A Rare Case of Subacute Painful Thyroiditis Causing Thyroid Storm and a Successful Trial of Propylthiouracil

Division

Capital

Hospital

LewisGale Medical Center

Document Type

Case Report

Publication Date

7-29-2020

Keywords

thyroid crisis, subacute granulomatous thyroiditis, de quervain thyroiditis, thyroid storm, propylthiouracil (ptu)

Disciplines

Emergency Medicine | Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Internal Medicine

Abstract

Thyroid storm is a rare, life-threatening condition characterized by severe or exaggerated clinical manifestations of thyrotoxicosis, commonly occurring in patients with longstanding, untreated hyperthyroidism such as Graves' disease and toxic nodular goiter. Subacute painful thyroiditis, also known as de Quervain thyroiditis, is a self-limited inflammatory disease of the thyroid gland that is characterized by neck pain, a tender diffuse thyroid goiter, elevated inflammatory markers, and a predictable course of thyroid function evolution. Rarely, it can cause thyroid storm. Herein, we report a rare case of a 25-year-old woman who was admitted for sepsis and acute painful thyroiditis who then developed thyroid storm. The patient was treated in the intensive care unit (ICU) and responded very well to steroids, propranolol, a seven-day trial of propylthiouracil, and ultimately achieved a euthyroid state on discharge.

Publisher or Conference

Cureus

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