Lithium as pre-radioablative treatment of Graves’ Disease Complicated by Thyroid Storm and Methimazole-induced Agranulocytosis: A case report
- Author:
Valerie R. Ramiro
1
,
2
;
Jose Paolo P. Panuda
2
,
3
;
Cecileen Anne M. Tuazon
1
,
2
;
Roland Reuben B. Angeles
1
,
2
;
Iris Thiele Isip-Tan
2
,
3
Author Information
- Publication Type:Case Reports
- MeSH: Methimazole; Lithium
- From: Philippine Journal of Internal Medicine 2022;60(2):143-146
- CountryPhilippines
- Language:English
- Abstract: Thyroid storm and thionamide-induced agranulocytosis are both rare and serious medical emergencies. We report a case of a patient in which these two rare events simultaneously occurred. A 33-year-old male, maintained on Methimazole for Graves’ Disease, presented with fever, throat pain, and uncontrolled thyrotoxic symptoms. Methimazole was promptly discontinued. Thyroid storm was alternatively treated with lithium, hydrocortisone, and propranolol. Agranulocytosis was managed supportively with GCSF and empiric antibiotics. Lithium was maintained until after radioablation. When thionamides are contraindicated, lithium is a viable option for the acute management of thyroid storm and a bridge to definitive therapy.
- Full text:Lithium.pdf
