Thyrotoxic storm diagnosed due to postoperative tachycardia: A case report

Lee, Soon Ae; Kim, Seong Hoon; Lee, Seung Duk; Yoon, Sang Jo; Kim, Jae Hyun

doi:2015.10.1.57

Anesth Pain Med > Volume 10(1); 2015 > Article

Case Report

General Article

Anesthesia and Pain Medicine 2015;10(1):57-60.
DOI: https://doi.org/10.17085/apm.2015.10.1.57 Published online January 31, 2015.

Thyrotoxic storm diagnosed due to postoperative tachycardia: A case report

Soon Ae Lee, Seong Hoon Kim, Seung Duk Lee, Sang Jo Yoon, Jae Hyun Kim

¹Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang, Korea. anesth-lsa@ncc.re.kr
²Center for Liver Cancer, National Cancer Center, Goyang, Korea.

Received: 4 September 2014 • Revised: 18 September 2014 • Accepted: 16 December 2014

Abstract

Thyrotoxic storm is an extreme state of thyrotoxicosis and a medical emergency. The clinical presentation of thyrotoxic storm includes tachycardia, fever, organ effect of central nervous system, cardiovascular system, and gastrointestinal system dysfunction. It usually occurs in patients with untreated or partially treated Graves' disease. Although it is rare, its mortality rate has reached 10-20%. There are no specific tests for establishing the diagnosis; it can only be diagnosed based on the clinical expression and laboratory results. Rapid diagnosis and treatment are necessary when it unexpectedly occurs during the perioperative period. We report a case of unnoticed hyperthyroidism that was diagnosed due to thyrotoxic storm-induced tachycardia in the post anesthesia care unit.

Key Words: Hyperthyroidism, Liver transplantation, Living donors, Thyroid crisis