title: A patient with Graves' disease who survived despite developing thyroid storm and lactic acidosis.
abstract: A 56-year-old woman with Graves' disease presented with the complaints of diarrhea and palpitations. Physical examination and laboratory data revealed hypothermia and signs of mild hyperthyroidism, heart failure, hepatic dysfunction with jaundice, hypoglycemia, and lactic acidosis. The patient was diagnosed as having developed the complication of thyroid storm in the absence of marked elevation of the thyroid hormone levels, because of the potential hepatic and cardiac dysfunctions caused by heavy alcohol drinking. A year later, after successful treatment, the patient remains well without any clinical evidence of heart failure or hepatic dysfunction. Thyroid storm associated with lactic acidosis and hypothermia is a serious condition and has rarely been reported. Prompt treatment is essential even if the serum thyroid hormone levels are not markedly elevated. We present a report about this patient, as her life could eventually be saved.
authors: Department of Internal Medicine, Nerima General Hospital, Asahigaoka, Nerima-ku, Tokyo, Japan.
authors: Tetsuhiro
authors: T
authors: Yoshino
authors: Daisuke
authors: D
authors: Kawano
authors: Takeo
authors: T
authors: Azuhata
authors: Tsukasa
authors: T
authors: Kuwana
authors: Rikimaru
authors: R
authors: Kogawa
authors: Atsushi
authors: A
authors: Sakurai
authors: Katsuhisa
authors: K
authors: Tanjoh
authors: Tatsuo
authors: T
authors: Yanagawa
mesh_terms: D000140:Acidosis, Lactic / Q000628:therapy*; D000437:Alcoholism / Q000150:complications; D003967:Diarrhea / Q000150:complications; D004452:Echocardiography / Q000379:methods; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000628:therapy*; D006801:Humans; D007035:Hypothermia; D008713:Methimazole / Q000494:pharmacology; D008875:Middle Aged; D013958:Thyroid Crisis / Q000628:therapy*; D013963:Thyroid Hormones / Q000097:blood; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D013963:Thyroid Hormones; D008713:Methimazole