Sepsis-induced Pancytopenia in an Adolescent Girl with Thyroid Storm: A Case Report
Qing Zhou1, Li-Yong Zhang3, Qing-Xian Fu2, Chao-Chun Zou4, Hui Liu11Fujian Maternity and Child Health Hospital, Clinic of Endocrinology, Fuzhou, China2Fujian Children’s Hospital, Clinic of Endocrinology, Fuzhou, China
3Fujian Medical University Union Hospital, Minimal Invasive Center, Clinic of Thyroid and Vascular Surgery, Fuzhou, China
4Children’s Hospital of Zhejiang University School of Medicine, Clinic of Endocrinology, Hangzhou, China
Thyroid storm is a rare but life-threatening condition mainly triggered by infection and abrupt discontinuation of antithyroid drug therapy for Graves’ disease. Pancytopenia is a rare adverse reaction to antithyroid drugs. We present a 13-year-old girl with thyroid storm and pancytopenia with symptoms similar to those of methimazole-induced pancytopenia. Although in this context the use of methimazole is still under debate, due to multiple normal complete blood counts (CBC) monitored during fever, sepsis-induced pancytopenia with thyroid storm was considered, and methimazole treatment combined with methylprednisolone and meropenem was able to resolve both pancytopenia and thyroid storm. During the period of infection and antithyroid drug therapy, close monitoring of CBC may help differentiate the aetiology of pancytopenia. This is the first paediatric case report that outlines the use of methimazole in the management of thyroid storm with pancytopenia.
Keywords: Thyroid storm, pancytopenia, sepsis, antithyroid drugsManuscript Language: English
