title: Perioperative management of a patient with thyroid hormone resistance who underwent total thyroidectomy for thyroid cancer.
abstract: Resistance to thyroid hormone (RTH) is a rare, predominantly inherited syndrome that involves impaired tissue responsiveness to thyroid hormones. We describe the perioperative management of a patient with RTH who underwent total thyroidectomy. Although surgery performed under general anesthesia was uneventful, after the surgery the patient developed difficult-to-treat hypocalcemia that lasted until postoperative day 4. Moreover, thyroid function even after discharge remained unstable despite replacement therapy. We suggest that the parathyroid and thyroid function of patients with RTH be followed very closely and that nociceptive stimulus of the surgery and postoperative pain be reduced as much as possible.
authors.affiliation: Department of Anesthesiology, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto, 860-8556, Japan. msugita@kumamoto-u.ac.jp
authors.forename: Michiko
authors.initials: M
authors.lastname: Sugita
authors.forename: Hana
authors.initials: H
authors.lastname: Harada
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D002291:Carcinoma, Papillary / Q000601:surgery*; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D009154:Mutation / Q000502:physiology; D010149:Postoperative Pain / Q000628:therapy; D019990:Perioperative Care; D011183:Postoperative Complications / Q000628:therapy; D011988:Receptors, Thyroid Hormone / Q000235:genetics; D013960:Thyroid Function Tests; D018382:Thyroid Hormone Resistance Syndrome / Q000150:complications* / Q000235:genetics; D013963:Thyroid Hormones / Q000097:blood / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*
chemical_list: D011988:Receptors, Thyroid Hormone; D013963:Thyroid Hormones