scholarly journals Corrigendum For: “Effect of Plasma Exchange in Thyroid Storm With Consideration of Its Distribution Into the Extravascular Space”

2020 ◽  
Vol 4 (9) ◽  
Keyword(s):  
Plasma Exchange ◽  
Thyroid Storm ◽  
Extravascular Space

scholarly journals Effect of Plasma Exchange in Thyroid Storm With Consideration of Its Distribution Into the Extravascular Space

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Mai Shinohara ◽  
Toyoyoshi Uchida ◽  
Takashi Funayama ◽  
Mika Watanabe ◽  
Makio Kusaoi ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Plasma Exchange ◽  
Fresh Frozen Plasma ◽  
Thyroid Storm ◽  
Extravascular Space ◽  
Before And After ◽  
Fresh Frozen ◽  
Thyroid Hormone Levels ◽  
Frozen Plasma

Abstract Plasma exchange (PE), which directly removes some plasma thyroid hormones, is a treatment option for thyroid storm. However, the effect of PE has not been accurately assessed yet. Here we assessed the effect of PE in a patient with thyroid storm while taking into consideration the distribution of thyroid hormones in the extravascular space. A 51-year-old woman with thyroid storm underwent 2 PE procedures at our hospital. By measuring changes in thyroid hormone levels in plasma, fresh frozen plasma (FFP) used, and waste fluid during each 2.5-hour PE procedure, we calculated the efficiency of thyroid hormone removal based on the hypothesis that total thyroid hormone content before and after PE is the same. During the patient’s first PE procedure, the estimated thyroxine (T4) balance in the extravascular space (ΔX) was −70 μg, which corresponds to approximately 19% of T4 in the waste fluid. During the second PE procedure, ΔX was −131 μg, which corresponds to approximately 52% of T4 in the waste fluid. These data indicated that the source of removed T4 during PE varies. The amount of T4 removed from the extravascular space should be taken into account during assessment of the effect of PE in thyroid storm.

scholarly journals THERAPEUTIC PLASMA EXCHANGE AS A BRIDGE TO TOTAL THYROIDECTOMY IN PATIENTS WITH SEVERE THYROTOXICOSIS

2020 ◽  
Vol 6 (1) ◽  
pp. e14-e18
Author(s):  
Kelsey Tieken ◽  
Ameena Madan Paramasivan ◽  
Whitney Goldner ◽  
Ana Yuil-Valdes ◽  
Abbey L. Fingeret
Keyword(s):  
Total Thyroidectomy ◽  
Plasma Exchange ◽  
Medical Management ◽  
Response To Therapy ◽  
Therapeutic Plasma Exchange ◽  
Thyroid Storm ◽  
Antithyroid Drugs ◽  
Average Percentage ◽  
The Mean ◽  
Definitive Management

Objective: Graves disease is the most common cause of thyrotoxicosis. Medical management is the first-line treatment but may be contraindicated or ineffective. In patients with severe, refractory thyrotoxicosis therapeutic plasma exchange (TPE) may be indicated as a bridge to thyroidectomy. Methods: We present 3 cases of thyrotoxicosis refractory to medical management that were successfully treated with TPE and subsequent total thyroidectomy, and provide an analysis of the response to therapy via a change in free thyroxine (fT4) levels throughout their treatment course. Results: The average change in fT4 per liter of fluid exchanged was 0.37 ng/dL (SD = 0.08) and the average percentage change of fT4 after each treatment was 20.7% (SD = 8.28). The mean decrease in fT4 after 4 TPE treatments was 57.4%. All patients successfully underwent total thyroidectomy without complication and were discharged from the hospital. Conclusion: TPE should be considered for thyrotoxic patients with severe hyperthyroidism or thyroid storm refractory to medical management or contraindications to antithyroid drugs who need a bridge to total thyroidectomy. In these cases, TPE was a safe and effective treatment that enabled definitive management with thyroidectomy and may be considered in other patients with severe refractory hyperthyroidism or thyrotoxicosis.

scholarly journals A case of fatal heart and liver failure accompanied by thyroid storm treated with prompt plasma exchange

2017 ◽  
Vol 15 (3) ◽  
pp. 100-103 ◽  
Author(s):  
Feibi Zeng ◽  
Tomofumi Takaya ◽  
Naofumi Yoshida ◽  
Tatsuro Ito ◽  
Makiko Suto ◽  
...  
Keyword(s):  
Liver Failure ◽  
Plasma Exchange ◽  
Thyroid Storm

