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Case reports
- Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report
- So Hee Kwon, Min-Ji Kim, Sin Yeong Jung, Jae-Han Jeon
- J Yeungnam Med Sci. 2023;40(Suppl):S93-S97. Published online May 17, 2023
- DOI: https://doi.org/10.12701/jyms.2023.00199
- 2,620 View
- 81 Download
- 1 Web of Science
- 1 Crossref
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Abstract
PDF - Thyroid storm is a life-threatening form of thyrotoxicosis and an endocrinological emergency. We present a case of thyroid storm in a patient with metastatic papillary thyroid cancer. A 67-year-old woman with a history of total thyroidectomy 4 years prior to presentation was admitted with deteriorating mental status, fever, and tachycardia. Laboratory tests revealed severe thyrotoxicosis. Although the patient had no residual thyroid tissue after total thyroidectomy, she had a previously diagnosed metastatic thyroid cancer lesion in the pelvic bone. Despite initial treatment with a standard thyroid storm regimen, the patient died 6 days after hospitalization. The patient had no history of Graves disease; however, a thyroxine receptor antibody was detected postmortem. The patient had a history of exposure to an iodine contrast agent, which is a rare cause of thyrotoxicosis. Thyroxine production from a differentiated thyroid carcinoma is rare but can be a source of clinically significant thyrotoxicosis in patients post-thyroidectomy. Overlapping Graves disease is a common stimulus; however, other causes, such as exogenous iodine, cannot be excluded. This case demonstrates that in the setting of metastatic thyroid carcinoma, thyrotoxicosis cannot be completely ruled out as a cause of suspicious symptoms, even in patients with a history of total thyroidectomy.
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Citations
Citations to this article as recorded by
- Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock
Eman Elmenyar, Sarah Aoun, Zain Al Saadi, Ahmed Barkumi, Basar Cander, Hassan Al-Thani, Ayman El-Menyar
Diagnostics.2023; 13(19): 3028. CrossRef
- Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock
- Massive cerebral venous sinus thrombosis secondary to Graves' disease
- Hye-Min Son
- Yeungnam Univ J Med. 2019;36(3):273-280. Published online September 18, 2019
- DOI: https://doi.org/10.12701/yujm.2019.00339
- 6,433 View
- 94 Download
- 10 Crossref
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Abstract
PDF
- Cerebral venous sinus thrombosis (CVT) is a rare cerebrovascular condition accounting for 0.5–1% of all types of strokes in the general population. Hyperthyroidism is associated with procoagulant and antifibrinolytic activity, thereby precipitating a hypercoagulable state that predisposes to CVT. We report the case of a 31-year-old Korean man with massive CVT and diagnosis of concomitant Graves’ disease at admission. Early diagnosis and prompt treatment of CVT are important to improve prognosis; therefore, CVT should be considered in the differential diagnosis in all patients with hyperthyroidism presenting with neurological symptoms.
