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Year : 2020  |  Volume : 10  |  Issue : 1  |  Page : 38-41

Thyroid storm with encephalopathy and cardiovascular symptoms refractory to medical management in an adolescent

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

Correspondence Address:
Dr. Jigar C Chauhan
Department of Pediatrics, Division of Pediatric Critical Care Medicine, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, Delaware 19803
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJCIIS.IJCIIS_58_19

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Thyroid storm (TS) is rare in pediatrics, most cases reported in literature responded well to medical therapy. We report the case of an adolescent female presented with TS refractory to anti-thyroid medical management. She had refractory hypertension, tachycardia, and progressive encephalopathy despite aggressive medical management. She underwent subtotal thyroidectomy after 2 weeks of failed medical management with a complete resolution of symptoms within days of surgery. We also learned sodium nitroprusside with its direct vasodilatory effect on conduit vessels, verapamil with its rate control properties, and labetalol with its dual sympathetic blockage property were beneficial in the management of this patient.

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