, Endocrinology, Cairo, Egypt
Introduction: Thyroid storm is a rare complication of hyperthyroidism. In pregnant patients can cause spontaneous abortions, fetal demise. Aggressive treatment is needed.
Case report: 26 years female 20 weeks pregnant; Graves’ disease for five years, was on carbimazole but she discontinued since she became pregnant Shortly after that, she started to complain with progressive dyspnea at less than ordinary effort, bilateral lower limb swelling, increase in abdominal girth, 10 days ago, she developed lower abdominal pain and severe vaginal bleeding, Spontaneous abortion of her twins occurred The patient was orthopnea, pulse 105 /mint, temp 38c, RR 25/mint, BP 150/90 and generalized edema, she was admitted to the Gynecological ICU for stabilization and further management Exophthalmos, staring look, Pallor, Neck veins: congested pulsating Hb 8.5 g/dl, TSH: 0.005 µIU/ml (normal range: 0.55–4.78), Free T3: 7 pg/dl, Free T4 = 3 ng/dl Ejection fraction: 48%. The patient was diagnosed as a case of thyroid storm (based on clinical manifestations and low TSH 0.005) complicated by congestive heart failure. Treatment was given (Inderal 40 mg/12 hour carbimazole 1 mg/day, hydrocortisone 1 mg/8 hours, Fursemide infusion, Spironolactone 1 mg/day, Ramipril 1 mg. The general condition of the patient partially improved and then she was discharged from ICU. Improvement of her condition on carbimazole 1 mg/day however TSH was 0.05 thyroidectomy was done on thyroxin replacement
Conclusions: Thyroid storm in pregnancy is a medical emergency needs high index of suspicion and early management by a multidisciplinary team Thyroidectomy may be the only option in selected cases like our case.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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