title: QT prolongation in a child with thyroid storm.
abstract: A 12-year-old girl presented with an acute confusional state and a 2-year history of weight loss, anxiety, agitation and recurrent fever. Thyroid function tests confirmed severe hyperthyroidism, and a diagnosis of thyroid storm was made (Burch and Wartofsky score=75). ECG showed a prolonged QTc interval of 506 ms. Acute treatment for thyroid storm consisted of Lugol's iodine, prednisolone, carbimazole and propranolol. She made a steady recovery and by 3 months her thyroid function had normalised; a repeat ECG showed a QTc within the normal range (430 ms). There was no relevant family history. This is a case of QTc prolongation with hyperthyroidism and normalisation with euthyroidism. It is not commonly recognised that hyperthyroidism in children may be associated with QTc prolongation. QTc measurement should be incorporated into management protocols for hyperthyroidism.
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Albert
authors.forename: Luke Gerard
authors.initials: LG
authors.lastname: Eckersley
authors.forename: Jonathan Robert
authors.initials: JR
authors.lastname: Skinner
authors.forename: Craig
authors.initials: C
authors.lastname: Jefferies
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000209:etiology*; D013958:Thyroid Crisis / Q000150:complications*
references.citation: JAMA. 2003 Apr 23-30;289(16):2120-7
references.pmid: 12709470
references.citation: Biomed Pharmacother. 2010 Oct;64(8):546-9
references.pmid: 20650598
references.citation: Horm Metab Res. 2006 Jan;38(1):44-7
references.pmid: 16477540
references.citation: Clin Endocrinol (Oxf). 2001 Jul;55(1):27-32
references.pmid: 11453949
references.citation: Angiology. 1992 Apr;43(4):287-93
references.pmid: 1558314
references.citation: N Engl J Med. 2004 Mar 4;350(10):1013-22
references.pmid: 14999113
references.citation: Heart. 2003 Nov;89(11):1363-72
references.pmid: 14594906
references.citation: Endocrinol Metab Clin North Am. 1993 Jun;22(2):263-77
references.pmid: 8325286
references.citation: Am J Med. 2002 Jan;112(1):58-66
references.pmid: 11812408
references.citation: Horm Metab Res. 2003 Jan;35(1):55-61
references.pmid: 12669272
references.citation: Heart Rhythm. 2013 Feb;10(2):233-8
references.pmid: 23123674
references.citation: Br J Clin Pharmacol. 2009 Sep;68(3):447-54
references.pmid: 19740403
references.citation: J Mol Cell Cardiol. 2000 Nov;32(11):1969-80
references.pmid: 11040102
references.citation: Circulation. 1993 May;87(5):1435-41
references.pmid: 8490997
references.citation: J Am Coll Cardiol. 2008 Jun 17;51(24):2291-300
references.pmid: 18549912
references.citation: J Endocrinol. 2008 Jul;198(1):253-60
references.pmid: 18463146