methimazole and Mental-Disorders

Summary A 19-year-old woman with asphyxiation complicated by cardiac arrest, following an unsuccessful suicide attempt by hanging, developed an uncommon complication of trauma-induced thyroid storm. She was initially admitted to the intensive care unit intubated and mechanically ventilated for postcardiac arrest management. Investigation of thyroid storm was pursued after the patient was noted to be persistently hypertensive, tachycardic and agitated despite high levels of sedation. Thyroid function tests confirmed the clinical suspicion of progressive thyrotoxicosis, with associated imaging consistent with thyroid inflammation secondary to band-like traumatic pressure to the lower half of the thyroid gland. Treatment with β-blockers and a thionamide resulted in the eventual resolution of her thyroid storm state and normalisation of her thyroid function. We conclude that traumatically induced thyroid storm should be considered in all hypermetabolic patients following blunt neck injuries including hanging, and that traditional treatment of hyperthyroidism can be successfully applied.

Topics: Adrenergic beta-Antagonists; Adult; Antithyroid Agents; Asphyxia; Directive Counseling; Female; Heart Arrest; Humans; Mental Disorders; Methimazole; Neck Injuries; Suicide, Attempted; Thyroid Crisis; Treatment Outcome

Topics: Antithyroid Agents; Female; Humans; Hyperthyroidism; Mental Disorders; Methimazole; Middle Aged