Perfect storm: Therapeutic plasma exchange for a patient with thyroid storm

2017 ◽  
Vol 33 (1) ◽  
pp. 113-116 ◽  
Author(s):  
Andrea M. McGonigle ◽  
Aaron A. R. Tobian ◽  
Jennifer L. Zink ◽  
Karen E. King
Keyword(s):  
Plasma Exchange ◽  
Therapeutic Plasma Exchange ◽  
Thyroid Storm ◽  
Perfect Storm

scholarly journals Plasma exchange in the treatment of thyroid storm secondary to type II amiodarone-induced thyrotoxicosis

2016 ◽  
Vol 2016 ◽  
Author(s):  
Ling Zhu ◽  
Sueziani Binte Zainudin ◽  
Manish Kaushik ◽  
Li Yan Khor ◽  
Chiaw Ling Chng
Keyword(s):  
Plasma Exchange ◽  
Thyroid Storm ◽  
List Type ◽  
Type Ii ◽  
Free Triiodothyronine ◽  
Bridging Therapy ◽  
Session Type ◽  
Learning Points ◽  
Prompt Diagnosis

Summary Type II amiodarone-induced thyrotoxicosis (AIT) is an uncommon cause of thyroid storm. Due to the rarity of the condition, little is known about the role of plasma exchange in the treatment of severe AIT. A 56-year-old male presented with thyroid storm 2months following cessation of amiodarone. Despite conventional treatment, his condition deteriorated. He underwent two cycles of plasma exchange, which successfully controlled the severe hyperthyroidism. The thyroid hormone levels continued to fall up to 10h following plasma exchange. He subsequently underwent emergency total thyroidectomy and the histology of thyroid gland confirmed type II AIT. Management of thyroid storm secondary to type II AIT can be challenging as patients may not respond to conventional treatments, and thyroid storm may be more harmful in AIT patients owing to the underlying cardiac disease. If used appropriately, plasma exchange can effectively reduce circulating hormones, to allow stabilisation of patients in preparation for emergency thyroidectomy. Learning points Type II AIT is an uncommon cause of thyroid storm and may not respond well to conventional thyroid storm treatment. Prompt diagnosis and therapy are important, as patients may deteriorate rapidly. Plasma exchange can be used as an effective bridging therapy to emergency thyroidectomy. This case shows that in type II AIT, each cycle of plasma exchange can potentially lower free triiodothyronine levels for 10h. Important factors to consider when planning plasma exchange as a treatment for thyroid storm include timing of each session, type of exchange fluid to be used and timing of surgery.

scholarly journals Fulminant hepatitis and elevated levels of sIL-2R in thyroid storm

2019 ◽  
Vol 2019 ◽  
Author(s):  
Yuri Tanaka ◽  
Taisuke Uchida ◽  
Hideki Yamaguchi ◽  
Yohei Kudo ◽  
Tadato Yonekawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Transplantation ◽  
Plasma Exchange ◽  
Fulminant Hepatitis ◽  
Poor Prognosis ◽  
Interleukin 2 ◽  
Thyroid Storm ◽  
List Type ◽  
Interleukin 2 Receptor ◽  
Soluble Interleukin 2 Receptor

Summary We report the case of a 48-year-old man with thyroid storm associated with fulminant hepatitis and elevated levels of soluble interleukin-2 receptor (sIL-2R). Fatigue, low-grade fever, shortness of breath, and weight loss developed over several months. The patient was admitted to the hospital because of tachycardia-induced heart failure and liver dysfunction. Graves’ disease with heart failure was diagnosed. He was treated with methimazole, inorganic iodide, and a β-blocker. On the day after admission, he became unconscious with a high fever and was transferred to the intensive care unit. Cardiogenic shock with atrial flutter was treated with intra-aortic balloon pumping and cardioversion. Hyperthyroidism decreased over 10 days, but hepatic failure developed. He was diagnosed with thyroid storm accompanied by fulminant hepatitis. Laboratory investigations revealed elevated levels of sIL-2R (9770 U/mL). The fulminant hepatitis was refractory to plasma exchange and plasma filtration with dialysis, and no donors for liver transplantation were available. He died of hemoperitoneum and gastrointestinal hemorrhage due to fulminant hepatitis 62 days after admission. Elevated circulating levels of sIL-2R might be a marker of poor prognosis in thyroid storm with fulminant hepatitis. Learning points: The prognosis of thyroid storm when fulminant hepatitis occurs is poor. Liver transplantation is the preferred treatment for fulminant hepatitis induced by thyroid storm refractory to plasma exchange. Elevated levels of soluble interleukin-2 receptor might be a marker of poor prognosis in patients with thyroid storm.

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