title: Acute severe asthma with thyroid crisis and myasthenia: a case report and literature review.
abstract: OBJECTIVE
  Acute severe asthma, thyroid crisis and acute myasthenia are all medical emergencies that rarely coexistent. Here, we report a young man with severe asthma attack, necessitate invasive mechanical ventilation at the onset, followed by thyroid crisis, rhabdomyolysis, acute kidney injury, thrombocytopenia and progressive myasthenia. The aim of this study is to better understand the relationships among severe asthma, autoimmune thyroiditis and myasthenia.
  
  
  METHODS
  The case was presented and former literatures were reviewed.
  
  
  RESULTS
  This is the first case report of a young patient presented with severe asthma and autoimmune thyroiditis, followed by thyroid storm, multiple organ dysfunction and myasthenia. Neither conventional treatment for asthma or thyroid storm was effective separately. The patient's clinical condition did not improve until after plasmapheresis.
  
  
  CONCLUSIONS
  Here, we highlighted both the importance of early recognition of thyroid storm and prompt therapies, which likely attenuated organ dysfunction and enabled this patient to recover from the life-threatening attack. Asthmatic patients should be closely controlled when suspected of thyroid disorders, especially those with high levels of anti-thyroid antibodies irrespective of thyroid hormones concentrations.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.
authors.forename: Pi-Hua
authors.initials: PH
authors.lastname: Gong
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.
authors.forename: Xiao-Song
authors.initials: XS
authors.lastname: Dong
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Bao
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.
authors.forename: Zhao-Long
authors.initials: ZL
authors.lastname: Cao
authors.affiliation: Department of neurology, Peking University First Hospital, Beijing, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University International Hospital, Beijing, China.
authors.forename: Ya-Li
authors.initials: YL
authors.lastname: Zheng
authors.affiliation: Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.
authors.forename: Zhan-Cheng
authors.initials: ZC
authors.lastname: Gao
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000150:complications; D000328:Adult; D044466:Asian People / Q000208:ethnology; D001249:Asthma / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000209:etiology; D018908:Muscle Weakness / Q000150:complications*; D010956:Plasmapheresis / Q000379:methods; D012121:Respiration, Artificial / Q000379:methods; D012206:Rhabdomyolysis / Q000150:complications / Q000473:pathology; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000150:complications; D013958:Thyroid Crisis / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome
keywords: asthma - myasthenia - plasmapheresis - rhabdomyolysis - thyroid crisis