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Peri-operative Concerns in a Patient with Thyroid Storm Secondary to Molar Pregnancy

Overview
Journal Indian J Anaesth
Specialty Anesthesiology
Date 2016 Jan 13
PMID 26755840
Citations 5
Authors
Tanvir Samra
Ranvinder Kaur
Neha Sharma
Lalita Chaudhary
Affiliations
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Abstract

Awareness of the presence of thyroid function abnormalities in patients with molar pregnancy is important for its prompt diagnosis and management. We report the development of thyroid storm in the immediate post-operative period in a 25-year-old female who underwent evacuation of her molar pregnancy under saddle spinal block after being controlled for her thyrotoxicosis with a combination of antithyroid drugs, iodine, steroids and adrenergic blocking agents. We advocate the use of esmolol infusions up to a maximum dose of 200 μg/kg/min for immediate haemodynamic management of the patient. Optimum time needed for stabilisation of the hyper metabolic state after initiation of antithyroid drugs is still not known and evacuation of molar pregnancy remains the only definitive management of the thyrotoxic state.

Citing Articles

Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock.

Elmenyar E, Aoun S, Al Saadi Z, Barkumi A, Cander B, Al-Thani H Diagnostics (Basel). 2023; 13(19).

PMID: 37835772 PMC: 10572182. DOI: 10.3390/diagnostics13193028.

Severe Thyrotoxicosis Caused by Molar Pregnancy: A Case Report and Review of the Literature.

Frasik C, Luong E, Chang M, Sandhu S, Shah A Cureus. 2023; 15(4):e37582.

PMID: 37197102 PMC: 10184734. DOI: 10.7759/cureus.37582.

The Perfect Storm: A Case of Ischemic Stroke in the Setting of Thyroid Storm.

Snyder S, Joseph M Cureus. 2020; 12(5):e7992.

PMID: 32523847 PMC: 7274259. DOI: 10.7759/cureus.7992.

A Patient with Graves' Disease Scheduled for Thyroidectomy with High Risk for Thyroid Storm Caused by Severe Medication Nonadherence: Anaesthetic and Surgical Considerations.

Reber A, Valenti L, Muller S Case Rep Anesthesiol. 2019; 2019:4781902.

PMID: 31428477 PMC: 6679877. DOI: 10.1155/2019/4781902.

Advanced gestational trophoblastic disease: A case report of medical management prior to surgical intervention.

Lehto A, Hitscherich K, Argeros O Case Rep Womens Health. 2018; 19:e00072.

PMID: 30167379 PMC: 6111126. DOI: 10.1016/j.crwh.2018.e00072.

References
1.
Burch H, Wartofsky L . Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993; 22(2):263-77. View
2.
Papi G, Maria Corsello S, Pontecorvi A . Clinical concepts on thyroid emergencies. Front Endocrinol (Lausanne). 2014; 5:102. PMC: 4076793. DOI: 10.3389/fendo.2014.00102. View
3.
Seckin K, Baser E, Yeral I, Togrul C, Ozdal B, Gungor T . The impact of ultrasonographic lesion size and initial human chorionic gonadotropin values on treatment success in cases with complete hydatidiform mole. Eur Rev Med Pharmacol Sci. 2014; 17(24):3381-4. View
4.
Harada Y, Akiyama H, Yoshimoto T, Urao Y, Ryuzaki M, Handa M . Thyroid storm with multiple organ failure, disseminated intravascular coagulation, and stroke with a normal serum FT3 level. Intern Med. 2012; 51(17):2379-83. DOI: 10.2169/internalmedicine.51.7974. View
5.
Almeida C, Curi E, de Almeida C, Vieira D . Thyrotoxic crisis associated with gestational trophoblastic disease. Rev Bras Anestesiol. 2011; 61(5):604-9, 331-3. DOI: 10.1016/S0034-7094(11)70071-X. View