24 August 2023: Articles
Thyroid Storm-Induced Refractory Multiorgan Failure Managed by Veno-Arterial Extracorporeal Membrane Oxygenation Support: A Case-Series
Unusual clinical course, Management of emergency care
Mugahid Eltahir A , Hamza Chaudhry A , Ezzeddin Abdulsalam Ibrahim A , Marwa Mokhtar B , Hani Jaouni A , Ibrahim Fawzy Hassan D , Ayman El-Menyar A* , Ahmed Labib Shehatta ADOI: 10.12659/AJCR.940672
Am J Case Rep 2023; 24:e940672
Table 2. Laboratory tests and outcomes of the 4 cases.
| Patient 1 | Patient 2 | Patient 3 | Patient 4 | Reference range | |
|---|---|---|---|---|---|
| TSH on presentation | 0.03 | 0.01 | 0.01 | 0.005 | 0.65–3.7 mU/L |
| T4 on presentation | 38 | 38.9 | 15.9 | 84 | 0.65–3.7 mU/L |
| Antithyroid peroxidase | Positive | Positive | Positive | Positive | |
| Creatinine | 323 | 172 | 81 | 184 | 54–101 µmol/L |
| Continuous renal replacement therapy | Yes | Yes | Yes | Yes | |
| ALT | 114 | 125 | 320 | 829 | 6–66 U/L |
| AST | 283 | 93 | 753 | 4606 | 2–42 U/L |
| IgE count | 1203 | 480 | Not sent | Not sent | 1.5–144 IU/mL |
| Plasmapheresis | 3 sessions | 3 sessions | 3 sessions | 3 sessions | |
| Iodine before surgery | Received | Received | Received | Received | |
| Thyroidectomy on ECMO support | Yes | Yes | 5 days after decannulation | Thyroidectomy was not done | |
| Duration of ECMO | 4 days | 6 days | 5 days | 9 days | |
| Outcome | Discharged well | Discharged well | Discharged well | Deceased |