scholarly journals THYROID STORM AS A LIFE-THREATENING CONDITION IN THE PRACTICE OF EMERGENCY MEDICAL SERVICE TEAMS

2021 ◽  
Vol 8 (4) ◽  
pp. 260-264
Author(s):  
Agnieszka Ciastkowska-Berlikowska
Keyword(s):  
Thyroid Hormones ◽  
Clinical Symptoms ◽  
Auxiliary Function ◽  
Medical Emergency ◽  
Thyroid Storm ◽  
The Status ◽  
Threatening Condition ◽  
Life Threatening ◽  
Initiation Of Therapy ◽  
The Right

Thyroid storm is a medical emergency. It comprises disorders of several organs and body systems, including disturbances of consciousness (also coma), heart failure, symptoms of shock, and high body temperature. The diagnosis of thyroid storm is challenging because it is based primarily on medical history and physical examination. Additional laboratory tests only perform an auxiliary function, and the initiation of therapy should not be delayed until the determination of thyroid hormones in the blood. Moreover, clinical symptoms often do not correlate with thyroid hormones concentration in the blood. Diarrhea, vomiting, and fever may lead to the diagnosis of thyroid storm. These are not typical symptoms of uncomplicated hyperthyroidism. The remaining symptoms of thyroid storm are symptoms of decompensation of individual organs and systems. When diagnosing thyroid storm, one uses the Burch and Wartofsky criteria. Accurate and quick diagnosis and implementation of initial treatment is the aim of pre-hospital management. These are fluid therapy, oxygen therapy, and antipyretic drugs. For this reason, it is essential not to delay the patient’s transport to the nearest hospital emergency department. One may also consider calling a specialist ambulance with a doctor who can give the right medication on the spot. Rapid treatment initiation can improve the status of most patients within 12-24 hours. Treatment delay worsens, and intensive treatment improves the prognosis in patients with thyroid storm. The mortality rate of thyroid storm has decreased and is now 20-30%.

May-Thurner syndrome – Are we aware enough?

VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 381-388 ◽  
Author(s):  
Katalin Mako ◽  
Attila Puskas
Keyword(s):  
Contraceptive Use ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
The Right

Summary. Iliac vein compression syndrome (May-Thurner syndrome – MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Although MTS is rare, its true prevalence is underestimated but it can be a life-threatening condition due to development of pulmonary embolism (PE). In this case based review the authors present three cases of MTS. All patients had been previously confirmed with PE, but despite they were admitted to hospital, diagnosed and correctly treated for PE and investigated for thrombophilia, the iliac vein compression syndrome was not suspected or investigated. With this presentation the authors would like to emphasize that MTS is mostly underdiagnosed, and it needs to be ruled out in left iliofemoral vein thrombosis in young individuals.

scholarly journals Myelodysplastic Syndrome Clinically Presenting with the “Classic TTP Pentad”

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Santiago Fabián Moscoso Martínez ◽  
Evelyn Carolina Polanco Jácome ◽  
Elizabeth Guevara ◽  
Vijay Mattoo
Keyword(s):  
Myelodysplastic Syndrome ◽  
Clinical Presentation ◽  
Renal Involvement ◽  
Medical Emergency ◽  
Complete Blood Cell Count ◽  
Blood Cell Count ◽  
Thrombocytopenic Purpura ◽  
Life Saving ◽  
Threatening Condition ◽  
Life Threatening

The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving. The following case illustrates an unusual presentation of MDS in a patient who came in to the emergency room with the classic TTP “pentad” of fever, renal involvement, MAHA, mental status changes, and thrombocytopenia. We will focus our discussion in the clinical presentation of this case.

scholarly journals A forgotten life-threatening medical emergency: myxedema coma

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Elisa Pizzolato ◽  
Alberto Peano ◽  
Letizia Barutta ◽  
Emanuele Bernardi ◽  
Elena Maggio ◽  
...  
Keyword(s):  
Life Support ◽  
Neurological Status ◽  
Medical Emergency ◽  
Myxedema Coma ◽  
Emergency Department Stay ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Alithiasic Cholecystitis ◽  
The Right ◽  
Tomography Scan

Nowadays myxedema coma is a rare medical emergency but, sometimes, it still remains a fatal condition even if appropriate therapy is soon administered. Although physical presentation is very non-specific and diversified, physicians should pay attention when patients present with low body temperature and alteration of neurological status; the presence of precipitating events in past medical history can help in making a diagnosis. Here we discuss one such case: an 83-year-old female presented with abdominal pain since few days. Laboratory tests and abdomen computed tomography scan demonstrated alithiasic cholecystitis; she was properly treated but, during the Emergency Department stay she experienced a cardiac arrest. Physicians immediately started advance cardiovascular life support algorithm and she survived. Later on, she was admitted to the Intensive Care Unit where doctors discovered she was affected by severe hypothyroidism. Straightway they started the right therapy but, unfortunately, the patient died in a few hours.

scholarly journals Necrotizing fasciitis with group A Streptococci and Eggerthella lenta as a complication of Varicella in a child – case presentation –

