Weathering the Crisis: A Case of Thyroid Crisis with Propranolol-Induced Circulatory Collapse Successfully Treated with Therapeutic Plasma Exchange

J ASEAN Fed Endocr Soc. 2019;34(2):206-209. doi: 10.15605/jafes.034.02.12. Epub 2019 Nov 9.

Abstract

Thyroid crisis is a life-threatening form of thyrotoxicosis characterized by multi-system dysfunction. Therapeutic plasma exchange has been reported to be effective in removing excessive circulating thyroid hormones. We present a 46-year-old female with recently diagnosed Graves' disease associated with thyrotoxic cardiomyopathy admitted for thyroid crisis complicated by propranolol-induced circulatory collapse, acute kidney injury and ischemic hepatitis. The tachyarrhythmia was refractory to conventional therapy. Initiation of TPE resulted in rapid clinical and biochemical stabilization.

Keywords: cardiomyopathy; circulatory collapse; propranolol; therapeutic plasma exchange; thyroid crisis.

Publication types

  • Case Reports