Graves' disease treated by complementary medicine leading to thyroid storm: A case report.


Journal

Caspian journal of internal medicine
ISSN: 2008-6164
Titre abrégé: Caspian J Intern Med
Pays: Iran
ID NLM: 101523876

Informations de publication

Date de publication:
2021
Historique:
received: 12 06 2020
revised: 28 10 2020
accepted: 10 11 2020
entrez: 11 11 2021
pubmed: 12 11 2021
medline: 12 11 2021
Statut: ppublish

Résumé

Thyroid storm is a rare, life-threatening condition characterized by severe clinical manifestations of thyrotoxicosis and can be precipitated by several factors. We described a thyroid storm precipitated by a long-term treatment using homeopathic medicine containing iodine. A 55-year-old Italian woman was admitted to our Sub-Intensive Care Unit with the diagnosis of congestive heart failure and thyrotoxicosis. She has been diagnosed with Graves' disease two years before; she refused conventional therapy and in the preceding six months had been using phytotherapeutic and homeopathic medicine. We found serum and urine iodine levels consistent with severe intoxication by iodine (serum iodine: 42100 mcg/L and urinary iodine: 4223 mcg/L, respectively). After a few hours, the patient went into cardiac arrest. She was subjected to invasive ventilation, dialyzed with continuous veno-venous hemofiltration and treated with vasoactive amines. The high level of iodemia manifested in our patient - around a thousand times greater than the normal range and itself associated with fatal outcomes - was caused by long-term homeopathic treatment. This long-term treatment has two consequences: first, iodine load-precipitated hyperthyroidism in thyroid storm, and secondly, it prevents us from treating patients with inorganic iodide.

Sections du résumé

BACKGROUND BACKGROUND
Thyroid storm is a rare, life-threatening condition characterized by severe clinical manifestations of thyrotoxicosis and can be precipitated by several factors. We described a thyroid storm precipitated by a long-term treatment using homeopathic medicine containing iodine.
CASE PRESENTATION METHODS
A 55-year-old Italian woman was admitted to our Sub-Intensive Care Unit with the diagnosis of congestive heart failure and thyrotoxicosis. She has been diagnosed with Graves' disease two years before; she refused conventional therapy and in the preceding six months had been using phytotherapeutic and homeopathic medicine. We found serum and urine iodine levels consistent with severe intoxication by iodine (serum iodine: 42100 mcg/L and urinary iodine: 4223 mcg/L, respectively). After a few hours, the patient went into cardiac arrest. She was subjected to invasive ventilation, dialyzed with continuous veno-venous hemofiltration and treated with vasoactive amines.
CONCLUSION CONCLUSIONS
The high level of iodemia manifested in our patient - around a thousand times greater than the normal range and itself associated with fatal outcomes - was caused by long-term homeopathic treatment. This long-term treatment has two consequences: first, iodine load-precipitated hyperthyroidism in thyroid storm, and secondly, it prevents us from treating patients with inorganic iodide.

Identifiants

pubmed: 34760085
doi: 10.22088/cjim.12.0.371
pmc: PMC8559635
doi:

Types de publication

Case Reports

Langues

eng

Pagination

S371-S375

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Références

Int J Endocrinol. 2018 Apr 22;2018:5794054
pubmed: 29849619
N Engl J Med. 2009 Jan 22;360(4):424-6
pubmed: 19164199
J Clin Endocrinol Metab. 1985 Oct;61(4):723-7
pubmed: 3928675
Ann Intern Med. 1978 Mar;88(3):379-91
pubmed: 204241
J Clin Endocrinol Metab. 2007 Jun;92(6):2182-9
pubmed: 17389702
Endocrinol Metab Clin North Am. 2006 Dec;35(4):663-86, vii
pubmed: 17127140
Curr Med Chem. 2011;18(31):4836-50
pubmed: 21919844
Emerg Med Australas. 2005 Apr;17(2):173-7
pubmed: 15796735
J Biol Chem. 1948 Jun;174(2):555-64
pubmed: 18865621
Caspian J Intern Med. 2020;11(2):231-234
pubmed: 32509255
Am Fam Physician. 1999 Mar 1;59(5):1239-45
pubmed: 10088878
J Intensive Care Med. 2015 Mar;30(3):131-40
pubmed: 23920160
N Engl J Med. 1993 Jan 28;328(4):246-52
pubmed: 8418405
Rev Med Chir Soc Med Nat Iasi. 2014 Oct-Dec;118(4):1013-7
pubmed: 25581962
Endocrinol Metab Clin North Am. 1993 Jun;22(2):263-77
pubmed: 8325286
Forsch Komplementmed. 2015;22(1):30-5
pubmed: 25824402
Drugs. 2001;61(15):2163-75
pubmed: 11772128
J Clin Endocrinol Metab. 2015 Feb;100(2):451-9
pubmed: 25343237
Intern Emerg Med. 2011 Aug;6(4):385-7
pubmed: 21136307

Auteurs

Linda Daffini (L)

Department of Clinical and Experimental Sciences, SSD Medicina ad indirizzo Endocrino-Metabolico, University of Brescia, ASST Spedali Civili di Brescia, Italy.

Ilenia Pirola (I)

Department of Clinical and Experimental Sciences, SSD Medicina ad indirizzo Endocrino-Metabolico, University of Brescia, ASST Spedali Civili di Brescia, Italy.

Giovanni Saccà (G)

Department of Clinical and Experimental Sciences.

Massimo Salvetti (M)

Department of Clinical and Experimental Sciences.

Carlo Cappelli (C)

Department of Clinical and Experimental Sciences, SSD Medicina ad indirizzo Endocrino-Metabolico, University of Brescia, ASST Spedali Civili di Brescia, Italy.

Classifications MeSH