2014 ◽  
Vol 20 (1) ◽  
pp. 35-39
Author(s):  
Cambrea Simona Claudia ◽  
Ilie Maria Margareta ◽  
Carp Dalia Sorina ◽  
Ionescu C.
Keyword(s):  
Necrotizing Fasciitis ◽  
Severe Disease ◽  
The Body ◽  
Group A Streptococci ◽  
Threatening Condition ◽  
Life Threatening ◽  
Group A ◽  
The Right ◽  
Surgery Department ◽  
Short Time

ABSTRACT Necrotizing fasciitis is a life threatening condition that can be quickly spread through the flesh surrounding the muscle. The disease can be polymicrobial, or caused by group A beta hemolytic Streptococci, or by Clostridium spp. We present a case of a 7 years old girl, which was hospitalized in Children Infectious Diseases Department in a 7th day of chickenpox (hematic crusts all over the body), high fever, asthenia, vomiting, oligoanuria, and tumefaction, pain and functio lessa in the right thigh. In a very short time in the right thigh swelling, edema and congestion have increased gradually, and in the third highest middle thigh the ecchymotic areas appeared evolving towards bubbles and blisters which included the right thigh and calf. After excluding the diagnosis of thrombophlebitis was raised suspicion of necrotizing fasciitis. CT pelvic scan evidenced pelvic asymmetry by maximus and medium right gluteal muscles swelling with important inflammatory infiltrate extended laterally in the subcutaneous adipose tissue. In blood culture was isolated Eggerthella lenta, and from throat swab was isolated group A Streptococci. Treatment consists of a combination of antibiotics associated with intravenous immunoglobulin administration. Despite medical treatment evolution worsened and required transfer in a pediatric surgery department where emergent surgical debridement associated with intensive antibiotic therapy was done. After this intervention evolution was slowly favorable without major limb dysfunction. Polymicrobial necrotizing fasciitis is a severe disease, which if recognized early can have a favorable outcome.

scholarly journals Stridor in infant caused by subglottic hemangiome: case report

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Raquel Lot ◽  
Caroline Rosa ◽  
Camila Freitas ◽  
Gracinda Adnet ◽  
Luisa Costa ◽  
...  
Keyword(s):  
Beta Agonist ◽  
First Year ◽  
Vascular Neoplasms ◽  
Threatening Condition ◽  
Life Threatening ◽  
Diagnostic Hypothesis ◽  
Therapeutic Measures ◽  
The Right ◽  
First Year Of Life ◽  
Age Range

Subglottic hemagioma is a rare cause of stridor, but it is one of the most common vascular neoplasms of the airways in childhood. If the treatment is not promptly instituted, it becomes a life-threatening condition. The diagnosis should be suspected when infants outside the age range for acute laryngitis present with stridor associated with severe respiratory effort, without viral prodromes, with a condition that is not responsive to initial therapeutic measures considering the main diagnostic hypothesis. Infantile hemangiomas begin to proliferate during the first year of life (between the 1st and 2nd month of life). Involution usually occurs between 6 months and 12 months of life (most involution until 4 years). The case is a 5-month-old female infant, with sudden stridor associated with respiratory distress without viral prodromes or fever, with little response to inhaled short-acting beta-agonist, inhaled adrenaline, as well as corticosteroids inhalation/parenteral. Bronchoscopy showed a bulging of the submucosa to the right of the subglottis with slight vascularization, suggestive of subglottic hemangioma. Treatment with propranolol was initiated orally with the aim of regressing the hemangioma and after clinical stability, the infant was discharged with outpatient follow-up.

scholarly journals Intensive Care Management of Multiorgan Dysfunction and Hypoxic Brain Injury Secondary to Refractory Status Epilepticus

2021 ◽  
Vol 2 (4) ◽  
pp. 3
Author(s):  
Sanum Kashif
Keyword(s):  
Status Epilepticus ◽  
Refractory Status Epilepticus ◽  
Medical Emergency ◽  
High Grade Fever ◽  
Refractory Status ◽  
Hypoxic Brain Injury ◽  
Hypoxic Brain ◽  
Threatening Condition ◽  
Life Threatening ◽  
Permanent Brain Damage

Refractory Status Epilepticus (RSE) is a medical emergency that may lead to permanent brain damage or death.Mortality rate is 16-39%. It is the life threatening condition in which continuous fits occur, despite treatmentwith benzodiazepines and one antiepileptic drug.A 25-year-old female, brought in emergency department with high-grade fever and frequent fits. GlasgowComa Scale (GCS) was 3/15 with unstable hemodynamics. Resuscitation started immediately and managed asstatus epilepticus. Patient was in multi organ failure on arrival. On the basis of history and examination, hypoxicbrain injury was diagnosed initially. Later on, refractory status epilepticus (RSE) with multi organ dysfunctionsyndrome (MODS) was diagnosed, after necessary investigations and treatment. Patient was managed as ateam with multidisciplinary approach and after continuous effort of 2 weeks, patient was successfullydischarged to home.

