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Thyroid Storm Superimposed on Gestational Hypertension: A Case Report and Review of Literature

A thyroid storm is an extreme manifestation of thyrotoxicosis, and is life threatening without an early diagnosis. Pregnancy or childbirth may worsen maternal hyperthyroidism or induce the development of a thyroid storm. Gestational hypertension, a disorder defined as new-onset hypertension, develop...

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Autores principales: Chen, Yen-Hua, Liao, Chan-Pin, Lu, Cheng-Wei, Lin, Tzu-Yu, Chang, Ya-Ying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951575/
https://www.ncbi.nlm.nih.gov/pubmed/35334626
http://dx.doi.org/10.3390/medicina58030450
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author Chen, Yen-Hua
Liao, Chan-Pin
Lu, Cheng-Wei
Lin, Tzu-Yu
Chang, Ya-Ying
author_facet Chen, Yen-Hua
Liao, Chan-Pin
Lu, Cheng-Wei
Lin, Tzu-Yu
Chang, Ya-Ying
author_sort Chen, Yen-Hua
collection PubMed
description A thyroid storm is an extreme manifestation of thyrotoxicosis, and is life threatening without an early diagnosis. Pregnancy or childbirth may worsen maternal hyperthyroidism or induce the development of a thyroid storm. Gestational hypertension, a disorder defined as new-onset hypertension, develops after 20 weeks of gestation and shares symptoms with a thyroid storm. The diagnosis of a thyroid storm may be challenging in patients with gestational hypertension. To highlight the significance of early thyrotoxicosis-related gastrointestinal symptoms, we report a case of a 38-year-old woman with a twin pregnancy, who was diagnosed with gestational hypertension, and then developed a thyroid storm during the peripartum period. She complained of nausea and abdominal pain, followed by tachycardia, hypertension, and a disturbance of consciousness with desaturation. After emergency caesarean section, fever, diarrhea, and high-output heart failure, with pulmonary edema, were noted during the postoperative period in the intensive care unit. The diagnosis of a thyroid storm was confirmed using the Burch–Wartofsky point scale, which was 75 points. In this patient, the uncommon gastrointestinal symptoms, as initial manifestations of thyrotoxicosis, indicated the development of a thyroid storm. The distinguished presentation of thyrotoxicosis-induced cardiomyopathy and peripartum cardiomyopathy also helped in the differential diagnosis between a thyroid storm and gestational hypertension. Aggressive treatment for thyrotoxicosis should not be delayed because of a missed diagnosis.
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spelling pubmed-89515752022-03-26 Thyroid Storm Superimposed on Gestational Hypertension: A Case Report and Review of Literature Chen, Yen-Hua Liao, Chan-Pin Lu, Cheng-Wei Lin, Tzu-Yu Chang, Ya-Ying Medicina (Kaunas) Case Report A thyroid storm is an extreme manifestation of thyrotoxicosis, and is life threatening without an early diagnosis. Pregnancy or childbirth may worsen maternal hyperthyroidism or induce the development of a thyroid storm. Gestational hypertension, a disorder defined as new-onset hypertension, develops after 20 weeks of gestation and shares symptoms with a thyroid storm. The diagnosis of a thyroid storm may be challenging in patients with gestational hypertension. To highlight the significance of early thyrotoxicosis-related gastrointestinal symptoms, we report a case of a 38-year-old woman with a twin pregnancy, who was diagnosed with gestational hypertension, and then developed a thyroid storm during the peripartum period. She complained of nausea and abdominal pain, followed by tachycardia, hypertension, and a disturbance of consciousness with desaturation. After emergency caesarean section, fever, diarrhea, and high-output heart failure, with pulmonary edema, were noted during the postoperative period in the intensive care unit. The diagnosis of a thyroid storm was confirmed using the Burch–Wartofsky point scale, which was 75 points. In this patient, the uncommon gastrointestinal symptoms, as initial manifestations of thyrotoxicosis, indicated the development of a thyroid storm. The distinguished presentation of thyrotoxicosis-induced cardiomyopathy and peripartum cardiomyopathy also helped in the differential diagnosis between a thyroid storm and gestational hypertension. Aggressive treatment for thyrotoxicosis should not be delayed because of a missed diagnosis. MDPI 2022-03-20 /pmc/articles/PMC8951575/ /pubmed/35334626 http://dx.doi.org/10.3390/medicina58030450 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Chen, Yen-Hua
Liao, Chan-Pin
Lu, Cheng-Wei
Lin, Tzu-Yu
Chang, Ya-Ying
Thyroid Storm Superimposed on Gestational Hypertension: A Case Report and Review of Literature
title Thyroid Storm Superimposed on Gestational Hypertension: A Case Report and Review of Literature
title_full Thyroid Storm Superimposed on Gestational Hypertension: A Case Report and Review of Literature
title_fullStr Thyroid Storm Superimposed on Gestational Hypertension: A Case Report and Review of Literature
title_full_unstemmed Thyroid Storm Superimposed on Gestational Hypertension: A Case Report and Review of Literature
title_short Thyroid Storm Superimposed on Gestational Hypertension: A Case Report and Review of Literature
title_sort thyroid storm superimposed on gestational hypertension: a case report and review of literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951575/
https://www.ncbi.nlm.nih.gov/pubmed/35334626
http://dx.doi.org/10.3390/medicina58030450
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