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Citations
Citations to this article as recorded by- Associations between deep venous thrombosis and thyroid diseases: a two-sample bidirectional Mendelian randomization study
Lifeng Zhang, Kaibei Li, Qifan Yang, Yao Lin, Caijuan Geng, Wei Huang, Wei Zeng
European Journal of Medical Research.2024;[Epub] CrossRef - Association Between Thyrotoxicosis and Cerebral Venous Thrombosis
Margherita Paccagnella, Anna Pizzo, Veronica Calabrò, Valerio Velardi, Bruno Fabris, Stella Bernardi
Journal of Clinical Medicine.2024; 13(21): 6547. CrossRef - Hyperthyroidism-induced Cerebral Venous Thrombosis Presenting as Chronic Isolated Intracranial Hypertension
Takumi Tashiro, Yuichi Kira, Norihisa Maeda
Internal Medicine.2023; 62(20): 3021. CrossRef - Cerebral Sinus Vein Thrombosis and Gender: A Not Entirely Casual Relationship
Tiziana Ciarambino, Pietro Crispino, Giovanni Minervini, Mauro Giordano
Biomedicines.2023; 11(5): 1280. CrossRef - Insights Into a Hypercoagulable Case of Thyrocardiac Disease and Literature Overview
Pin-Yi Wu, Ruchika Meel
Annals of Internal Medicine: Clinical Cases.2023;[Epub] CrossRef - Cerebral Venous Thrombosis during Thyrotoxicosis: Case Report and Literature Update
Emanuela Maria Raho, Annibale Antonioni, Niccolò Cotta Ramusino, Dina Jubea, Daniela Gragnaniello, Paola Franceschetti, Francesco Penitenti, Andrea Daniele, Maria Chiara Zatelli, Maurizio Naccarato, Ilaria Traluci, Maura Pugliatti, Marina Padroni
Journal of Personalized Medicine.2023; 13(11): 1557. CrossRef - Unprovoked Isolated Pulmonary Embolism and Graves’ Disease in a Patient With Dyspnea: A Case Report
Roshan Bisural, Deepak Acharya, Samaj Adhikari, Baikuntha Chaulagai, Arjun Mainali, Tutul Chowdhury, Nicole Gousy
Cureus.2022;[Epub] CrossRef - Cerebral venous sinus thrombosis caused by traumatic brain injury complicating thyroid storm: a case report and discussion
Shurong Gong, Wenyao Hong, Jiafang Wu, Jinqing Xu, Jianxiang Zhao, Xiaoguang Zhang, Yuqing Liu, Rong-Guo Yu
BMC Neurology.2022;[Epub] CrossRef - Severe headache as a monosymptom of cerebral venous sinus thrombosis: a case report with effective utilization of the SNNOOP10 approach
Garik Yeganyan, Hasmik Sargsyan, Mariam Manukyan, Henrik Schytz, Samson Khachatryan
Armenian Journal of Health & Medical Sciences.2022; : 52. CrossRef - Hyperthyroidism as a Precipitant Factor for Cerebral Venous Thrombosis: A Case Report
Ahmed Elkhalifa Elawad Elhassan, Mohammed Omer Khalil Ali, Amina Bougaila, Mohammed Abdelhady, Hassan Abuzaid
Journal of Investigative Medicine High Impact Case Reports.2020;[Epub] CrossRef
- Associations between deep venous thrombosis and thyroid diseases: a two-sample bidirectional Mendelian randomization study
Case Report
- Delayed presentation of aggravation of thyrotoxicosis after radioactive iodine therapy at Graves disease.
- Ji Hyun Lee, Hyun Jin Na, Jin Woo Park, Cheol Ho Lee, Hyun Jeong Han, Tae Ho Kim, Se Hwa Kim
- Yeungnam Univ J Med. 2014;31(2):148-151. Published online December 31, 2014
- DOI: https://doi.org/10.12701/yujm.2014.31.2.148
- 2,370 View
- 9 Download
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Abstract
PDF
- Radioactive iodine (RAI) therapy is widely used for the treatment of Graves disease. After RAI therapy, 44% become hypothyroid and up to 28% remain hyperthyroid. The development of thyrotoxicosis after RAI therapy is believed to be mediated by 2 different mechanisms: a transient increased release of thyroid hormone due to radiation thyroiditis and the rare development of Graves disease due to the formation of antibodies to the thyroid-associated antigens released from the damaged follicular cells. A 55-year-old woman was hospitalized with severe headache, weight loss, and palpitation. She received a dose of 7 mCi of RAI (I-131) about 6 weeks earlier. Thyroid function test showed 7.98 ng/dL free T4, >8 ng/mL T3, <0.08 microIU/L thyroid stimulating hormone, and high titer thyroid stimulating immunoglobulin (TSI) (85.8 IU/L). She improved with propylthiouracil, propranolol, and steroid treatment. The TSI, however, was persistently elevated for 11 months.
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