DOI: 10.36347/sjmcr.2019.v07i03.012

Pages: 207-211

Thyroid storm is a rare, but life-threatening condition that requires rapid diagnosis and emergent treatment. In the treatment of thyrotoxicosis, alternative treatment modalities are required when anti-thyroid drugs (ATD) cannot be used either because of their side effects or their inefficiencies, or when it is necessary to start a rapid action such as thyroid storm. By using plasmapheresis, it is possible to effectively and rapidly remove the thyroid hormones that have been increased in the blood. This observation aimed to illustrate the difficulties to treat a patient allergic to ATD who presented a thyroid storm caused by multinodular thyrotoxic goiter. She presented a cardiovascular compromise and massively elevated free thyroxin (FT4: 70 pmol/l). Corticosteroid, propanolol, lugol solution and antibiotic were administrated. Plasmapheresis was also indicated. After three sessions of plasma exchanges, FT4 declined and the patient's status was stable and allowed her to get surgery. Plasma exchanging appears to be effective in removing protein bound thyroid hormone when a thyroid storm occurs or when common ATD can’t be used as it was the case of our patient.