Fatal case of possible Thyroid Crisis Induced by SARS-CoV-2 Infection: A case report
https://doi.org/10.15605/jafes.037.02.19
- Author:
Febriyani Hamzah
1
;
Andi Makbul Aman
2
;
Harun Iskandar
3
Author Information
1. Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
2. Division of Metabolic Endocrine, Department of Internal Medicine, Faculty of Medicine, Hasanuddin University - Wahidin Sudirohusodo Hospital, Makassar, Indonesia
3. Division of Pulmonology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
- Publication Type:Other Types
- Keywords:
SARS CoV-2
- MeSH:
COVID-19;
Thyroid Crisis;
Thyroid Crisis;
Thyrotoxicosis
- From:
Journal of the ASEAN Federation of Endocrine Societies
2022;37(2):101-105
- CountryPhilippines
- Language:English
-
Abstract:
Thyroid crisis is an emergency due to impaired thyroid function caused by various conditions, particularly infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that result in the dysfunction of various vital organs. We report a case of a 31-year-old Indonesian female with a 2-year history of hyperthyroidism with elevated thyroid-stimulating hormone (TSH) receptor antibodies. (TRAb) who developed thyroid crisis possibly in association with SARS-CoV-2 pneumonia, sepsis, and disseminated intravascular coagulation (DIC). Prior to admission, she was treated for her hyperthyroidism with propylthiouracil and had been in stable remission for a year. She was admitted to the Emergency Room with complaints of watery stools, icteric sclerae, jaundice, coughing, and shortness of breath. The physical examination showed a World Health Organization (WHO) performance score of 4, delirium, blood pressure within normal limits, tachycardia, tachypnea, axillary temperature of 36.7°C, icteric sclerae, jaundice, and exophthalmos. There was a 3 cm palpable nodule on the right side of the neck. Auscultation of the lungs revealed bilateral pulmonary rales. Abdominal examination noted a palpable liver and enlarged spleen. Laboratory tests showed thrombocytopenia, electrolyte imbalance, hypoalbuminemia and elevated transaminases. The thyroid function tests showed a suppressed TSH level with an elevated free thyroxine (FT4) level. The SARS-CoV-2 polymerase chain reaction (PCR) swab test was positive. Initial patient management was with supportive therapy that included favipiravir and anti-hyperthyroidism medication; however, despite these interventions, her condition continued to deteriorate and she died after a few hours. This case demonstrates no difference in therapy between patients with thyroid crises and COVID-19 or other infections. Proper and timely treatment is important for reducing mortality rates.
- Full text:2171-Article Text-21575-1-10-20221125.pdf
