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Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease

Patient: Female, 11 Final Diagnosis: Thyroid storm Symptoms: Diarrhea • tachycardia • tachypnea • tremor • wheezing Medication: — Clinical Procedure: — Specialty: — OBJECTIVE: Rare disease BACKGROUND: A growing number of pediatric endocrinologists treat Graves disease with radioactive iodine (RAI) t...

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Autores principales: Rohrs, Henry J., Silverstein, Janet H., Weinstein, David A., Amdur, Robert J., Haller, Michael J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026146/
https://www.ncbi.nlm.nih.gov/pubmed/24847412
http://dx.doi.org/10.12659/AJCR.890366
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author Rohrs, Henry J.
Silverstein, Janet H.
Weinstein, David A.
Amdur, Robert J.
Haller, Michael J.
author_facet Rohrs, Henry J.
Silverstein, Janet H.
Weinstein, David A.
Amdur, Robert J.
Haller, Michael J.
author_sort Rohrs, Henry J.
collection PubMed
description Patient: Female, 11 Final Diagnosis: Thyroid storm Symptoms: Diarrhea • tachycardia • tachypnea • tremor • wheezing Medication: — Clinical Procedure: — Specialty: — OBJECTIVE: Rare disease BACKGROUND: A growing number of pediatric endocrinologists treat Graves disease with radioactive iodine (RAI) therapy due to the typically definitive nature of I-131 therapy. Given the published benefits and perceived low risks of RAI when compared to surgery or long-term anti-thyroid medication, the trend towards therapy with RAI is likely to continue. Nevertheless, RAI is not without significant risk. CASE REPORT: An 11-year-old girl with newly diagnosed Graves disease received RAI for definitive treatment of her hyperthyroidism. Within 24 hours of receiving I-131, she developed increasing sleepiness and eventually became unresponsive. Upon arrival at the emergency department she had a tonic-clonic seizure and was diagnosed with thyroid storm. Despite best efforts to manage her hyperthyroidism, she suffered a stroke of the left cerebral hemisphere that left her with persistent neurological deficits. CONCLUSIONS: Although thyroid storm after thyroid ablation is rare, the significant morbidity and potential mortality of pediatric thyroid storm warrant further studies to determine if children with markedly elevated thyroid hormone concentrations at diagnosis should receive prolonged pretreatment with anti-thyroid drugs. While such an approach may reduce the efficacy of I-131 ablation, it can also reduce and hopefully eliminate the risk of post-ablative thyroid storm.
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spelling pubmed-40261462014-05-20 Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease Rohrs, Henry J. Silverstein, Janet H. Weinstein, David A. Amdur, Robert J. Haller, Michael J. Am J Case Rep Articles Patient: Female, 11 Final Diagnosis: Thyroid storm Symptoms: Diarrhea • tachycardia • tachypnea • tremor • wheezing Medication: — Clinical Procedure: — Specialty: — OBJECTIVE: Rare disease BACKGROUND: A growing number of pediatric endocrinologists treat Graves disease with radioactive iodine (RAI) therapy due to the typically definitive nature of I-131 therapy. Given the published benefits and perceived low risks of RAI when compared to surgery or long-term anti-thyroid medication, the trend towards therapy with RAI is likely to continue. Nevertheless, RAI is not without significant risk. CASE REPORT: An 11-year-old girl with newly diagnosed Graves disease received RAI for definitive treatment of her hyperthyroidism. Within 24 hours of receiving I-131, she developed increasing sleepiness and eventually became unresponsive. Upon arrival at the emergency department she had a tonic-clonic seizure and was diagnosed with thyroid storm. Despite best efforts to manage her hyperthyroidism, she suffered a stroke of the left cerebral hemisphere that left her with persistent neurological deficits. CONCLUSIONS: Although thyroid storm after thyroid ablation is rare, the significant morbidity and potential mortality of pediatric thyroid storm warrant further studies to determine if children with markedly elevated thyroid hormone concentrations at diagnosis should receive prolonged pretreatment with anti-thyroid drugs. While such an approach may reduce the efficacy of I-131 ablation, it can also reduce and hopefully eliminate the risk of post-ablative thyroid storm. International Scientific Literature, Inc. 2014-05-14 /pmc/articles/PMC4026146/ /pubmed/24847412 http://dx.doi.org/10.12659/AJCR.890366 Text en © Am J Case Rep, 2014 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License
spellingShingle Articles
Rohrs, Henry J.
Silverstein, Janet H.
Weinstein, David A.
Amdur, Robert J.
Haller, Michael J.
Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease
title Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease
title_full Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease
title_fullStr Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease
title_full_unstemmed Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease
title_short Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease
title_sort thyroid storm following radioactive iodine (rai) therapy for pediatric graves disease
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026146/
https://www.ncbi.nlm.nih.gov/pubmed/24847412
http://dx.doi.org/10.12659/AJCR.890366
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