Thyroid storm is a rare condition of thyroid caused due to the sudden release of thyroid hormones from the thyroid gland. A 50-year-old lady Mrs. Surji Devi was case of hyperthyroidism since 15 years. The patient was admitted with severe symptoms of thyrotoxicosis with palpitations, vomiting and increased heart rate. At the time of admission, her heart rate was more than 130/minute with low blood pressure and low saturation levels.
According to Dr. Ankur Gahlot, Senior Endocrinologist, CK Birla Hospital, Jaipur, her thyroid hormone levels (T3/T4) were more than 5-10 times of normal levels, in the presence of such severity of illness the standard treatment for thyroid storm was not showing results hence decision to treat it by plasmapheresis technique was taken. Dr. Ankur said that thyroid storm is a very rare condition of hyperthyroidism in which T3/T4 hormones increases to very high levels due over-activity of the thyroid gland and it poses a life-threatening risk for the patient. Though rare condition with an incidence of 1-2 cases / 10 lac population, but it carries a high modality rate of 20-30%.
Dr. Alok Jain, Director Nephrology, CK Birla Hospital, Jaipur said that plasmapheresis is a technique in which unwanted products (T3/T4 in this case) can be filtered from the blood by dialysis machine and pure blood is pumped back into circulation. There are only few case reports of use plasmapheresis in thyroid storm in world literature & none is in India as per our knowledge.
Dr. Rakesh Godara, Consultant – Pulmonologist, Dr. Arun Sharma, Critical Care Specialist and Dr. Abhinav Gupta, Endocrinologist were part of treating team.