14 May 2014
: Case report
Thyroid storm following radioactive iodine (RAI) therapy for pediatric Grave's disease
Diagnostic / therapeutic accidents, Management of emergency care, Rare disease, Adverse events of drug therapy
Henry J. Rohrs IIIABDEF, Janet H. SilversteinABDEF, David A. WeinsteinABDEF, Robert J. AmdurABDEF, Michael J. HallerABDEFGDOI: 10.12659/AJCR.890366
Am J Case Rep 2014; 15:212-215
Abstract
BACKGROUND: A growing number of pediatric endocrinologists treat Graves disease with radioactive iodine (RAI) therapy due to the typically definitive nature of I-131 therapy. Given the published benefits and perceived low risks of RAI when compared to surgery or long-term anti-thyroid medication, the trend towards therapy with RAI is likely to continue. Nevertheless, RAI is not without significant risk.
CASE REPORT: An 11-year-old girl with newly diagnosed Graves disease received RAI for definitive treatment of her hyperthyroidism. Within 24 hours of receiving I-131, she developed increasing sleepiness and eventually became unresponsive. Upon arrival at the emergency department she had a tonic-clonic seizure and was diagnosed with thyroid storm. Despite best efforts to manage her hyperthyroidism, she suffered a stroke of the left cerebral hemisphere that left her with persistent neurological deficits.
CONCLUSIONS: Although thyroid storm after thyroid ablation is rare, the significant morbidity and potential mortality of pediatric thyroid storm warrant further studies to determine if children with markedly elevated thyroid hormone concentrations at diagnosis should receive prolonged pretreatment with anti-thyroid drugs. While such an approach may reduce the efficacy of I-131 ablation, it can also reduce and hopefully eliminate the risk of post-ablative thyroid storm.
Keywords: Graves Disease, hyperthyroidism, Iodine Radioisotopes, thyroid storm, Pediatrics
In Press
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.945747
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.945539
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.945795
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.946588
Most Viewed Current Articles
21 Jun 2024 : Case report
88,518
DOI :10.12659/AJCR.944371
Am J Case Rep 2024; 25:e944371
07 Mar 2024 : Case report
50,005
DOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
20 Nov 2023 : Case report
25,154
DOI :10.12659/AJCR.941424
Am J Case Rep 2023; 24:e941424
18 Feb 2024 : Case report
22,640
DOI :10.12659/AJCR.943030
Am J Case Rep 2024; 25:e943030