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Thyrotoxic Crisis in a 75-Year-Old Woman

Branko Bečejac
Milan Vrkljan
Miljenko Solter
Nikola Sikirica


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Abstract

A 75-year-old female patient was admitted to the Intensive Care Unit with the signs of thyrotoxic crisis. Although hyperthyroidism had been previously suspected, thyrosuppressive therapy was not initiated on time. This along with other adverse factors like acute urinary infection contributed to deterioration and unfavorable development of the disease. Clinical improvement was noticed 24 hours from the introduction of combined therapy with propylthiouracil, propranolol, hydrocortisone and cardiotonics for rapid atrial fibrillation caused by atherosclerotic and thyrotoxic heart, supplemented with sedatives and necessary medical care. Shortly upon normalization of the thyroid hormone levels, RJ therapy was administered as a final solution. Pancytopenia verified before the initiation of thyrostatic therapy also contributed to this solution. The intention of this case report is to point to the yet possible occurrence of thyrotoxic crisis, which is nowadays extremely rare owing to appropriate management of hyperthyroidism. Nevertheless, may the disease failed to be recognized on time and therapy is introduced too late, along with other unfavorable factors such as acute infection, the disease can still occur sporadically. Although the mortality rate has been drastically lowered, it is still rather high, i.e. about 7%, therefore these patients should be treated at intensive care unit.

Keywords

Thyroid crisis, diagnosis; Thyroid crisis, therapy; Hyperthyroidism, etiology; Case report

Hrčak ID:

14666

URI

https://hrcak.srce.hr/14666

Publication date:

1.9.2003.

Article data in other languages: croatian

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