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Case Reports
. 2020 Jul 6;13(7):e235536.
doi: 10.1136/bcr-2020-235536.

Sepsis and thyroid storm in a patient with methimazole-induced agranulocytosis

Vaishnavi Divya Nagarajan  1 , Alba Morales  2 , Lawtanya Pleasant  2 , Asha Shenoi  2
Affiliations
Case Reports

Sepsis and thyroid storm in a patient with methimazole-induced agranulocytosis

Vaishnavi Divya Nagarajan et al. BMJ Case Rep. .

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.

Keywords: drugs: endocrine system; paediatrics (drugs and medicines); thyrotoxicosis.

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Conflict of interest statement

Competing interests: None declared.

References

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