Thyrotoxicosis and Choledocholithiasis Masquerading as Thyroid Storm
Joint Authors
Horn, Christian L.
Short, Patricia A.
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-08-23
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
A 26-year-old female, thirteen months postpartum, presented to the emergency department for four weeks of epigastric abdominal pain, pruritus, new onset jaundice, and 11.3 kgs (25 lbs) unintentional weight loss.
On examination, she was afebrile, tachycardic, alert, and oriented and had jaundice with scleral icterus.
Labs were significant for undetectable TSH, FT4 that was too high to measure, and elevated total bilirubin, direct bilirubin, alkaline phosphatase, and transaminases.
Abdominal ultrasound revealed cholelithiasis without biliary ductal dilation.
Treatment for presumed thyroid storm was initiated.
Further work-up with magnetic resonance cholangiopancreatography (MRCP) revealed an obstructing cholelith within the distal common bile duct.
With the presence of choledocholithiasis explaining the jaundice and abdominal pain, plus the absence of CNS alterations, the diagnosis of thyroid storm was revised to thyrotoxicosis complicated by choledocholithiasis.
Endoscopic retrograde cholangiopancreatogram (ERCP) with sphincterotomy was performed to alleviate the biliary obstruction, with prompt symptomatic improvement.
Thyroid storm is a rare manifestation of hyperthyroidism with a high rate of morbidity and mortality.
The diagnosis of thyroid storm is based on clinical examination, and abnormal thyroid function tests do not correlate with disease severity.
Knowledge of the many manifestations of thyroid storm will facilitate a quick and accurate diagnosis and treatment.
American Psychological Association (APA)
Horn, Christian L.& Short, Patricia A.. 2017. Thyrotoxicosis and Choledocholithiasis Masquerading as Thyroid Storm. Case Reports in Medicine،Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1146921
Modern Language Association (MLA)
Horn, Christian L.& Short, Patricia A.. Thyrotoxicosis and Choledocholithiasis Masquerading as Thyroid Storm. Case Reports in Medicine No. 2017 (2017), pp.1-5.
https://search.emarefa.net/detail/BIM-1146921
American Medical Association (AMA)
Horn, Christian L.& Short, Patricia A.. Thyrotoxicosis and Choledocholithiasis Masquerading as Thyroid Storm. Case Reports in Medicine. 2017. Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1146921
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1146921