Abstract
IntroductionWe report an unusual case of upper airway compromise complicated by thyroid storm in a pregnant woman with Graves' disease, ending with the in utero death of the fetus. This complication might have developed due to upper airway edema as a result of poorly controlled hyperthyroidism.Case presentationA 41-year-old Turkish woman at 27 weeks' gestation suffering from Graves' disease was referred to our emergency department with a diagnosis of respiratory arrest. She was unconscious and had been intubated. Her laboratory results were compatible with thyrotoxicosis. The patient had suffered from respiratory difficulty for a long time and had stopped using her antithyroid medications after the first trimester of pregnancy. One day before, she had visited an obstetrician because her respiratory distress had increased. At that time, her fetus was still alive. She was given oxygen therapy and then sent home. With a presumptive diagnosis of thyroid storm, she was admitted to the intensive care unit and treated with aggressive medical therapy. The baby was found to be no longer alive and was delivered vaginally after labor induction. The mother was discharged 10 days later with maintenance therapy.ConclusionHyperthyroidism during pregnancy warrants very close attention and should almost always be treated with appropriate antithyroid medications. Maternal respiratory distress in such patients can be an early sign of impending upper airway compromise and thyroid storm, which can endanger the mother and fetus unless prompt and aggressive therapy is initiated.
Highlights
We report an unusual case of upper airway compromise complicated by thyroid storm in a pregnant woman with Graves’ disease, ending with the in utero death of the fetus
Maternal respiratory distress in such patients can be an early sign of impending upper airway compromise and thyroid storm, which can endanger the mother and fetus unless prompt and aggressive therapy is initiated
We report an unusual case of upper airway compromise complicated by thyroid storm in a pregnant woman with undertreated Graves’ disease, which resulted in respiratory arrest of the mother and death of the fetus
Summary
Hyperthyroidism during pregnancy warrants very close attention and almost always should be treated with appropriate antithyroid medications. Maternal respiratory distress in uncontrolled pregnant patients can be an early sign of impending upper airway compromise and/or thyroid storm, which can endanger the mother and fetus unless prompt and aggressive therapy is initiated. Consent Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. Authors’ contributions RY was the primary consultant physician and was responsible for the management of the case. MK interpreted the patient data regarding the endocrinological disease and gestation. He had primary responsibility for writing the manuscript. EA and AK contributed to this patient’s evaluation and treatment. All authors read and approved the final manuscript
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
