Key result
In a 75-year-old man with amiodarone-induced thyroid storm and refractory monomorphic ventricular tachycardia, plasmapheresis was initiated as a salvage therapy but the patient ultimately expired.
Why the study?
Thyroid storm is a rare endocrine emergency with high mortality, and optimal management options are needed when standard anti-arrhythmic therapy becomes contraindicated for refractory ventricular arrhythmias.
Case Report (n=1)
Plasmapheresis was attempted as a salvage therapy for amiodarone-induced thyroid storm with refractory ventricular tachycardia when standard medical therapies were contraindicated, though it was ultimately unsuccessful in this case.
Case of amiodarone-induced thyroid storm illustrates management; leaves open optimal antiarrhythmic strategies in refractory thyrotoxicosis.
Thyroid storm is a rare endocrine emergency with a high mortality rate approaching 20%. It manifests with the exaggerated symptoms of hyperthyroidism including hyperpyrexia, hypotension, cardiac arrhythmias, and death. The mainstay of treatment includes supportive intensive care and initiation of thionamides, beta blockers, corticosteroids, and if necessary anti-arrhythmics in the presence of refractory ventricular arrhythmias. We describe a case of amiodarone-induced thyrotoxicosis and thyroid storm leading to refractory ventricular tachycardias treated with plasmapheresis when anti-arrhythmic therapy became contraindicated. Amiodarone-induced thyroid storm can lead to monomorphic ventricular tachycardia. Under the circumstances of limited medical therapies, plasmapheresis can be an effective treatment option.
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Upadhyaya et al. (2020) conducted a case report in Amiodarone-induced thyroid storm with sustained monomorphic ventricular tachycardia (n=1). Plasmapheresis was evaluated on Clinical outcome. In a 75-year-old man with amiodarone-induced thyroid storm and refractory monomorphic ventricular tachycardia, plasmapheresis was initiated as a salvage therapy but the patient ultimately expired.
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