Diagnosis and management of intraoperative thyroid storm in a child with undiagnosed Graves’ disease: a case report

Amanda W. Schaefer, Pedro J. Solorzano, Ana C. Mavarez, Gustavo M. Muñoz-Monaco

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Thyroid storm is a life-threatening manifestation of thyrotoxicosis and presents with fever, diaphoresis, tachycardia, hypertension, and widened pulse pressure. Case presentation: We present a case of intraoperative thyroid storm in a 12-year-old female undergoing posterior spinal fusion. Despite adequate depth of anesthesia and analgesia, the patient was persistently tachycardic and hypertensive. The surgical procedure was uneventful. A thyroid panel drawn immediately after surgery showed undetectable thyroid stimulating hormone (TSH) and high free thyroxine (T4) consistent with thyroid storm. Conclusions: Intraoperative thyroid storm in a pediatric patient is extremely rare with nonspecific clinical symptoms. Low to undetectable TSH and elevated free T4 is diagnostic.

Original languageEnglish (US)
Article number52
JournalJA Clinical Reports
Volume8
Issue number1
DOIs
StatePublished - Dec 2022

Keywords

  • Graves’ disease
  • Pediatrics
  • Thyroid storm
  • Thyrotoxicosis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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