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Case report: Thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia

Thyroid storm, though extremely rare in toddlers, requires prompt diagnosis and treatment because it can be fatal if left untreated. However, thyroid storm is not often considered in the differential diagnosis of a febrile convulsion due to its rarity in children. Herein, we report the case of a 3-y...

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Autores principales: Aoki, Yusuke, Hanaki, Ryo, Toyoda, Hidemi, Emori, Koichi, Miyahara, Masazumi, Hirayama, Masahiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10311634/
https://www.ncbi.nlm.nih.gov/pubmed/37397147
http://dx.doi.org/10.3389/fped.2023.1213040
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author Aoki, Yusuke
Hanaki, Ryo
Toyoda, Hidemi
Emori, Koichi
Miyahara, Masazumi
Hirayama, Masahiro
author_facet Aoki, Yusuke
Hanaki, Ryo
Toyoda, Hidemi
Emori, Koichi
Miyahara, Masazumi
Hirayama, Masahiro
author_sort Aoki, Yusuke
collection PubMed
description Thyroid storm, though extremely rare in toddlers, requires prompt diagnosis and treatment because it can be fatal if left untreated. However, thyroid storm is not often considered in the differential diagnosis of a febrile convulsion due to its rarity in children. Herein, we report the case of a 3-year-old girl with thyroid storm who presented with febrile status epilepticus. Although the seizure was stopped by diazepam administration, her tachycardia and widened pulse pressure persisted, and severe hypoglycemia was observed. Based on the findings of thyromegaly, a history of excessive sweating and hyperactivity, and a family history of Graves' disease, she was eventually diagnosed with a thyroid storm. The patient was successfully treated with thiamazole, landiolol, hydrocortisone, and potassium iodide. Propranolol, a non-selective β-blocker, has been used to manage tachycardia during thyroid storm. However, a cardio-selective β1-blockers, landiolol hydrochloride, was used in our case to avoid worsening hypoglycemia. Febrile status epilepticus is one of the most common medical emergencies in childhood; it is necessary to rule out treatable underlying critical diseases such as septic meningitis and encephalitis. Thyroid storm should be considered in children presenting with prolonged febrile convulsion accompanied by findings that are not usually observed with febrile convulsions.
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spelling pubmed-103116342023-07-01 Case report: Thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia Aoki, Yusuke Hanaki, Ryo Toyoda, Hidemi Emori, Koichi Miyahara, Masazumi Hirayama, Masahiro Front Pediatr Pediatrics Thyroid storm, though extremely rare in toddlers, requires prompt diagnosis and treatment because it can be fatal if left untreated. However, thyroid storm is not often considered in the differential diagnosis of a febrile convulsion due to its rarity in children. Herein, we report the case of a 3-year-old girl with thyroid storm who presented with febrile status epilepticus. Although the seizure was stopped by diazepam administration, her tachycardia and widened pulse pressure persisted, and severe hypoglycemia was observed. Based on the findings of thyromegaly, a history of excessive sweating and hyperactivity, and a family history of Graves' disease, she was eventually diagnosed with a thyroid storm. The patient was successfully treated with thiamazole, landiolol, hydrocortisone, and potassium iodide. Propranolol, a non-selective β-blocker, has been used to manage tachycardia during thyroid storm. However, a cardio-selective β1-blockers, landiolol hydrochloride, was used in our case to avoid worsening hypoglycemia. Febrile status epilepticus is one of the most common medical emergencies in childhood; it is necessary to rule out treatable underlying critical diseases such as septic meningitis and encephalitis. Thyroid storm should be considered in children presenting with prolonged febrile convulsion accompanied by findings that are not usually observed with febrile convulsions. Frontiers Media S.A. 2023-06-16 /pmc/articles/PMC10311634/ /pubmed/37397147 http://dx.doi.org/10.3389/fped.2023.1213040 Text en © 2023 Aoki, Hanaki, Toyoda, Emori, Miyahara and Hirayama. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Aoki, Yusuke
Hanaki, Ryo
Toyoda, Hidemi
Emori, Koichi
Miyahara, Masazumi
Hirayama, Masahiro
Case report: Thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia
title Case report: Thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia
title_full Case report: Thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia
title_fullStr Case report: Thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia
title_full_unstemmed Case report: Thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia
title_short Case report: Thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia
title_sort case report: thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10311634/
https://www.ncbi.nlm.nih.gov/pubmed/37397147
http://dx.doi.org/10.3389/fped.2023.1213040
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