Plasma exchange as a rescue therapy for treatment‐resistant thyroid storm with concurrent heart failure: a literature review based on a case report
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Title
Plasma exchange as a rescue therapy for treatment‐resistant thyroid storm with concurrent heart failure: a literature review based on a case report
Subject
Plasma exchange as a rescue therapy
for treatment‐resistant thyroid storm
with concurrent heart failure: a literature review
based on a case report
for treatment‐resistant thyroid storm
with concurrent heart failure: a literature review
based on a case report
Description
Abstract
Introduction Thyroid storm or severe hyperthyroidism can present with various signs and symptoms. They are
mostly controlled by general treatment, such as anti-thyroid drugs and other medications to control clinical features.
However, in rare cases, they are more severe, and they only respond to more aggressive treatments, such as plas-
mapheresis and total thyroidectomy. The final histopathological features, such as the loci of differentiated thyroid
carcinoma, are sometimes surprising.
Case presentation Here, we present a 40-year-old female who presented with severe palpitation, diaphoresis,
and chest pain. After taking the initial steps of treatment and stabilizing the patient, the history, physical exam,
and laboratory results confirmed the diagnosis of a thyroid storm in the background of Graves’ disease that is accom-
panied by heart failure with reduced ejection fraction (HFrEF). She was admitted to an ICU setting and received
principal treatment of thyroid storm. However, the systematic treatment was not effective, and finally, plasmapheresis
and total thyroidectomy were performed. Histopathologic evaluation following surgery confirmed the presence
of foci of papillary thyroid carcinoma (PTC) in the background of the grave’s disease.
This case underscores the complexity of managing Grave’s induced thyroid storm in severe cases, which might lead
to plasmapheresis and total thyroidectomy. Urgent and invasive treatment may be necessary in rare cases when nor-
mally applied treatment modalities are not able to control the situation and result in life-threatening critical health
conditions. In such a severe case, it can result in serious cardiovascular complications such as decompensated heart
failure with a high rate of mortality.
Key clinical message Thyroid storm, though rare, can be accompanied by severe medical conditions such as heart
failure and death. In cases in which primary medical and symptomatic therapies do not work, more aggressive treat-
ment (such as plasmapheresis and total thyroidectomy) should be considered. On the other hand, precise histopatho-
logic evaluation of the thyroid tissue is necessary.
Keywords Thyroid storm, Grave’s diseases, Plasmapheresis, Thyroidectomy, Papillary thyroid cancer, Case Report
Introduction Thyroid storm or severe hyperthyroidism can present with various signs and symptoms. They are
mostly controlled by general treatment, such as anti-thyroid drugs and other medications to control clinical features.
However, in rare cases, they are more severe, and they only respond to more aggressive treatments, such as plas-
mapheresis and total thyroidectomy. The final histopathological features, such as the loci of differentiated thyroid
carcinoma, are sometimes surprising.
Case presentation Here, we present a 40-year-old female who presented with severe palpitation, diaphoresis,
and chest pain. After taking the initial steps of treatment and stabilizing the patient, the history, physical exam,
and laboratory results confirmed the diagnosis of a thyroid storm in the background of Graves’ disease that is accom-
panied by heart failure with reduced ejection fraction (HFrEF). She was admitted to an ICU setting and received
principal treatment of thyroid storm. However, the systematic treatment was not effective, and finally, plasmapheresis
and total thyroidectomy were performed. Histopathologic evaluation following surgery confirmed the presence
of foci of papillary thyroid carcinoma (PTC) in the background of the grave’s disease.
This case underscores the complexity of managing Grave’s induced thyroid storm in severe cases, which might lead
to plasmapheresis and total thyroidectomy. Urgent and invasive treatment may be necessary in rare cases when nor-
mally applied treatment modalities are not able to control the situation and result in life-threatening critical health
conditions. In such a severe case, it can result in serious cardiovascular complications such as decompensated heart
failure with a high rate of mortality.
Key clinical message Thyroid storm, though rare, can be accompanied by severe medical conditions such as heart
failure and death. In cases in which primary medical and symptomatic therapies do not work, more aggressive treat-
ment (such as plasmapheresis and total thyroidectomy) should be considered. On the other hand, precise histopatho-
logic evaluation of the thyroid tissue is necessary.
Keywords Thyroid storm, Grave’s diseases, Plasmapheresis, Thyroidectomy, Papillary thyroid cancer, Case Report
Creator
Pouya Ebrahimi1
, Moloud Payab1
, Maryam Taheri2
, Salma Sefidbakht3
, Neda Alipour4
, Taha Hasanpour4
,
Pedram Ramezani1
, Mahbube Ebrahimpur4,5,7* and Hamid Reza Aghaei Meybodi6,7*
, Moloud Payab1
, Maryam Taheri2
, Salma Sefidbakht3
, Neda Alipour4
, Taha Hasanpour4
,
Pedram Ramezani1
, Mahbube Ebrahimpur4,5,7* and Hamid Reza Aghaei Meybodi6,7*
Source
https://doi.org/10.1186/s12245-024-00783-2
Date
2024
Contributor
Peri Irawan
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Pouya Ebrahimi1
, Moloud Payab1
, Maryam Taheri2
, Salma Sefidbakht3
, Neda Alipour4
, Taha Hasanpour4
,
Pedram Ramezani1
, Mahbube Ebrahimpur4,5,7* and Hamid Reza Aghaei Meybodi6,7*, “Plasma exchange as a rescue therapy for treatment‐resistant thyroid storm with concurrent heart failure: a literature review based on a case report,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12545.