SHM Converge Scientific Abstract ePoster Gallery-Defying the Storm; Hospitalist Led Multidisciplinary Management of Thyroid Storm in a Community Hospital

Defying the Storm; Hospitalist Led Multidisciplinary Management of Thyroid Storm in a Community Hospital

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This case report describes a life-threatening thyroid storm in an 80-year-old woman with Graves disease who developed atrial fibrillation with rapid ventricular response and heart failure symptoms after a respiratory infection. Initial treatment with beta-blockade, high-dose methimazole, corticosteroids, and cholestyramine was insufficient, and her care was complicated by hypotension limiting beta-blocker use and by coagulopathy.<br /><br />Because of persistent instability, a multidisciplinary team including hospital medicine, endocrinology, cardiology, and critical care was assembled in a community hospital setting. She was transferred to the ICU for therapeutic plasmapheresis, which led to rapid improvement in thyroid levels, heart rate control, and hemodynamics, allowing medications to be reduced.<br /><br />The report emphasizes that thyroid storm must be recognized early, especially in elderly patients with multiple comorbidities, and that escalation beyond standard therapy is sometimes necessary. It also highlights the importance of individualized antithyroid drug selection, especially when hepatic dysfunction is present, and notes that therapeutic plasmapheresis can serve as an effective rescue treatment for medication-refractory cases. Overall, the case underscores the central role of hospitalists in coordinating timely, cross-specialty management in resource-limited community hospital environments.

Asset Subtitle

Anitha Chandran

Meta Tag

Author List Anitha Chandran, Sushma Madala

Category Clinical Vignettes

Concept Thyroid Storm

Concept Refractory Disease

Concept Total Plasma Exchange

Concept Antithyroid Medication

Distinguished Non-Finalist

Presenter Organization Vituity

Presenting Author Anitha Chandran

Track Adult

Keywords

thyroid storm

Graves disease

atrial fibrillation

heart failure

plasmapheresis

beta-blockade

methimazole

corticosteroids

community hospital

critical care

Thyroid Storm

Refractory Disease

Total Plasma Exchange

Antithyroid Medication