Thyroid Storm Masked by Hemodialysis and Glucocorticoid Therapy in a Patient with Rheumatoid ArthritisSasaki Y. · Shimizu Y. · Nakata J. · Kameda T. · Muto M. · Ohsawa I. · Io H. · Hamada C. · Horikoshi S. · Tomino Y.
Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
Thyroid function test values are generally at low levels in patients with end-stage kidney disease. Life-threatening thyrotoxicosis or thyroid storm is rare, especially in hemodialysis (HD) patients, and is characterized by multisystem involvement and a high mortality rate if not immediately recognized and treated. Here, we report a female patient with severe symptomatic thyroid storm, receiving long-term HD and glucocorticoid therapy. Methimazole at a dose of 15 mg per day, β-adrenergic blockade and HD succeeded in controlling the patient’s condition by gradually adjusting the target dry weight for hyperthyroidism-induced weight loss. When she was discharged from the hospital, her dry weight was reduced from 47.2 to 39.2 kg. The management of patients with severe symptomatic thyroid storm on HD represents a rare scenario. It is essential to initiate the available treatments as early as possible to reduce its mortality.
Yasuhiko Tomino, MD, PhD
Division of Nephrology, Department of Internal MedicineJuntendo University Faculty of Medicine2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421 (Japan)
Tel. +81 3 5802 1065, E-Mail firstname.lastname@example.org
Published online: February 16, 2012
Number of Print Pages : 5
Number of Figures : 1,
Case Reports in Nephrology and Urology
Vol. 2, No. 1, Year 2012 (Cover Date: January - April)
Journal Editor: Tomino Y. (Tokyo), Tang S. (Hong Kong)
ISSN: 1664-5510 (Print), eISSN: 1664-5510 (Online)
For additional information: http://www.karger.com/CRU