Sudden death due to ruptured oesophageal varices – autopsy-based case report

2020 ◽  
Vol 88 (4) ◽  
pp. 189-191
Author(s):  
Nagendra Singh Sonwani ◽  
Navneet Ateriya ◽  
Arvind Kumar ◽  
Anil Kohli ◽  
Kalyan Kumar Banerjee
Keyword(s):  
Chronic Alcoholism ◽  
Medical Emergency ◽  
Oesophageal Varices ◽  
High Morbidity ◽  
Forensic Pathologist ◽  
Threatening Condition ◽  
Life Threatening ◽  
Cirrhotic Patients ◽  
Acute Haemorrhage

Acute haemorrhage from ruptured oesophageal varices is a serious consequence of portal hypertension in cirrhotic patients. It represents a medical emergency with a high morbidity and mortality rate. Studies over the years have shown a direct link with chronic alcoholism in the development of such complications. Although the gastrointestinal system accounts for a few numbers of sudden deaths, bleeding through ruptured varices represent a life-threatening condition. The role of forensic pathologist is vital in dealing with sudden deaths. Here, we report a case of a 46-year-old man who died suddenly following the rupture of oesophageal varices.

scholarly journals Aortic Dissection Presenting as Acute Pancreatitis: Suspecting the Unexpected

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Adam Hafeez ◽  
Dillon Karmo ◽  
Adrian Mercado-Alamo ◽  
Alexandra Halalau
Keyword(s):  
Blood Pressure ◽  
Acute Pancreatitis ◽  
Aortic Dissection ◽  
Epigastric Pain ◽  
Pressure Control ◽  
Sudden Onset ◽  
Medical Emergency ◽  
Threatening Condition ◽  
Life Threatening ◽  
Normal Triglyceride

Aortic dissection is a life-threatening condition in which the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). It is considered a medical emergency. We report a case of a healthy 56-year-old male who presented to the emergency room with sudden onset of epigastric pain radiating to his back. His blood pressure was 167/91 mmHg, equal in both arms. His lipase was elevated at 1258 U/L, and he was clinically diagnosed with acute pancreatitis (AP). He denied any alcohol consumption, had no evidence for gallstones, and had normal triglyceride level. Two days later, he endorsed new suprapubic tenderness radiating to his scrotum, along with worsening epigastric pain. A MRCP demonstrated evidence of an aortic dissection (AD). CT angiography demonstrated a Stanford type B AD extending into the proximal common iliac arteries. His aortic dissection was managed medically with rapid blood pressure control. The patient had excellent recovery and was discharged home without any surgical intervention.

Intracranial aneurysm following radiation therapy for medulloblastoma

1997 ◽  
Vol 38 (1) ◽  
pp. 37-42 ◽  
Author(s):  
F. K. Jensen ◽  
A. Wagner
Keyword(s):  
Radiation Therapy ◽  
Intracranial Aneurysm ◽  
Intracranial Aneurysms ◽  
Distal Part ◽  
Anterior Cerebral Artery ◽  
Craniospinal Radiation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Radiation Induced ◽  
The Right

Radiation-induced intracranial aneurysm formation is a rare but life-threatening condition with a high mortality rate secondary to rupture of the aneurysm. Further-more, this condition can mimic tumour recurrence. Only 10 months after craniospinal radiation therapy for medulloblastoma, a 9-year-old boy developed a subarachnoid haemorrhage secondary to a ruptured saccular aneurysm arising from the distal part of the right anterior cerebral artery. The development of intracranial aneurysms and rupture following radiation damage of the arteries has been reported previously, but in no case as soon as 10 months after radiation therapy. It is important to diagnose these aneurysms as they can be successfully treated.

scholarly journals Emergent thyroidectomy with sternotomy due to acute respiratory failure with severe thyroid storm

2018 ◽  
Vol 100 (8) ◽  
pp. e223-e225
Author(s):  
A Matsushita ◽  
S Hosokawa ◽  
D Mochizuki ◽  
J Okamura ◽  
K Funai ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Airway Obstruction ◽  
Total Thyroidectomy ◽  
Upper Airway ◽  
Thyroid Storm ◽  
Graves Disease ◽  
Nasal Intubation ◽  
Threatening Condition ◽  
Life Threatening

Huge cervical and mediastinal masses may lead to acute respiratory failure caused by laryngotracheal compression and airway obstruction. Thyroid storm is also a life-threatening endocrine emergency originating almost exclusively from uncontrolled Graves’ disease. We report a case of a 42-year-old man with acute upper airway obstruction and tachycardia from progressive swelling of a giant thyroid, in conjunction with thyroid storm resulting from uncontrolled Graves’ disease. Fibreoptic-assisted nasal intubation was performed while the patient was awake, immediately followed by emergency total thyroidectomy via a cervical and sternal approach. The patient had an uneventful postoperative course and recovered well. Respiratory failure due to swelling of a giant thyroid is a life-threatening condition and should be treated immediately with endotracheal intubation while the patient is awake following emergent total thyroidectomy, even with a sternotomy.

Sign in / Sign up

Export Citation Format

Share Document