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  • Title: Sepsis and thyroid storm in a patient with methimazole-induced agranulocytosis.
    Author: Nagarajan VD, Morales A, Pleasant L, Shenoi A.
    Journal: BMJ Case Rep; 2020 Jul 06; 13(7):. PubMed ID: 32636230.
    Abstract:
    Paediatric hyperthyroidism cases are mostly caused by Grave's disease. Thyroid storm is a life-threatening condition seen rarely, in severe thyrotoxicosis, occurring in about 1%-2% of patients with hyperthyroidism. Antithyroid medications and beta-blockers are typically the first-line management of thyroid storm. We report a challenging case of a 15-year-old girl who presented with thyroid storm in the setting of septic shock and methimazole-induced agranulocytosis. Since the first-line agents were contraindicated, plasmapheresis was used to control the thyroid storm and as a bridging therapy to the definitive therapy of early thyroidectomy. This is the first paediatric case report that outlines the use of plasmapheresis in the management of complicated thyrotoxicosis in a setting of septic shock.
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