1/10. Hypoglycemic coma masquerading thyrotoxic storm.A 59-year-old woman was hospitalized in hypoglycemic coma. Although hypoglycemia was promptly reversed, she was in a somnolent, restless state with tachycardia, tremor, profuse sweating, and high body temperature. Thyrotoxic storm was highly suspected and vigorous antithyroid regimens gradually brought her up to normal mental and cardiovascular states in several days. However, profound generalized myopathy necessitated the maintenance with a respirator. One month later, an episode of angina pectoris was followed by generalized convulsion, coma, and death in a few days. neuroimaging study disclosed posterior leukoencephalopathy syndrome. This case is instructive in that hypoglycemic coma may masquerade the major symptomatology of thyrotoxic storm, and that profound myopathy and angiopathic or angiospastic processes of the brain and the heart may interfere with the outcome.- - - - - - - - - - ranking = 1keywords = coma (Clic here for more details about this article) |
2/10. thyroidectomy in iodine induced thyrotoxic storm.Between January 1996 and September 1997 we treated 4 patients with iodine-induced thyrotoxic storm (2 females, 2 men; age 54-77 years). iodine contamination was due to iodine-containing contrast media in 3 patients and iodine-containing disinfectant in 1 patient. Thyroid storm with tachycardia, hypertension, sweating, tremor, weight loss and coma occured 3-10 weeks after iodine contamination. These symptoms were accompanied by raised fT4- and fT3-values. All 4 patients were initially treated with antithyroid drugs for 7 days, whereas 2 patients with coronary artery disease, demonstrated by coronary angio-graphy, were treated with antithyroid drugs for 2 weeks. Because of unsuccessful antithyroid drug treatment, all 4 patients underwent subtotal thyroidectomy. There were no perioperative complications. We conclude that early thyroidectomy is the appropriate treatment for iodine-induced thyrotoxicosis even in patients with severe accompanying diseases.- - - - - - - - - - ranking = 0.14285714285714keywords = coma (Clic here for more details about this article) |
3/10. Coma and thyroid storm in apathetic thyrotoxicosis.We report the case of an 87-year-old woman with coma who was found to be in thyrotoxic crisis. The patient had a recent history of decreased mentation and apathy, and laboratory findings were found to be consistent with hyperthyroidism. After a stormy course, the clinical condition recovered to baseline, with return of laboratory values to normal following antithyroid therapy. We provide the details of this rarely documented presentation of apathetic hyperthyroidism with thyroid storm and coma and review the characteristics of similar cases in the literature.- - - - - - - - - - ranking = 0.28571428571429keywords = coma (Clic here for more details about this article) |
4/10. rhabdomyolysis accompanying thyroid crisis: an autopsy case report.rhabdomyolysis is occasionally associated with metabolic disorders such as diabetic coma, severe electrolyte disturbances and myxedema coma. We describe rhabdomyolysis accompanying thyroid crisis. A 50-year-old man with Graves' disease developed rhabdomyolysis, congestive heart failure and hepatic failure during the course of thyroid crisis and then died of acute renal failure. Postmortem examination revealed rhabdomyolysis in the cardiac and psoas muscles, old myocardial infarction, hepatic centrilobular necrosis, renal cortical necrosis, and follicular hyperplasia in the thyroid. Circulatory collapse and dehydration under excessive hypermetabolic state presumably suppressed the source of energy and oxygen for muscle cells, leading to cellular damage.- - - - - - - - - - ranking = 0.28571428571429keywords = coma (Clic here for more details about this article) |
5/10. Thyroid storm and ventricular tachycardia.A 34-year-old woman was brought to our emergency department because of sudden loss of consciousness. Ventricular tachycardia and fibrillation were noted on electrocardiographic monitoring and reverted to sinus rhythm after repeated defibrillation. She was treated as a case of thyroid storm. Although tachycardia and fever normalized after 2 days, she remained comatose and died. This is an unusual case because the patient's initial presentation was cardiac arrest without previous history of cardiac disease. To our knowledge, this is the first reported case where ventricular tachyarrhythmia was the initial presenting sign of thyroid storm.- - - - - - - - - - ranking = 0.14285714285714keywords = coma (Clic here for more details about this article) |
6/10. Thyroid storm as precipitating factor in onset of coma in an elderly woman: case report and literature review.Thyroid storm is an uncommon but life-threatening manifestation of hyperthyroidism which, unless appropriately treated by combined therapy, causes 30-60% of deaths in hospitalized patients. Mental deterioration leading to apathy and eventually coma is a rare clinical presentation of this pathology, frequently observed in the elderly. We present the case of a 77-year-old hypertensive woman who was hospitalized for fast onset of coma, probably due to the unusual combination of a hypernatremic hyperosmolar state and an unexpected thyroid storm (TS). Although not definitely ascertained, the possible etiology was the hyperthyroid phase of chronic autoimmune thyreopathy (Hashitoxicosis). Notably, the significant adjunctive role of thyroid hyperfunction in the pathogenesis of coma was confirmed by the fact that, although metabolic abnormalities were overcome, complete and satisfactory recovery of the patient's mental and physical condition occurred only with normalization of thyroid hormones by antithyroid treatment. Our case highlights the importance of properly evaluating thyroid function in elderly patients who show a sudden progressive impairment in their mental condition, for early detection of potentially fatal conditions such as thyroid storm or myxedematous coma.- - - - - - - - - - ranking = 1.1428571428571keywords = coma (Clic here for more details about this article) |
7/10. Thyroid storm. Presenting with coma and seizures. In a 3-year-old girl.Thyroid storm is a rare occurrence in the adult population and is even more unusual in children. The current report is of a 3.5-year-old girl who had thyroid storm with unique neurologic manifestations, namely seizure and coma. Acute medical management with propylthiouracil, saturated solution of potassium iodide, hydrocortisone, and propranolol brought about complete resolution of symptoms.- - - - - - - - - - ranking = 0.71428571428571keywords = coma (Clic here for more details about this article) |
8/10. Thyroid storm presenting as coma.Presented is the case of a 32-year-old man admitted with coma, hyperthermia, and tachycardia. The patient had a progressive downhill course and died in the medical ICU ten hours after admission. autopsy and further investigation revealed thyroid storm as the most likely cause of death.- - - - - - - - - - ranking = 0.71428571428571keywords = coma (Clic here for more details about this article) |
9/10. reserpine in propranolol-resistant thyroid storm.beta-Adrenergic blockers are considered the drugs of choice in the management of the hyperadrenergic state in hyperthyroidism. However, we observed a patient in thyroid storm and coma who failed to respond to large doses of oral and intravenous propranolol hydrochloride but who responded promptly to intramuscular reserpine. reserpine may have been lifesaving and should be considered in propranolol-resistant hyperthyroidism and in hyperthyroid patients in whom propranolol is contraindicated.- - - - - - - - - - ranking = 0.14285714285714keywords = coma (Clic here for more details about this article) |
10/10. thyroid crisis presenting as coma.Coma is a rare complication of thyrotoxicosis. A patient with coma due to a thyroid crisis is reported. The EEG showed extremely slow and low voltage activity, which gradually returned to normal. Coma as a presenting symptom of thyroid crisis has not been reported before.- - - - - - - - - - ranking = 0.71428571428571keywords = coma (Clic here for more details about this article) |
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